Background: Mediastinal masses are not uncommon, and an overall incidence of one case per 100,000 population per year in individuals of all ages and with no difference in sex incidence may be a reasonable estimation. At least half of all mediastinal masses are asymptomatic and this proportion has increased in recent decades with wider use of screening chest roentgenography. Symptoms in patients with mediastinal mass lesions are usually due to compression or invasion of nearby intrathoracic structures. Most mediastinal mass lesions have characteristic predilectional locations. The basic focus of diagnostic evaluation is an orderly preparation for obtaining a tissue diagnosis but even lesions discovered to be benign must generally be removed. Seldom is this status known for certain preoperatively. In additaion, benign tumors may continue to enlarge, thus compromising vital organs; they may rupture, hemorrhage, become infected or have the possibility of various malignant degeneration. Therefore, all mediastinal masses must be surgically removed whether they are malignant or benign. Methods: We reviewed the medical records of 344 cases previously confirmed as mediastinal tumors or cysts from January, 1960 to August, 1992 and investigated the clinical findings. Results: Neurogenic tumors were the most common(24.7%) and thymomas were distinctively increased recently. Overall ratio between males and females was 1.1:1 and age distribution was relatively even among all age groups. Predilectional sites were posterior for neurogenic tumors, and anterior for teratodermoid tumors, thymomas and lymphomas. Dyspnea was the most common symptom in the patients of the mediastinal tumors and asymptomatic patients were 19.5%, Benign mediastinal mass lesions were 66.0% and malignant, 34.0%, Complete or partial resection was done in 42.4%. Conclusion: We could find the increasing incidence and the tendency of aggressive resection as possible in the mediastinal tumors. We expect the discovery of more mediastinal tumors with wider use of regular check-up and development of diagnostic methods.
Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
Tuberculosis and Respiratory Diseases
/
v.57
no.6
/
pp.535-542
/
2004
Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.
Journal of agricultural medicine and community health
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v.31
no.1
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pp.21-34
/
2006
Objectives: The purpose of this study was to investigate the knowledge, attitude and practice toward sanitary administration of the new restaurateurs, to carry out the sanitary management of business for improvement of sanitary level, and to provide basic data which were necessary for sanitary education of the restaurateurs. Methods: The self-recording survey on the attitude and the knowledge toward the sanitation, the sanitary administration, and its education was conducted against new 393 restaurateurs by the administrative division of Gwangju city in charge of the food industry which put in the regular sanitary education annually for the new restaurateurs. Results: In regard to food sanitation, some 87.9% to 94.4% got the right knowledge about the reason and precaution of food poisoning, storage methods of frozen or cold food, and the disposal of product after expiration of validity term. But it was about 56.0% to 63.0% who knew right about the cause and the major precaution of food poisoning, storage temperature in the refrigerator. 30.6% of the subject placed an emphasis on personal sanitation of the workers as the most important thing in the sanitary management. 83.6% replied that it was necessary to improve the sanitary level. Concerning the health examination, 78.3% replied it was needed. 76.4% pointed the need for education, but respondents with higher educational level less emphasized its needs. It was most frequently pointed out by 71.6% restaurateur's poor awareness about it. 36.7% indicated the environmental sanitation like facilities in the restaurants as the first thing to be improved. The rate of personal sanitation was 43.7%. Conclusions: To improve the poor sanitary conditions of the food service business, it was recommended to offer institutional backing and financial aid from administrative office, to encourage restaurateurs to take pride in their job, and to conduct the sanitary education effectively by the technical education institution.
Journal of agricultural medicine and community health
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v.41
no.1
/
pp.1-12
/
2016
Objectives: In establishing policies for agricultural safety, evaluating injury burdens as well as investigating the rates and characteristics of work injury is important. This study investigated the types and characteristics of agricultural injury subjective burdens. Methods: By analyzing the injured farmers identified in the 2013 Korean Farmers' Occupational Injury Survey, the burdens caused by injuries were categorized using one direct cost item (medical costs) and five indirect cost items (including productivity decreases and wage increases). Statistical differences among the burden items were analyzed using logistic regression analysis according to the characteristics of the farmers and their farm injuries. Results: Among the subjective burdens indicated by the 457 injured farmers, disruption to work was most common. The major influences on each subjective burden item are as follows: for the item of disruption to work, age, time of injury occurrence, treatment period, and farming machine use were influential; for an increased family member's burden of farm works, the number of family members and treatment period were influential. Regarding cost burden of treatment, the results varied according to whether or not the patient was hospitalized and annual income. Conclusion: Subjective burdens induced by indirect costs rather than those induced by direct costs were found to be higher in ratio. In regard to each burden item, the results varied according to the characteristics of the farmers and their farm injuries. To support injured farmer, setting goals to reduce indirect cost burdens and preparing concrete methods is necessary.
