• Title/Summary/Keyword: management methods

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Comparison of Thallium-201, Tc-99m MIBI and I-131 Scan in the Follow-up Assessment after I-131 Ablative Therapy in Differentiated Thyroid Cancer (방사성 옥소 치료 후 분화된 갑상선암 추적관찰에서 Thallium-201 스캔, Tc-99m MIBI 스캔과 I-131 스캔 검사 결과의 비교)

  • Kwon, Jae-Sung;Lee, Sung-Keun;Kim, Doe-Min;Park, Sae-Jong;Jang, Kyong-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.493-501
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    • 1999
  • Purpose: We conducted a comparative study to evaluate the diagnostic values of T1-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. Materials and Methods: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or mote times of I-131 retreatments (33 cases). In all patients, T1-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Results: Positive rates (PR) of Tc-99m MIBI, T1-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant T1-201 and I-131 scans were in the order of therapeutic 131 scan 71%, T1-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between T1-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Conclusion: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. T1-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.

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The effect of rearing, health and nutrition intervention services on grandparents-grandchildren families in a rural Korean area (농촌 조손가정의 양육, 건강 및 영양중재서비스의 효과)

  • Cho, Young-Hyang;Park, Yoon-Chang
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.274-286
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    • 2010
  • Objectives: The purpose of this study was to examine the effects of the rearing, health and nutrition services through intervention in GP-GC (grandparents-grandchildren) families. Methods: A structured questionnaire was administered in January 2008 and January 2009 to 55(70) grandparents of GP-GC families who received intervention services also GP-GC families that did not receive services. The study area was the city of Chunnam Province, South Korea. The intervention services were provided by electronic voucher one day per week. The questionnaire assessed the general characteristics of the grandparents, childcare stress and burden, health status (ADL, IADL, depression, subjective health status and fall index) and mini nutritional assessment(MNA). The data were analyzed using SPSS software and an F-test, Chi-squared test and t-test. Results: The stress of grandparents resulting from childcare was high, but depression in grandparents perceived by grandchildren was significantly lower in served GP-GC families than in non-served GP-GC families. Differences in scores of affection (t=2.12, df=116, p<.05), automatics (t=2.92, df=116, p<.01), realistic(t=2.24, df=116, p<.05), and level of depression(t=2.90, df=116, p<.01) were significant. Incidences of acute disease, IADL cognitive fuction and depression of grandparents were slightly higher. Intervention services for GP-GC families had an impact on the childcare attitude and health status of grandparents. The intervention services of nutrition for grandparents were not promoted, but the scoring for subjective nutrition status were statistically higher for the served group (t=18.230, p<.0001). Conclusions: This study found that intervention programs of childcare services and health and nutrition management are effective for grandparents of GP-GC families. Intervention services for GP-GC family should establish the political issue.

Influence of Lifestyle-Related Diseases on the Oral Health of the Rural Elderly in Korea (일부 농촌지역 60세 이상 노인의 생활습관병이 구강건강에 미치는 영향)

  • Park, Jung-Hye;Lee, Hee-Kyung;Lee, Kyeong-Soo;Jang, Eun-Jin
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.249-259
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    • 2010
  • Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea. Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses. Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased. Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

A Study of the History of Korean Public Library after the Korean Liberation Day - An Emphasis on the influence of public Libraries System under the Japanese Imperialism- (광복이후 한국 공공도서관사 연구 -일제하 공공도서관제도의 영향을 중심으로-)

