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Transition of Occupational Health Nursing Education in Korea (한국 산업간호교육의 변화추세 분석)

  • Cho, Tong Ran;June, Kyung Ja;Kim, So Yeon
    • Korean Journal of Occupational Health Nursing
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    • v.6 no.2
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    • pp.144-155
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    • 1997
  • In December 1990, Occupational Safety and Health Law was amended to reinforce employer's responsibilities on employees' health and safety. Among the amended law it was important to expand the role of an occupational health nurse to the role of an occupational health manager. An occupational health manager should take charge of coordinating periodic health examination and environmental hazard evaluation, providing primary care, monitoring employees' health status, giving the workplace walk-through, selecting safe protection equipment, providing health information, counseling and health education, independently. This position of occupational health nurse is equivalent to the role of doctors or occupational hygienists. In 1991, government made a master plan to prevent occupational disease and injury. Under the plan, Korea Industrial Nursing Association (KINA) was established in 1994 with the purpose of improving health services and upgrading career opportunities for members. Therefore, this study was designed to analyze the transition of occupational health nursing education with the changes of law and policy in Korea between 1991 and 1996. In details, it was to analyze the rate of school providing occupational health nursing practice based lecture, lecture hours, lecture contents in undergraduate curriculum, program contents of graduate school, kinds of continuing education, etc. For this purpose, we conducted survey two times. In February 1991, baseline study was conducted with all nursing programs in Korea (19 BSN programs and 43 nursing departments of junior college). From April to May in 1996, the second survey was conducted with all nursing programs (38 BSN programs and 69 junior colleges). The first response rate was 66.1% and the second was 40.6%. Structured questionnaires were mailed to the deans or the community health nursing faculties. In the case of graduate school, telephone survey was conducted with 10 school of public health or environmental health area. Data from the yearbook of Industrial Safety Training Institute (ISTI), the history of Korea Industrial Health Association, and the journals of KINA were also included in the analysis. As the results, we found that there were remarkable improvement in undergraduate and graduate programs, obligatory as well as voluntary continuing education in terms of occupational health nursing expertise between 1991 and 1996. 1) The number of school providing occupational health nursing practice-based lecture was increased with the rate from 7.3% to 25.6%. The rate of school giving over 15 class-hours was increased from 33.3% to 46.6%. 2) Content areas were composed of introduction of occupational health, occupational epidemiology, industrial hygiene, occupational disease and injury, law and policy, health education, concept of occupational health nursing, role of occupational health nurse, occupational health nursing process, etc. Of content areas, occupational health nursing process was more emphasized with the increased rate from 43.9% to 88.4%. 3) In the case of graduate school, occupational health programs were increased from 4 to 10. One of them has developed occupational health nursing program as an independent course since 1991. 4) The law increased educational hours from 28 hours to 36 hours for introductory course at the time of appointment, and from 14 hours to 24 hours every 2 years for continuing education. Course contents were Occupational safety and health law, introduction of occupational health, health education methodology, planning and evaluation, periodic health exam, occupational disease care, primary care, emergency care, management, industrial environment evaluation, etc. In 1996, Korea Industrial Nursing Association has begun to provide continuing education after Industrial Safety Training Institute. 5) Various educational programs in voluntary base were developed such as monthly seminar, CE articles, annual academic symposium, etc. It was shown that changes of law and policy led rapid growth of occupational health nursing education in various levels. From this trend, it is expected that occupational health nurse expertise be continuously to be enhanced in Korea. Legal and political supports should proceed for the development of occupational health nursing in early stage.

