• Title/Summary/Keyword: health care system

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Individualized Chemotherapy for Metastatic Gastric Cancer: Retrospective Data from a University Hospital in Brazil

  • Aguiar, Pedro Nazareth Junior;Ribas, Christian;Forones, Nora Manoukian
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5289-5296
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    • 2015
  • Background: Despite the decreased incidence, gastric cancer is still a frequent cause of cancer related death. The 1st line 2 or 3 drugs regimen is still a debatable issue. HER2 targeted therapy has emerged as the standard of care, but it is unavailable in the Brazilian Public Health System. The end-point of this trial was overall survival (OS) in patients with metastatic gastric cancer treated in a public university hospital in Brazil. The secondary end-points were efficacy and safety of regimens with 2 (F+P) or 3 (EOX) drugs to develop an institutional guideline to facilitate optimal treatments. Materials and Methods: In this retrospective study, 1st line regimens were evaluated for OS and PFS stratified by age and ECOG using Cox regression. Results: 47 patients were treated over the last 3 years. In 1st line, 29 were treated with F+P (mean 59.3 years, 34.5% ECOG 2 and a mean of 5.69 cycles) and 16 with EOX (mean 47 years, 18.8% ECOG 2 and a mean of 5.44 cycles). The median OS was 13.8 months (95%CI 10.7-16.9). Response was evaluated in 40 cases and was 64.3% for EOX and 37.5% for F+P (p=0.25). The median PFS was 9.5 months for EOX and 5.6 months for F+P (HR 0.85, 95%CI 0.41-1.74). However, among patients with ECOG 2 mPFS was 3.70 vs 5.40 months, respectively (p=0.86). Regimens showed similar manageable adverse events. A total of 34 patients suffered progression and 14 received $2^{nd}$ line therapy. Diffuse histology (HR 1.89, 95%CI 1.22-2.88), achieving 2nd line (HR: 0.25, 95%CI 0.11-0.58) and treatment response (HR 0.23, 95%CI 0.12-0.47) were OS prognostic factors. Conclusions: Patients treated in our hospital had outcomes compatible with the literature. The regimen choice should be related to patient features. Second line treatment should be considered.

Perception Level of Nurses and Auxiliary Nurses for Radiological technologist (간호사와 간호조무사가 지각하는 방사선사 인식도)

  • Shin, Seong-Gyu
    • The Journal of the Korea Contents Association
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    • v.11 no.8
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    • pp.211-220
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    • 2011
  • The study conducted a survey on the perception level for radiological technologists with 321 nurses and auxiliary nurses working at university hospitals in Busan in order to supply preliminary data to enhance the status as well as professional images of radiological technologists. The result shows the perception level of $3.02{\pm}0.42$ with the highest score for the professional image and the lowest score for the business image. By question, 'they are professional' gets the highest score while 'they understand problems of patients well' gets the lowest. Among respondents, those who are well aware of education courses as well as leading organization of examination and who answer as a health care provider or a medical technician under the medical law show a high level of perception while those who answer as technician show a low perception level. Those who agree with radiologists as a career and consider their status as high in medical institutions have a high level of perception. In order to improve the perception level, individuals as well as associations' promotion and strategies are required to fix the title and enhance the negative images through active interests and kind attitudes toward patients. Also, efforts to escape from previous images limited to technical colleges, to vitalize academic conference and remedial education, and to frame the law of professional radiological technologists system are asked to heighten the qualification and status of radiological technologists. More than that, advertising and monitoring via mass media are needed to develop the image as professional career men as well.

Spatial Information Application Case for Appropriate Location Assessment of PM10 Observation Network in Seoul City (서울시 미세먼지 관측망 위치 적정성 평가를 위한 공간정보 활용방안)

  • Jeong, Jong-Chul
    • Journal of Cadastre & Land InformatiX
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    • v.47 no.2
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    • pp.175-184
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    • 2017
  • Recently, PM10 is becoming a main issue in Korea because it causes a variety of diseases, such as respiratory and ophthalmologic diseases. This research studied to spatial information application cases for evaluating the feasibility of the location for PM10 observation stations utilizing Geogrphic Information System(GIS) spatial analysis. The spatial Information application cases for optimal location assessment were investigated to properly manage PM10 observation stations which are closely related with public spatial data and health care. There are 31 PM10 observation stations in Seoul city and the observed PM10 data at these stations were utilized to understand the overall assessment of PM10 stations to properly manage using interpolation methods. The estimated PM10 using Inverse Distance Weighted(IDW) and Kriging techniques and the map of PM10 concentrations of monitoring stations in Seoul city were compared with public spatial data such as precipitation, floating population, elementary school location. On the basis of yearly, seasonal and daily PM10 concentrations were used to evaluate the feasibility analysis and the location of current PM10 monitoring stations. The estimated PM10 concentrations were compared with floating population and calculated 2015 PM10 distribution data using zonal statistical methods. The national spatial data could be used to analyze the PM10 pollution distribution and additional determination of PM10 monitoring sites. It is further suggested that the spatial evaluation of national spatial data can be used to determine new location of PM10 monitoring stations.