  • Kim Po Ok
    • Journal of the Korean Society for Library and Information Science
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    • v.20
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    • pp.65-125
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    • 1991
  • The study has tried to analize and appraise how did public library system under the Japanese imperialism affect the establishment and managemant of Korean public libraries. To achieve the purpose of the above-mentioned study, the contents of $\ulcorner$Japanese library statute$\lrcorner$ under Japanese imperialism and the current $\ulcorner$Korean library law$\lrcorner$ have been mutually compared, at the same time, the vestiage of Japanese imperialism in view of the establishment, personnel administration and reading systems have been concretely investigated, analyzed and compared. The conclusions obtained from the above are as followings. 1. In those days of the Korean Liberation, the situation of Korean public libraries was such as it under the Japanese rule and so, their names were only changed. However, as a part of its independent activities, the national library have once carried out the various programs such as the training of professional librarians, the establishment of the new classification schedule and the chief Librarian and deputy Librarian from the professional librarians in the office regulations, and they were well worth being the good examples for today's Korean library circle. Though the Goverment of the Republic of Korea had been formally established, the situation of the library circle was very dull owing to the Korean war for a long time. In 1963, $\ulcorner$The Korean library law$\lrcorner$ was promulgated, but the establishment of public libraries did not give satisfactory results because of the institutional fragility. In the 1980's the importance of library was embossed from the viewpoint of life-long education and the number of libraries was increased. However, there were still the remaining vestiges of Japanese library system in the practical library services. 2. After the Korean Liberation, the influnces of public library system under the Japanese imperialism showed in the office regulation of national library and the Korea library Law were also in the legal mechanism. In particular, the regulations of $\ulcorner$The staff-member of public library$\lrcorner$ and $\ulcorner$Admission fee of public library$\lrcorner$ including the chief librarian have referred to the library system under the Japanese imperialism since the liberation day to date. 3. At that time of the Korean Liberation, the U.S.Military Government Office had decided that the public library administration should be attached to the administration of local and internal affairs in accordance with the Japanese administative system. As a result, the public libraries had been forced to be indirectly affected by public library system under the Japanese imperialism for twenty years since the Liberation. 4. Since the Liberation, the personnel adminstration of public library has been so far on the steps of model under the Japanese imperialism. As the result of the field survey, the position standards of local chief librarians, non-professional character, the extra post system and the preponderant appointment of non-professional offices have analyzed by the influence of Public library system under the Japanese imperialism. Therefore, the Government authorities-concerned must readjust the standards of qualification and the divided duties corresponding to the position of public library staff members and to stipulate expressly in the revised library law. In addition, the regulation of the admission fee should be also actively detected for the free adminssion of library users. 5. Since the Liberation Day, the reading methods of public library have been so far similar to reading method under the Japaness imperialism. For example, the admission fee levied, the complicated procedures of using books including entrance and exit of a library, no-admission system, the limited lending books, the deposit system of outdoor lending books and the surety liable jointly and severally are originally caused by bureaucracy of under the Japanese imperialism. Therefore, the public libraries should make an offer space and opportunities which can enjoy freedom to the gull in future. The procedures and standards of library users will be simplified, if possible. As the above-mentioned, the actual conditions of Korean public libraries have been examined and analyzed. As the result of it, there are still the remaining vestiges of public library system under the Japanese imperialism in the establishment and management of the nation-wide public libraries. Such the remnants are an obstacle to the democratic development of public libraries and so, the authorities-concerned should take the proper-measures as soon as possible.

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A Study on Denture Satisfaction in Rural Elderly People (농촌지역 노인의 의치만족도)

  • Lee, Ga-Ryoung;Yoo, Wang-Keun
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.56-66
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    • 2010
  • Objectives: The study aimed to explore dental status and denture satisfaction in some rural elderly people. Methods: A total of 546 participants aged over 65 years was surveyed cross-sectionally. The subjects were surveyed with regard to their denture satisfaction by a structured questionnaire. The Wilcoxon or Kruskal-Wallis test was used for analysis. Results: As for respondents' satisfaction for dentures by the Likert scale of 5 score, aesthetic satisfaction (3.73) was highest, followed by general satisfaction (3.56) and masticatory functions satisfaction (3.45). In addition, the educational level, occupation, monthly income, the number of remaining teeth, use of denture variables have statistically significant difference in the denture satisfaction of those elderly people interviewed. Conclusions: The results showed that denture satisfaction in some rural elderly people was different in each categories. Consequently, providing tailor-made oral health education programs for the effective denture management of the elderly people should be needed in order to improve the quality of life of the aged.

Effects of Oral Hygiene Improvement of the Elderly Patients by Caregiver's in Rural Long-term Care Hospital (농촌지역 노인요양병원 입원환자의 간병인을 통한 구강건강관리 효과)

  • Kim, Kyung-Won;Yoon, Hee-Jung;Kim, Mie-Ryung;Lee, Hee-Kyung;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.13-20
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    • 2010
  • Objectives: This study was conducted to be identify the effects oral hygiene improvement of the elderly by caregiver in a rural. Methods: It recruited Fifty three elderly patients were recruited who admitted at a long-term hospital located in Mokchon city, Chungchungnam-do province. as the intervention group. Fifty two elderly patients group were selected another one long-term care hospital in Daegu city as control group. study was conducted for seven months. long-term care hospital. for seven months from Dec. 2007 to June 2008. For three months, the caregivers provide tooth brushing and cleaning artificial teeth once a day, to intervention group. once a day for three months. Results: Before the program there was no significant difference between the control and the intervention groups in general characteristics, prevalence rates of diseases, oral sanitary condition. Dental plague score was decreased significantly(p<0.001) before and after intervention in the intervention group. Using analysis of covariance for evaluation of the effect of the intervention, a significant difference was observed between the intervention group and the control group(p<0.01). Conclusions: These results were thought to be used as important basic data to develop oral health management program for elderly patients who needed long-term care.