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Effects of Salinity Level and Irrigation Rate on Kentucky Bluegrass (Poa pratensis L.) Growth and Salt Accumulation in Sand Growing Media Established Over the Reclaimed Saline Soil (염해지 토양을 기반으로 조성된 모래 지반구조에서 관수용수의 량 및 염농도에 따른 토양내 염류 집적과 켄터키 블루그래스의 생육에 미치는 영향)

  • Rahayu, Rahayu;Yang, Geun-Mo;Choi, Joon-Soo
    • Asian Journal of Turfgrass Science
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    • v.25 no.1
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    • pp.79-88
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    • 2011
  • The purpose of this study was to obtain information on rates and salinity levels of irrigation for growth of Kentucky bluegrass by minimizing the hazard of salt accumulation in the sand based growing medium. Root zone profile consists of 20 cm sand based top soil, 20 cm of coarse sand as layer to interrupt capillary rise and 10 cm of reclaimed paddy soil as a base of the root zone profile. Topsoil was a mixture of dredged sand and peat with a ratio of 95%: 5% by volume. The columns were soaked into 5 cm depth saline water reservoir with salinity level of 3-5 $dSm^{-1}$. Salinity levels of irrigation water were 0, 2 and 3 $dSm^{-1}$. Irrigation rates were 3.8, 5.7 and 7.6 mm $day^{-1}$ which were equivalent to 70%, 100% and 130% of average ET (evapotranspiration) rate of Kentucky bluegrass, and irrigation interval was 3 days. Salt accumulation was due to irrigated water and moved up water from shallow water base. At the end of second year, the accumulation of salt in the rootzone showed ECc of3.86, 4.7 and 5.1 $dSm^{-1}$, and SAR of 19.2, 23.9 and 27.5 when the salinities were 0, 2 and 3 dS $m^{-1}$, respectively. Irrigation rates of 100% and 130% of ET rate with saline water did not decrease ECe and SAR in growing media. The growth of KEG was influenced by irrigation rate in the $1^{st}$ year, however, salinity level was more critical in the $2^{nd}$ year. Compared to non-saline water, saline water of 2 and 3 dS $m^{-1}$ resulted in decreased visual quality by 3.2% and 16.5%, by 6.4% and 39.3% in clipping weight, and by 5.5% and 5.0% in root mass, respectively.

Comparison of Outcomes after Curative Resection of Primary Lung Cancer between 50 Year or Younger and 70 Year or Older Patients (50세 이하와 70세 이상 원발성 폐암 환자에서의 근치적 수술 후 성적 비교)

  • Lee, Jae-Ik;Kim, Keun-Woo;Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.206-213
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    • 2009
  • Background: Previous series have suggested that younger patients with primary lung cancer exhibit a more aggressive disease course with a worse prognosis, as compared to older patients, although this issue is still debatable. Material and Method: We reviewed the medical records of 79 patients (32 patients 50 years and younger (Group I) and 47 patients 70 years and older (Group II)) who underwent curative resection for primary lung cancer between July 2000 and June 2008. Result: The median age of the patients was 46.5 years in Group I and this was 73 years in Group II. The older patients were more likely to have major comorbidities (44% versus 77%, respectively; p=0.003). Histological examinations identified that the minor histological types (excluding non-small cell lung cancer (NSCLC)) were predominantly found in the Group I patients (16% versus 2%, respectively; p=0.037). For the TNM staging of the NSCLC, with excluding the minor histologic types, a higher proportion of patients had stage III disease in Group I (33% versus 13%, respectively; p=0.038). There was no significant difference in major morbidity (16% versus 30%, respectively; p=0.148) and operative mortality (0% versus 4.3%; p=0.512) between the groups. The mean follow-up interval was 33 months (range: $1{\sim}98$ months) for patients in both groups. For the patients with NSCLC, the five-year overall survival rate was 52.3% for Group I and 53.7% for Group II (p=0.955). The rate of freedom from recurrence at five years was significantly lower for the Group I patients than for the Group II patients (39.4% versus 70.4%, respectively; p=0.027), and only being a member of Group I impacted recurrence, based on the Cox proportional hazard analysis (p=0.034). Of the patients who had recurrence, four patients in Group I underwent aggressive surgical treatment. All of these patients exhibited long-term survival (range: $46{\sim}87$ months). Conclusion: In our study, the early outcome and long-term survival were similar for the younger and older patients after curative resection of primary lung cancer. However, we think that younger patients require meticulous follow-up as they had a tendency to proceed to surgery with advanced stage disease, a higher recurrence rate than did the older patients and the survival rates were improved, even for the recurred cases, with early aggressive treatment.

Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer (진행성 비소세포폐암 환자에서 Gefitinib와 Erlotinib의 비교)

  • Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.280-287
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    • 2009
  • Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

Prognostic Factors for Local Control in Early Glottic Cancer Treated with Radiation Therapy (방사선치료를 받은 조기 성문암 환자의 국소 종양 제어에 관한 예후 인자)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Keun;Nah Byung Sik;Cho Jae-Shik;Lim Sang-Chull
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.226-232
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    • 2000
  • Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.

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A Study on the Reliability Analysis and Risk Assessment of Liquefied Natural Gas Supply Utilities (천연가스 공급설비에 대한 기기신뢰도 분석 및 위험성 평가)

  • Ko, Jae-Sun;Kim, Hyo
    • Fire Science and Engineering
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    • v.17 no.1
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    • pp.8-20
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    • 2003
  • Natural gas has been supplied through underground pipelines and valve stations as a new city gas in Seoul. In contrast to its handiness the natural gas has very substantial hazards due to fires and explosions occurring from careless treatments or malfunctions of the transporting system. The main objectives of this study are to identify major hazards and to perform risk assessments after assessing reliabilities of the composing units in dealing with typical pipeline networks. there-fore two method, fault tree analysis ;1nd event tree analysis, are used here. Random valve stations are selected and considered its situation in location. The value of small leakage, large rupture, and no supply of liquefied natural gas is estimated as that of top event. By this calculation the values of small leakage are 3.29 in I)C valve station, 1.41 in DS valve station, those of large rup-lure are $1.90Times10_{-2}$ in DC valve station, $2.32$\times$10^{-2}$ in DS valve station, and those of no supply of LNG to civil gas company are $2.33$\times$10 ^{-2}$ , $2.89$\times$10^{-2}$ in each valve station. And through minimal cut set we can find the parts that is important and should be more important in overall system. In DC valve station one line must be added between basic event 26,27 because the potential hazard of these parts is the highest value. If it is added the failure rate of no supply of LNG is reduced to one fourth. In DS valve station the failure rate of basic event 4 is 92eye of no supply of LNG. Therefore if the portion of this part is reduced (one line added) the total failure rate can be decreased to one tenth. This analytical study on the risk assessment is very useful to prepare emergency actions or procedures in case of gas accidents around underground pipeline networks and to establish a resolute gas safety management system for loss prevention in Seoul metropolitan area.

Predictors of Success of Selective Laser Trabeculoplasty Adjusted for Intraocular Pressure Variations (단안 선택적 레이저섬유주성형술에서 안압 변동을 보정한 성공예측인자의 분석)

  • Lee, Jun Seok;Lee, Chong Eun;Seo, Sam;Lee, Kyoo Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1166-1172
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    • 2018
  • Purpose: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. Methods: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ${\geq}20%$ of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. Results: The mean pretreatment IOP was $23.17{\pm}6.96mmHg$. The mean IOP reduction was $5.59{\pm}4.78mmHg$ (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was $4.70{\pm}4.67mmHg$ (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). Conclusions: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.

An Analysis on Factors Affecting Local Control and Survival in Nasopharvngeal Carcinoma (비인두암의 국소 종양 치유와 생존율에 관한 예후 인자 분석)

  • Chung Woong-Ki;Cho Jae-Shik;Park Seung Jin;Lee Jae-Hong;Ahn Sung Ja;Nam Taek Keun;Choi Chan;Noh Young Hee;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.91-99
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    • 1999
  • Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.