Factors Affecting the Organizational Citizenship Behaviors of Administrative Hospital Staff Members (종합병원 행정직원의 조직시민행동 영향요인)

  • Park, Jung-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.539-547
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    • 2017
  • This paper reports the results of descriptive research aimed at determining the effects of the administrative hospital staff members' organization-based self-esteem and work engagement on their organizational citizenship behaviors. The participants of the study were 200 administrative staff members of general hospitals, each with 200 beds or more, located in B city. Data were collected from March 15 to 30, 2017, and analyzed statistically using a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. The findings of this study can be summarized as follows. The organizational citizenship behaviors differed significantly according to whether they had an experience of turnover (t=-4.260, p=.000) and how long they had served at their present work (t=3.297, p=.039). In addition, the organizational citizenship behaviors had strong positive correlations with the organization-based self-esteem (r=.454, p=<.000) and work engagement (r=.595, p<.000). In addition, the factor that explained the organizational citizenship behaviors most significantly was work engagement, followed by organization-based self-esteem and the period of service at the present work. All three factors accounted for 41% of those behaviors. These findings suggest that the hospital should perform internal marketing or improve its welfare system to make administrative staff members raise their self-esteem based on their organization. Moreover, the hospital should form an organizational culture of its own, in which administrative staff members feel the importance of their job, enjoy it and are given autonomy in job performance, ultimately contributing to the development of hospital management.

Development of GZF Assessment System on Rating Curve (수위-유량관계곡선식의 GZF 평가 시스템 개발)

  • Lee, Yeon-Kil;Shim, Eun-Jeung;Kim, Hyoung-Seop;Lee, Jin-Won;Jung, Sung-Won
    • Proceedings of the Korea Water Resources Association Conference
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    • 2007.05a
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    • pp.1854-1858
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    • 2007
  • 수자원 분야에서 가장 기본적이면서 중요한 과업 중의 하나는 고품질의 유량측정 자료를 확보하여 신뢰성 있는 수위-유량관계곡선식을 개발하는 것이다. 이는 수공구조물 설계, 친수 하천공간 조성, 친환경적인 하천의 설계, 하천 관리수량 산정, 홍수 예 경보 운영 등에 기본적인 자료를 제공하게 된다. 신뢰성 있는 곡선식은 계측장비의 개량과 유량관측 기준의 강화 등을 통하여 축적된 양질의 유량측정 자료로부터 개발될 수 있으며, 또한 수위관측소 지점의 하도특성과 통제구조물의 특성 등을 고려하는 것도 곡선식의 신뢰도를 높일 수 있다. 본 연구는 통제단면의 가장 낮은 부분의 수위로 정의되는 흐름이 0인 수위인 GZF(Gauge Height of Zero Flow) 평가에 관한 연구이다. 이와 같은 연구를 수행하기 위해서 GZF의 변화에 따라 곡선식의 신뢰도를 분석할 수 있는 시스템을 개발하였으며, 이 시스템은 사용자들이 쉽게 이용할 수 있는 엑셀 VBA(Visual Basic for Applications)를 이용하여 개발하였다. GZF 평가 시스템은 입력자료 구축 모듈, 수위관측소 지점의 하도 단면 입력 모듈, GZF 설정 모듈, GZF 평가 모듈의 4개 모듈로 구성되었다. 입력자료 구축 모듈은 기 개발된 곡선식의 GZF 적정성을 파악할 수 있도록 자료를 구축하는 모듈이며, 하도 단면 입력 모듈은 수위관측소 지점의 하상의 변화 유무와 구간분리, 기간분리 등의 필요성을 파악할 수 있도록 구성하였다. GZF 설정 모듈은 GZF의 변화가 곡선식의 신뢰도를 파악할 수 있도록 구성되었다. 마지막으로 GZF 평가 모듈은 기 개발된 곡선식의 GZF와 금회 개발될 곡선식의 GZF를 비교 분석할 수 있도록 구성되었다. 본 연구의 성과는 향후 수위-유량관계곡선식을 개발할 때 GZF 산정의 오류를 감소시켜 앞으로 개발될 곡선식의 신뢰도 향상에 기여를 할 것으로 판단된다.소를 파악해야한다. 7. 부아 유대에 대한 위협요소 확인을 위한 도구개발과 그들에 대한 효과적인 간호전략이 필요 된다. 8. 가족에 있어서 모든 부모행위가 하나의 독립변수로서 연구되어야 하고 부아유대 증진에 관한 연구가 시도되어야겠다. 오늘날 부모들은 임신기간동안 많은 정보에 접하기를 원한다. 산전, 산후의 교육과 지식은 긍정적인 부아 관계를 증진시키고, 이것은 아동의 발달에 크게 기여할 수 있다. 긍정적으로 이러한 관계는 가족단위를 강하게 통합시키게 되므로 건강관리자(Health care workers)들은 애착에 대해 높은 관심을 갖어야 하겠다.2유수지는 BTL사업을 통해 주변공단으로부터의 오폐수를 원천적으로 차단하도록 하였으며 2유수지를 매립하여 지하는 강우시 유출수 저류가 가능한 화물차주차장으로 활용하고 지상은 녹지공간으로 조성하여 공단근로자 및 지역주민을 위한 휴식공간으로 활용될 수 있도록 제안하였다. 본 연구는 남동유수지 환경 개선 사업 실행을 위한 정책 연구로 연구결과를 인천시가 적극 수용하기로 결정함에 따라 인천시의 환경 현안 문제인 남동유수지의 수질개선을 통해 시민의 휴식 및 여가선용 공간으로 활용하기 위한 사업의 기초자료로 활용되며 이미 설계검토가 시작되었다. 본 연구결과는 유수지 및 저수지의 환경개선 사업의 선두적인 성공사례로 국내 타 지역의 유사한 사업에 있어 벤치마킹을 할 수 있는 훌륭한 사례가 될 것이다.요 생산이 증가하자 군신의 변별(辨別)과 사치를 이유로 강력하게 규제하여 백자의 확대와 발전에 걸림돌이 되었다. 둘째, 동기(銅器)의 대체품으로 자기를 만들어 충당해야할 강제성 당위성 상실로 인한 자기수요 감소를 초래하였을 것으로 사료된다. 셋째, 경기도 광주에서 백자관요가 운영되었으므로 지방인 상주지역에도 더 이상 백자를 조달받을 필요가 없이, 일반 지방관아와 서민들의 일상용기 생산으로 전락하여 소규모화 되었을 것이라고 사료

