• 한국노년학
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• v.25 no.2
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• pp.195-209
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• 2005

The purpose of this study was to identify the factors influencing file-up family stress in the caregivers of patients with dementia. Data was collected by questionnaires from 102 families with a member having a dementia, at neurology departments of hospitals, temporary shelter for dementia patient, and nursing homes for the elderly. The data was analyzed using descriptive statistics, pearson correlation coefficients, and multiple regression. In results, the score of file-up stress showed a significantly negative correlation with the score of level of family hardiness(r=-.200, p=.026), social support(r=-.361, p=.004), relative and friend support(r=-.416, p=.001), and F-COPES(r=-.345, p=.048). The multiple regression analysis revealed that the most powerful predictor of file-up family stress was family cost for patients with dementia. The results contribute to the understanding of Korean family caregivers' perceptions of caregiveing. Further researches should be conducted with the consideration of Korean traditional custom that family should take care of the elderly family members.

• 한국노년학
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• v.29 no.2
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• pp.425-440
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• 2009

The purpose of this study was to understand the ability of the elderly to activity of daily living, assess their quality of sleep and level of depression at home and analyze how such relate health related quality of life. The subject was 223 senior over 65 years old who lived in B Metropolitan City. Descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation and stepwise multiple regression were performed using SPSS WIN 14.0. The major findings of this study are as follow: 1) 34.1% of the respondents experienced a degree of sleep disorder and 57.8% were vulnerable to depression. 2) Activity of daily living, quality of sleep and depression were related to health related quality of life to a statistically significant degree. quality of sleep, activity of daily living positively related to health related quality of life. level of depression related to health related quality of life. Stepwise multiple regression analysis revealed the most powerful predictor of health related quality of life was depression. While age, level of education and quality of sleep were also found as significant predictor variables. Based on these results, it is necessary to perform more studies on health related quality of life and related factors according to that in various settings. Especially, to develop a program intended to improve the health related quality of life of the elderly at home, we need to consider not only physical factors but also psychological factors.

• Korean Journal of Exercise Nutrition
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• v.16 no.2
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• pp.65-71
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• 2012

Oxygen is the final acceptor of electron transport from fat and carbohydrate oxidation, which is the rate-limiting factor for cellular ATP production. Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate for the shortfall caused by reduced fatty acid oxidation [1]. Therefore, training at altitude is expected to strongly influence the human metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting diabetes or related metabolic problems. However, most people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness (AMS) and insulin resistance corresponding to a increased levels of the stress hormones cortisol and catecholamine [2]. Thus, less stringent conditions were evaluated to determine whether glucose tolerance and insulin sensitivity could be improved by moderate altitude exposure (below 4000 M). In 2003, we and another group in Austria reported that short-term moderate altitude exposure plus endurance-related physical activity significantly improves glucose tolerance (not fasting glucose) in humans [3,4], which is associated with the improvement in the whole-body insulin sensitivity [5]. With daily hiking at an altitude of approximately 4000 M, glucose tolerance can still be improved but fasting glucose was slightly elevated. Individuals vary widely in their response to altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity is not apparent in those individuals with low baseline DHEA-S concentration [6]. In addition, hematopoietic adaptation against altitude hypoxia can also be impaired in individuals with low DHEA-S. In short-lived mammals like rodents, the DHEA-S level is barely detectable since their adrenal cortex does not appear to produce this steroid [7]. In this model, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can still improve insulin sensitivity, secondary to an effective suppression of adiposity [8]. Genetically obese rats exhibit hyperinsulinemia (sign of insulin resistance) with up-regulated baseline levels of AMP-activated protein kinase and AS160 phosphorylation in skeletal muscle compared to lean rats. After prolonged hypoxia training, this abnormality can be reversed concomitant with an approximately 50% increase in GLUT4 protein expression. Additionally, prolonged moderate hypoxia training results in decreased diffusion distance of muscle fiber (reduced cross-sectional area) without affecting muscle weight. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on changing body composition. Conclusion: Prolonged moderate altitude hypoxia (rangingfrom 1700 to 2400 M), but not acute high attitude hypoxia (above 4000 M), can effectively improve insulin sensitivity and glucose tolerance for humans and antagonizes the obese phenotype in animals with a genetic defect. In humans, the magnitude of the improvementvaries widely and correlates with baseline plasma DHEA-S levels. Compared to training at sea-level, training at altitude effectively decreases fat mass in parallel with increased muscle mass. This change may be associated with increased perfusion of insulin and fuel towards skeletal muscle that favors muscle competing postprandial fuel in circulation against adipose tissues.