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Prognostic Factors of Thymic Carcinoma (흉선암의 예후인자)

  • Park, In-Kyu;Kim, Dae-Joon;Kim, Kil-Dong;Bae, Mi-Kyung;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.564-569
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    • 2005
  • Background: Thymic carcinoma is a rare malignant disease with sparse data for treatment and prognosis. We intended to investigate the prognostic factors of thymic carcinoma. Material and Method: Data of 42 patients, who were diagnosed and treated for thymic carcinoma from January of 1986 to August of 2003 were reviewed retrospectively. Influences of characteristics of patients, Masaoka stage, histologic grade, completeness of resection and adjuvant treatment on survival were evaluated. Result: There were 30 male and 12 female patients and their mean age was $52.0\pm15.7$ years old. There were 28 patients with low-grade histology and 13 patients with high-grade histology. Clinical stage according to Masaoka stage were I in 2, II in 2, III in 15 $(35.7\%)$, IVa in 10 $(23.8\%),\;and\;IVb\;in\;13\;(31\%)$ patients. Surgical resection was done in 22 patients, Complete resection was possible in 13 patients and incomplete resection was done in 9 patients. Among 20 patients without resection, 8 patients received chemotherapy, 7 patients received radiotherapy and 5 patients received combined therapy. Median survival time was $31.7\pm6.1$ months and 5 year survival rate was $28.5\%$. High grade histology (hazard ratio=3.009, $95\%\;confidence\;interval=1.178\sim7.685,$ p=0.021) and incompleteness of resection (hazard ratio=3.605, $95\%$ confidence interval= $1.1541\sim1.580$, p=0.023) were the prognostic factors of thymic carcinoma. Conclusion: In thymic carcinoma, low grade histology is a good prognostic factor and complete resection can prolong the survival of patients.

Treatments Results and Prognostic Factors in Locally Advanced Hypopharyngeal Cancer (국소 진행된 하인두암의 치료 결과와 예후 인자 분석)

  • Yoon, Mee-Sun;Ahn, Sung-Ja;Nam, Taek-Keun;Song, Ju-Young;Nah, Byung-Sik;Lim, Sang-Cheol;Lee, Joon-Kyoo;Chung, Woong-Ki
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.151-159
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    • 2007
  • Purpose: The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with locally advanced hypopharyngeal carcinoma. Materials and Methods: Between October 1985 to December 2000, 90 patients who had locally advanced stage IV hypopharyngeal carcinoma were studied retrospectively. Twelve patients were treated with radiotherapy alone, 65 patients were treated with a combination of chemotherapy and radiotherapy, and 13 patients were treated with surgery and postoperative radiotherapy with or without neoadjuvant chemotherapy. Total radiation dose ranged from 59.0 to 88.2 Gy (median 70 Gy) for radiotherpay alone. Most patients had ciplatin and 5-fluorouracil, and others had cisplatin and pepleomycin or vincristin. Median follow-up period was 15 months. Kaplan-Meier method was used for survival rate and Cox proportional hazard model for multivariate analysis of prognostic factors. Results: Overall 3-and 5-year survival rates were 27% and 17%, respectively. The 2-year locoregional control rates were 33% for radiotherapy alone, 32% for combined chemotherapy and radiotherapy, and 81 % for combined surgery and radiotherapy (p=0.006). The prognostic factors affecting overall survival were T stage, concurrent chemoradiation and treatment response. Overall 3-and 5-year laryngeal preservation rates in combined chemotherapy and radiotherapy were 26% and 22%, respectively. Of these, the 5-year laryngeal preservation rates were 52% for concurrent chemoradiation group (n=11), and 16% for neoadjuvant chemotherapy and radiotherapy (n=54, p=0.012). Conclusion: Surgery and postoperative radiotherapy showed better results than radiotherapy alone or with chemotherapy. Radiotherapy combined with concurrent chemotherapy is an effective modality to achieve organ preservation in locally advanced hypopharyngeal cancer. Further prospective randomized studies will be required.