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When Dose Losses of Maternal Lymphocytes Response to Trophoblast Antigen or Alloantigen Occur in Women with a History of Recurrent Spontaneous Abortion? (반복유산을 경험한 환자에서 임신중 태반항원과 동종항원에 노출된 모체 림프구면역반응은 언제부터 소실되나?)

  • Choi, Bum-Chae;Hill, Joseph A.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.115-122
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    • 1998
  • The maintenance of a viable pregnancy has long been viewed as an immunological paradox. The deveolping embryo and trophoblast are immunologically foreign to the maternal immune system due to their maternally inherited genes products and tissue-specific differentiation antigens (Hill & Anderson, 1988). Therefore, speculation has arisen that spontaneous abortion may be caused by impaired maternal immune tolerance to the semiallogenic conceptus (Hill, 1990). Loss of recall antigen has been reported in immunosuppressed transplant recipients and is associated with graft survival (Muluk et al., 1991; Schulik et al., 1994). Progesterone $(10^{-5}M)$ has immunosuppressive capabilities (Szekeres-Bartho et al., 1985). Previous study showed that fertile women, but not women with unexplained recurrent abortion (URA), lose their immune response to recall antigens when pregnant (Bermas & Hill, 1997). Therefore, we hypothesized that immunosuppressive doses of progesterone may affect proliferative response of lymphocytes to trophoblast antigen and alloantigen. Proliferative responses using $^3H$-thymidine ($^3H$-TdR) incorporation of peripheral blood mononuclear cells (PBMCs) to the irradiated allogeneic periperal blood mononuclear cells as alloantigen, trophoblast extract and Flu as recall antigen, and PHA as mitogen were serially checked in 9 women who had experienced unexplained recurrent miscarriage. Progesterone vaginal suppositories (100mg b.i.d; Utrogestan, Organon) beginning 3 days after ovulation were given to 9 women with unexplained RSA who had prior evidence of Th1 immunity to trophoblast. We checked proliferation responses to conception cycle before and after progesterone supplementation once a week through the first 7 weeks of pregnancy. All patients of alloantigen and PHA had a positive proliferation response that occmed in the baseline phase. But 4 out of 9 patients (44.4%) of trophoblast antigen and Flu antigen had a positive proliferative response. The suppression of proliferation response to each antigen were started after proliferative phase and during pregnancy cycles. Our data demonstrated that since in vivo progesterone treated PBMCs suppressed more T-lymphocyte activation and $^3H$-TdR incorporation compare to PBMCs, which are not influenced by progesterone. This data suggested that it might be influenced by immunosuppressive effect of progesterone. In conclusion, progesterone may play an important immunological role in regulating local immune response in the fetal-placental unit. Furthermore, in the 9 women given progesterone during a conception cycle, Only two (22%) repeat pregnancy losses occured in these 9 women despite loss of antigen responsiveness (one chemical pregnancy loss and one loss at 8 weeks of growth which was karyotyped as a Trisomy 4). These finding suggested that pregnancy loss due to fetal aneuploidy is not associated with immunological phenomena.