Journal of agricultural medicine and community health
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v.35
no.2
/
pp.134-150
/
2010
Objectives: This study was for analyzing the research about international marriage immigrant women and a trial to find the right direction for future research. Methods: Sixty articles published from June, 2004 to June, 2009 were reviewed and analyzed according to the general characteristics, major of author, and theme of health domains. Results: Most of them were master's thesis(71.7%) and journals(21.7%) and doctoral dissertation(6.7%) have been published mostly after thesis. Among 83.3% for quantitative research, descriptive(33.3%) and descriptive correlation(41.7%) methods were the most used and there were some qualitative researches(16.7%). The most frequently used data gathering method was questionnaire(81.7%) and the next was interview(16.7%). The major rates of the author were 61.7% for social welfare and 2.1% for nursing. The investigated variables in social health domain were adaptation(28.3%), and communication(1.7%). In psychological health domain, marriage satisfaction(16.7%), life satisfaction(11.7%), and depression(10.0%) were most researched. Utilization of medical center(5.0%) and health promotion behavior(1.7%) were investigated in physical health domain. Conclusions: Above this, most articles were researched about the adaptation of international marriage immigrant women. But the life in foreign countries can cause physical and psychosocial unhealthy conditions, so many-sided health related researches are supposed to be conducted for adaptation and prevention health problems of international marriage immigrant women.
Journal of agricultural medicine and community health
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v.41
no.4
/
pp.205-216
/
2016
Objectives: We compared the difference of lipid, insulin resistance and metabolic markers based on HCV RNA in Korean adults.Methods: This was a cross-sectional study of 222 subjects visited the health promotion center of Pusan nationaluniversity hospital from 2004 to 2007. Subjects were anti-HCV antibody positive and were performed RT-PCR for HCV RNA. The HCV RNA (+) group were 85 subjects, HCV RNA (-) control group were 115 subjects, and the HCV RNA (-) but past positive group were 22 subjects. We performed anthropometry, anti-HCV, RT-PCR, plasma concentrations of insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride.Results: BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride, HDL cholesterol, insulin resistance such as HOMA-IR and QUICKI were not significantly different between HCV RNA positive and negative groups. The serum total cholesterol and LDL cholesterol level were significantly lower in the HCV RNA positive group than in the negative group ($186.24{\pm}37.63$ vs $197.22{\pm}37.23$ mg/dl, p=0.041, $111.66{\pm}34.06$ vs $121.38{\pm}35.50$ mg/dl, p=0.042). After adjusting age and sex, high total cholesterol (${\geq}200mg/dl$) (adjusted OR=0.51, 95%CI 0.28-0.94, p=0.03) and high LDL cholesterol (${\geq}130mg/dl$) (adjusted OR=0.46, 95%CI 0.24~0.87, p=0.02) were inversely associated with being HCV RNA positive (p<0.05). Conclusion: The serum total cholesterol and LDL-cholesterol level were significantly lower in HCV RNA (+) group than in HCV RNA (-) group, but not in HCV RNA (-) but past positive group. Prospective cohort studies are needed to clarify the relationship between HCV RNA and metabolic markers.
There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.
Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.
Statement of problem: An incompatibility between the initiator systems of self-curing composite resins and light-curing adhesives was supposed recently. Purpose: The purpose of the study was to evaluate the influence of activators for self/dual bonding on dentin shear bonding strengths. Material and methods: Fifty human molars were divided into 5 groups. A flat dentin surface was created for each tooth. A self-curing composite resin (Luxacore) was bonded with the following adhesives (n = 10); One-Step, Prime&Bond NT, AdheSE, Prime&Bond NT and AdheSE were also used in combination with activators. Shear bond strengths were measured after 24 hours of water storage. The specimens were loaded in shear in the Instron until failure at a 1 mm/min crosshead speed. Data were compared using one-way ANOVA and Tukey HSD test (${\alpha}$= 0.05). Results: The dentin adhesive systems in order of decreasing median bond strength were One-Step > Prime&Bond NT with activator, AdheSE with activator > Prime&Bond NT, AdheSE. Among adhesives, One-Step had the highest bond strength. Prime&Bond NT with activator had higher bond strengths than Prime&Bond NT that was used alone, and so was AdheSE. Conclusion: Shear bond strengths were increased in Prime&Bond NT and AdheSE when these were used with activators comparing used without activators. But using activators was not effective clinically comparing One-Step.
We induced the activation of melanocytes in the epidermis of C57BL/6 mice by ultraviolet-B (UV-B) irradiation, and observed the effect of an herbal preparation (HemoHIM, HH) on the formation, and decrease of UV-B-induced epidermal melanocytes. C57BL/6 mice were irradiated by UV-B $80\;mJ{\cdot}cm^{-2}$ ($0.5\;mW{\cdot}sec^{-1}$) daily for 7 days, and HH was intraperitoneally, orally or topically applied pre- or post-irradiation. For the estimation of change of epidermal melanocytes, light microscopic observation with dihydroxyphenylalanine (DOPA) stain was performed. Split epidermal sheets prepared from the ear of untreated mice exhibited 13~15 melanocytes${\cdot}mm^{-2}$, and one week after UV irradiation, the applied areas showed an increased number of strongly DOPA-positive melanocytes with stout dendrites. But intraperitoneal, oral or topical treatment with HH before each irradiation interrupted UV-B-induced pigmentation and resulted in a marked reduction in the number of epidermal melanocytes as compared to the number found in UV-B-irradiated, untreated control skin. The number and size of DOPA-positive epidermal melanocytes were also significantly decreased in intraperitoneally injected or topically applicated group after irradiation with HH at 3rd and 6th weeks after irradiation. The present study suggests the HH as inhibitor of UV-B-induced pigmentation, and depigmenting agent.
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