Soft Tissue Sarcomas Presented with Hematoma (혈종을 동반한 연부 조직 육종)

  • Chung, Yang-Guk;Kang, Yong-Koo;Bahk, Won-Jong;Rhee, Seung-Koo;Lee, An-Hi;Park, Jeong-Mi;Cho, Hyun-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.163-171
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    • 2008
  • Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.

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A PLS Path Modeling Approach on the Cause-and-Effect Relationships among BSC Critical Success Factors for IT Organizations (PLS 경로모형을 이용한 IT 조직의 BSC 성공요인간의 인과관계 분석)

  • Lee, Jung-Hoon;Shin, Taek-Soo;Lim, Jong-Ho
    • Asia pacific journal of information systems
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    • v.17 no.4
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    • pp.207-228
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    • 2007
  • Measuring Information Technology(IT) organizations' activities have been limited to mainly measure financial indicators for a long time. However, according to the multifarious functions of Information System, a number of researches have been done for the new trends on measurement methodologies that come with financial measurement as well as new measurement methods. Especially, the researches on IT Balanced Scorecard(BSC), concept from BSC measuring IT activities have been done as well in recent years. BSC provides more advantages than only integration of non-financial measures in a performance measurement system. The core of BSC rests on the cause-and-effect relationships between measures to allow prediction of value chain performance measures to allow prediction of value chain performance measures, communication, and realization of the corporate strategy and incentive controlled actions. More recently, BSC proponents have focused on the need to tie measures together into a causal chain of performance, and to test the validity of these hypothesized effects to guide the development of strategy. Kaplan and Norton[2001] argue that one of the primary benefits of the balanced scorecard is its use in gauging the success of strategy. Norreklit[2000] insist that the cause-and-effect chain is central to the balanced scorecard. The cause-and-effect chain is also central to the IT BSC. However, prior researches on relationship between information system and enterprise strategies as well as connection between various IT performance measurement indicators are not so much studied. Ittner et al.[2003] report that 77% of all surveyed companies with an implemented BSC place no or only little interest on soundly modeled cause-and-effect relationships despite of the importance of cause-and-effect chains as an integral part of BSC. This shortcoming can be explained with one theoretical and one practical reason[Blumenberg and Hinz, 2006]. From a theoretical point of view, causalities within the BSC method and their application are only vaguely described by Kaplan and Norton. From a practical consideration, modeling corporate causalities is a complex task due to tedious data acquisition and following reliability maintenance. However, cause-and effect relationships are an essential part of BSCs because they differentiate performance measurement systems like BSCs from simple key performance indicator(KPI) lists. KPI lists present an ad-hoc collection of measures to managers but do not allow for a comprehensive view on corporate performance. Instead, performance measurement system like BSCs tries to model the relationships of the underlying value chain in cause-and-effect relationships. Therefore, to overcome the deficiencies of causal modeling in IT BSC, sound and robust causal modeling approaches are required in theory as well as in practice for offering a solution. The propose of this study is to suggest critical success factors(CSFs) and KPIs for measuring performance for IT organizations and empirically validate the casual relationships between those CSFs. For this purpose, we define four perspectives of BSC for IT organizations according to Van Grembergen's study[2000] as follows. The Future Orientation perspective represents the human and technology resources needed by IT to deliver its services. The Operational Excellence perspective represents the IT processes employed to develop and deliver the applications. The User Orientation perspective represents the user evaluation of IT. The Business Contribution perspective captures the business value of the IT investments. Each of these perspectives has to be translated into corresponding metrics and measures that assess the current situations. This study suggests 12 CSFs for IT BSC based on the previous IT BSC's studies and COBIT 4.1. These CSFs consist of 51 KPIs. We defines the cause-and-effect relationships among BSC CSFs for IT Organizations as follows. The Future Orientation perspective will have positive effects on the Operational Excellence perspective. Then the Operational Excellence perspective will have positive effects on the User Orientation perspective. Finally, the User Orientation perspective will have positive effects on the Business Contribution perspective. This research tests the validity of these hypothesized casual effects and the sub-hypothesized causal relationships. For the purpose, we used the Partial Least Squares approach to Structural Equation Modeling(or PLS Path Modeling) for analyzing multiple IT BSC CSFs. The PLS path modeling has special abilities that make it more appropriate than other techniques, such as multiple regression and LISREL, when analyzing small sample sizes. Recently the use of PLS path modeling has been gaining interests and use among IS researchers in recent years because of its ability to model latent constructs under conditions of nonormality and with small to medium sample sizes(Chin et al., 2003). The empirical results of our study using PLS path modeling show that the casual effects in IT BSC significantly exist partially in our hypotheses.