• Journal of The Geomorphological Association of Korea
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• v.27 no.1
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• pp.61-89
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• 2020

The objective of this study is to characterize landslide susceptibility depending on various geo-environmental variables as well as to compare the Frequency Ratio (FR) and Evidential Belief Function (EBF) methods for landslide susceptibility analysis of rainfall-induced landslides. In 2013, a total of 259 landslides occurred in Chuncheon, Gangwon Province, South Korea, due to heavy rainfall events with a total cumulative rainfall of 296~721mm in 106~231 hours duration. Landslides data were mapped with better accuracy using the geographic information system (ArcGIS 10.6 version) based on the historic landslide records in Chuncheon from the National Disaster Management System (NDMS), the 2013 landslide investigation report, orthographic images, and aerial photographs. Then the landslides were randomly split into a testing dataset (70%; 181 landslides) and validation dataset (30%; 78 landslides). First, geo-environmental variables were analyzed by using FR and EBF functions for the full data. The most significant factors related to landslides were altitude (100~200m), slope (15~25°), concave plan curvature, high SPI, young timber age, loose timber density, small timber diameter, artificial forests, coniferous forests, soil depth (50~100cm), very well-drained area, sandy loam soil and so on. Second, the landslide susceptibility index was calculated by using selected geo-environmental variables. The model fit and prediction performance were evaluated using the Receiver Operating Characteristic (ROC) curve and the Area Under Curve (AUC) methods. The AUC values of both model fit and prediction performance were 80.5% and 76.3% for FR and 76.6% and 74.9% for EBF respectively. However, the landslide susceptibility index, with classes of 'very high' and 'high', was detected by 73.1% of landslides in the EBF model rather than the FR model (66.7%). Therefore, the EBF can be a promising method for spatial prediction of landslide occurrence, while the FR is still a powerful method for the landslide susceptibility mapping.

• Food Science and Preservation
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• v.30 no.2
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• pp.311-320
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• 2023

Surfactin, one of the most powerful biosurfactants, can be widely applied in agriculture, food, and pharmaceutics. The purpose of the present study was to establish suitable indicators for a rapid detection method that can confirm the surfactin productivity of cheonggukjang. In the present study, changes in the total number of bacteria were quantified according to the fermentation time of chenggukjang. Furthermore, physicochemical factors, such as pH, color value, surface tension, refractive index, absorbance, and protein contents, were assessed in chenggukjang viscous substances, and a correlation analysis between the physicochemical factors and surfactin contents was performed. We found that the protein contents gradually increased up to 48 h (4.21±0.11 mg/mL) without a change in the surface tension. Furthermore, the refractive index, absorbance at 280 nm, and color value were significantly increased as the fermentation time increased; however, there were no statistically significant differences after 36 h of fermentation. Interestingly, this result exhibited a tendency similar to the surfactin content according to fermentation time. These findings suggest that surfactin can be used as a suitable quality indicator and may provide an experimental basis for the fermented food industry.

• IMMUNE NETWORK
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• v.22 no.5
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• pp.42.1-42.20
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• 2022

Vaccination with tumor peptide epitopes associated with MHC class I molecules is an attractive approach directed at inducing tumor-specific CTLs. However, challenges remain in improving the therapeutic efficacy of peptide epitope vaccines, including the low immunogenicity of peptide epitopes and insufficient stimulation of innate immune components in vivo. To overcome this, we aimed to develop and test an innovative strategy that elicits potent CTL responses against tumor epitopes. The essential feature of this strategy is vaccination using tumor epitope-loaded nanoparticles (NPs) in combination with polyinosinic-polycytidylic acid (poly-IC) and anti-PD1 mAb. Carboxylated NPs were prepared using poly(lactic-co-glycolic acid) and poly(ethylene/maleic anhydride), covalently conjugated with anti-H-2K^b mAbs, and then attached to H-2K^b molecules isolated from the tumor mass (H-2^b). Native peptides associated with the H-2K^b molecules of H-2K^b-attached NPs were exchanged with tumor peptide epitopes. Tumor peptide epitope-loaded NPs efficiently induced tumor-specific CTLs when used to immunize tumor-bearing mice as well as normal mice. This activity of the NPs significantly was increased when co-administered with poly-IC. Accordingly, the NPs exerted significant anti-tumor effects in mice implanted with EG7-OVA thymoma or B16-F10 melanoma, and the anti-tumor activity of the NPs was significantly increased when applied in combination with poly-IC. The most potent anti-tumor activity was observed when the NPs were co-administered with both poly-IC and anti-PD1 mAb. Immunization with tumor epitope-loaded NPs in combination with poly-IC and anti-PD1 mAb in tumor-bearing mice can be a powerful means to induce tumor-specific CTLs with therapeutic anti-tumor activity.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.431-451
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• 2000