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A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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Validation Study of Clinical Utility and Usability on Korean Version of the Life-Space Assessment to Assess Community Mobility (지역사회 이동성을 측정하는 한국어판 생활공간 평가(Korean Version of the Life-Space Assessment; K-LSA)의 임상적 유용성 및 사용성 검증 연구)

  • Kim, Jeong-Hui;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.1
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    • pp.1-10
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    • 2018
  • Objective : The purpose of study is to validate the clinical utility and usability of the Korean version of the Life Space Assessment(K-LSA) which is an assessment tool of community mobility of older adults. Methods : Surveys on the clinical utility and usability of the K-LSA are carried out with a total of aoaa60 occupational and physical therapists. The surveys included the multiple choice questions on the clinical utility and open questions on the usability. Responses to multiple questions are post processed by frequency analysis and technical statistics, and responses to the open questions are categorized by common factors in each questions. Results : Average value of clinical utility ranges from 3.6 to 4.0 with positive responses of 'fair (3 point)', 'agree (4 point)' and 'strongly agree (5 point)' being 95~100%. Average value for clinical usability ranges from 3.6 to 4 with positive answers of 'fair (3 point)', 'easy (4 point)' and 'very easy (5 point)' being 88.3~100%. Additionally out of open-type questions of clinical usability, it was pointed out that the concept of 'neighborhood' for the life space level 3 and 4 is unclear. Conclusion : The current study and research outcomes showed that the K-LSA is a validated tool in Korean health care system for the clinical utility and usability in measuring community mobility, and that it is straightforward in practical use. It will help clinicians and therapists promote the social participation of older adults, and set an intervention goal for enhancing community mobility. It will further help clinicians and researchers in education and research for medical intervention and goal-setting.

Synergistic Surface Activities and Phase Behavior in Mixtures of a Diglyceryl Cationic Surfactant and a Conventional Anionic Surfactant (디글리세릴계 양이온계면활성제와 일반 음이온계면활성제 혼합물에서의 계면활성 상승효과와 상거동)

  • Choi, Jeong-Jin;Cho, Wan-Goo;Rang, Moon-Jeong
    • Korean Chemical Engineering Research
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    • v.46 no.4
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    • pp.799-805
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    • 2008
  • In general, anionic and cationic surfactants are incompatible because their mixtures form insoluble complexes and precipitate in the water. There are, however, some equimolar complexes of anionic and cationic surfactant that are soluble and behave like regular surfactants, specifically like nonionic surfactants, thus named pseudo-nonionic surfactant complexes. Pseudo-nonionic complexes are more effective and efficient in surface activities than their ionic surfactant components as shown by their equilibrium and dynamic surface tensions. They pack at the interface more than their ionic components. When a novel cationic surfactant, diglyceryl dodecyl dimethyl ammonium chloride(DGDAC), having the polyhydroxyl group at the hydrophilic head group, was mixed with a conventional anionic surfactant (sodium dodecyl sulfate; SDS) at equimolar ratio, we found that the aqueous equimolar mixture showed strong positive synergism in which molecular interaction parameter ${\beta}^M$ was very low, -17.2. According to the studies of equilibrium phase behavior and microscopy, this mixed system could form homogenous solutions containing vesicles.

The Ethos of Uprising and the Community Searching for the Heart of May 18th in Gwangju (항쟁의 에토스와 공동체 1980년 5월 광주의 마음을 찾아서)

  • Park, Kyungseop
    • Korean journal of communication and information
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    • v.71
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    • pp.33-51
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    • 2015
  • In South Korea, the community building projects and so-called 'community businesses' are recently regarded as one of the popular issues for the local people and social activists. The project seems to be a miracle resolution for various social matters such as the deteriorating welfare, health care, security system and the worsening income problem, etc. But these promising social discourses and practices which encourage to build communities are not only constructing 'good governance' for the sound cooperation between the state and civil society, but also allowing government technologies to manage and regulate civil society and citizens. This irony of building community is not yet thoroughly considered. The aim of this article is to ask 'Is building community good for all of people?'; 'How does community guarantee the freedom of people who participate in?'. The reflection for community in South Korean Society has related to The May 18-community in Gwangju. The May 18-community is a keystone for understanding the ethos and pathos of community. This study tries to unravel the relation between the May Uprising and the idea of community throughout affects and hearts of participants. The lived experience and testimony of the people of Gwangju in May, 1980, reveals that community should not be in an order and an notion of security. Examining hearts of members of 'whatever community' in the May Uprising is essential to imagine a new form of community which incorporates liberation and freedom as its base.

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