Correlation of Serum Thyroglobulin and Thyroglobulin in the Wash out of the Needle in Thyroid Cancer (갑상선암에서의 혈중 Thyroglobulin 농도와 침생검 검체 Washout Solution의 Thyroglobulin 농도와의 상관관계)

  • An, Jae-Seok;Kim, Ji-Na;Won, Woo-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.152-155
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    • 2009
  • Purpose: The most widely accepted tool for follow up management of thyroid cancer patients is serum thyroglobulin (Tg) measurement, but its value is limited by the interference of anti-thyroglobulin antibodies (anti-Tg Ab). Recently thyroglobulin measurement in the wash out of fine-needle aspiration biopsy specimens (Tg-FNAB) is frequently used for differential diagnosis of recurrences/metastases. The aim of this study was the investigation of the diagnostic utility of Tg-FNAB compared with serum Tg. Materials and Methods: We enrolled 41 consecutive patients with thyroid cancer who were evaluated for Tg-FNAB between January 2007 and February 2008 retrospectively. We ruled out 6 patients who anti-Tg Ab positive (${\geq}$100 U/mL) in the RIA (BRAHMS anti-Tgn RIA 100Det; BRAHMS Aktiengesell schaft, Berlin, Germany). Serum Tg and Tg-FNAB were measured by immunoradiometric assay (BRAHMS Tg pluS RIA 100 Det; BRAHMS Aktienge sellschaft, Berlin, Germany). We evaluated for Tg-FNAB compared with serum Tg and corresponding cytological smear. To compare the values of the two the t-test was used. Results: Tg-FNAB values were significantly higher (median 1,060 ng/mL, range 0.2~434,000 ng/mL) than serum Tg (median 2.5 ng/mL, range 0.9~131 ng/mL) (p=0.0394). The rate of correspondence with Tg-FNAB between cytological result was 87.9% and 65.9% in the case of serum Tg. Tg-FNAB was positive in 28 (24 with positive and 4 with suspicious cytology). Of the remaining 13 patients with negative Tg-FNAB, 1 had suspicious and 12 had unsuspicious cytology. serum Tg was positive in 26 (17 with positive and 3 with suspicious and 6 with unsuspicious cytology), Of the remaining 15 patients with negative serum Tg, 8 was positive in cytological result and 1 had suspicious and 6 had unsuspicious cytology. Conclusions: Tg-FNAB measurement is more accurate with high sensitivity (87.9%) than serum Tg (65.9%). The Tg-FNAB was a useful predictor for detecting recurrences/metastases with serum Tg.

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Tumor Prosthetic Arthroplasty and Arthroplasty with Bone Cement for the Metastatic Malignant Bone Tumor in the lower Extremity (하지 관절 부위에 발생한 전이성 종양 환자의 종양 대치물 및 골시멘트와 인공관절 삽입술)

  • Yang, Jun-Young;Lee, June-Kyu;Hwang, Deuk-Soo;Shin, Hyun-Dae;Kwak, Sang-Koo;Kim, Kyung-Cheon;Nam, Dae-Cheul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.12-17
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    • 2003
  • Purpose: In this report we are going to discuss about the functional evaluation and the outcome of treatment of metastatic tumor in the lower extremities treated with tumor prosthetic arthroplasty. Materials and Methods: This report is based on nine patients diagnosed as a metastatic tumor and treated by tumor prosthetic arthroplasty, from June 1998 to December 2001. Age of the patients ranged from 49 to 63 with the average of 56.3. The average follow up period was 23.4 months. Two patients had lung cancer, three had breast cancer, two had renal cancer, one colon cancer, and one had multiple myeloma. All these were primary cancers. The site of metastasis were six in proximal femur, two in distal femur, and one in proximal tibia. Tumor excision was performed after biopsy in following the principle of primary tumor management. Excision with wide surgical margin was tried as possible could. Six cases were treated with tumor prosthesis, and the other three cases were reconstructed with bone cement and arthroplasty. Results: The functional evaluation in the extremities at the last follow up was performed on Enneking evaluation score with 6 categories. The highest scored 26, and the lowest scored 10, with an average of 19.5. A case in which the patient died 15 days after the operation was excluded from the evaluation. Among the categories, emotional acceptance to postoperative function and pain relief were highly scored. At the final follow up, seven patients survived, and one colon cancer patient died 68 days after operation. Conclusion: Metastatic tumor occurring in joints of lower extremities could be treated in accordance to the treatment principle of primary tumor. By insertion of tumor prosthesis, we can get satisfactory results of function in the lower extremity and pain relief especially. So, this aspect of medical favor must be considered in treating patients.

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