In this paper, I will examine the variables influencing the Quality of Life of arthritis patients and present basic materials which help arthritis patients have positive thinking in life and ultimately lead a satisfactory life. The subjects for this study are 231 inpatients and outpatients with arthritis living in J and K city in Chonbug Province. For the analysis of collected data I employed the SAS program. The variables for characteristics and the quality of life were analysed by descriptive statistics, T-test and ANOVA, and the relations among variables were analysed through Pearson Correlation; the Regression method was employed to predict the factors affecting quality of life. For the validity of reliance on measuring equipment Cronbach Alpha was used. The results of the study are as follows : (1) The mean score of quality of life of arthritis patients is 3.09(5 in the maximum). The general characteristics which affect the quality of life are age(F=5.13, p=0.0006), standard of education(F=6.49, p=0.0003), marriage status(F=7.77, p=0.0005), monthly pay(F=4.37, p=0.0020), medical benefits (F=4.85, p=0.0087), and supports(F=4.39, p=0.0050). For the disease-related characteristics, there is a significant difference in the 6 items: pain control method(F=5.92, p= 0.0002), physical therapy(F=3.25, p=0.013), whethere or not patients exercise(F=4.62, p=0.0000), regularity of exercise(F=4.79, p=0.0000), frequency of exercise(F=6.29, p=0.0001), and amount of exercise(F=4.62, p=0.0043). Depending on the type of arthritis, there is also a significant difference in the degree of pain felt. The patients with infectious arthritis suffer from pain the most, followed by those with gout, rheumatism and degenerative arthritis, in that order. Although statistics don't show any convincing evidence, those with gout perceive that they are in best health condition, followed by those with rheumatism, degenerative arthritis, and infectious arthritis, in that order(F=2.23, p=0.0669). (2) The quality of life of arthritis patients is correlated positively with perceived health status(r=0.56, p=0.0001), health promoting behavior(r=0.53, p=0.0001), family support (r=0.46, p=0.0001), amount of exercise (r=0.36, p=0.0001), ADL(r=0.36, p=0.0001), HLOC(r=0.32, p=0.0001), frequency of exercise(r=0.32, p=0.0001)in that order, while correlated negatively with the degree of pain felt(r=-0.32, p=0.0001), the number of pain regions(r=-0.19, p= 0.0041), and the duration of pain(r=-0.14, p=0.0279). (3) Regression analysis reveals that the most powerful predictor of the quality of life is perceived health status, which account for 31.11%. The other predictors of the quality of life, which account for 60.22%, are health promoting behavior(16.51%), family support(3.81%), ADL(2.52%), gender(1.86%), the number of family members(1.36%), level of pain(1.24%), duration of pain (1.08%), and level of education(0.67%). The results of the study show that perceived health status and health promoting behavior are the two most important variables. However, considering that the perceived health condition is difficult to control by nursing intervention, it is suggested that the level of expectation for patients, must be decided first, and the health promoting behavior and the family support influencing the quality of life must be taken into account as targets for nursing intervention. As a way of controlling the quality of life, I think that a more comprehensive approach comprising the above important variables along with demographic and general characteristics is needed. I also suggest that we must continue to explore the variables affecting the quality of life and include those variables in nursing intervention.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.610-618
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• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Korean Journal of Cognitive Science
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• v.2 no.2
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• pp.405-428
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• 1990

Language has a social function to communicate information. Linguists have gradually paid their attention to the function of language since the nineteen sixties, especially to the relationship of form, meaning and the function. The relationship could be more clearly grasped through disciyrse-based analysis than through sentence-based analysis. Many researches were centered on the discourse functional notion of topic. In the early 1970's the subject was defined as the grammatiocalized topic the topic as a discrete single constituent of the clause. In the late 1970's several lingusts including Givon suggerted that the topic was not an atomic, disctete entity, and that the clause could have more than one topic. The purpose of the present study is, following Givon, to study grammatical coding devices of topic and to measure the relative topic continuity/discontinuity of participant argu, ents in Korean narratives. By so doing, I would like to shed some light on effective ways of communicating information. The grammatical coding devices analyzed are the following eight structures: zero-anaphora, personal pronous, demonstrative pronouns, names, noun phrases following demonstratives, noun phrases following possessives, definite noun phrases and indefinite referentials. The narrative studied for the count was taken from the KoreanCIA chief's Testiomny:Revolution and Idol by Hyung Wook Kim. It was chosen because it was assumed that Kim's purpose in the novel was to tell a true story, which would not distort the natural use of language for literary effect. The measures taken in the analysis wre those of 'lookback', 'persistence', ambiguity'. The first of these, 'lookback', is a measure of the size of gap between the previous occurrence of a referent and its current occurence in the clause. The meausure of persistence, which is a measure of the speaker's topocal intent, reflects the topic's importance in the discourse. The third measure is a measure of ambiguity. This is necessary for assessing the disruptive effects that other topics within five previous clauses may have on topic identification. The more other topics are present within five previous clauses, the more difficult is the task of correct identification of a topic. The results of the present study show that the humanness of entities is the most powerful factior in topic continutiy in narrative discourse. The semantic roles of human arguments in narrative discourse tend to be agents or experiences. Since agents and experiences have high topicality in discourse, human entities clearly become clausal or discoursal topics. The results also show that the grammatical devices signal varying degrees of topic continuity discontinuity in continuous discourse. The more continuous a topic argument is, the less it is coded. For example, personal pronouns have the most continutiy and indefinite referentials have the least continutiy. The study strongly shows that topic continuity discontinutiy is controlled not only by grammatical devices available in the language but by socio-cultural factors and writer's intentions.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.