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Time Series Analysis on Outcomes of Tuberculosis Control and Prevention Program between Small Areas in Korea - with Patient Registry Data of 234 City.County.District Public Health Centers - (소규모 지역간 결핵관리사업 성과에 대한 시계열분석 - 전국 234개 시.군.구 보건소의 환자등록자료를 중심으로 -)

  • Kim, Chun-Bae;Choe, Heon;Shin, Kye-Chul;Park, Jong-Ku;Ham, Soo-Keun;Kim, Eun-Mi
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.837-852
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    • 2000
  • Backgrounds : Today, tuberculosis cannot only be cured medically, but also controlled by public health. Despite the overall worldwide decline in tuberculosis, the disease continues to be a significant problem among developing countries and in the slums of large cities in some industrialized countries. Particularly, this communicable disease has come into the public health spotlight because of its resurgence in the 1990's. our country has been operating the Korean National Tuberculosis Control Program since 1962, focusing around public health centers. Therefore, this study aims to compare the effectiveness of tuberculosis control activities, one of the major public health activities in Korea, by producing indexes, such as the yearly registration rate per 100,000 population and treatment compliance of tuberculosis on in small areas (communities). Methods : This work was accomplished by constructing a time-series analytic model using data from "1980~2000: the Yearly Statistical Report" with patient registry data of 234 City. County. District public health centers and by identifying the factors influencing the tuberculosis indexes. Results : The trends of pulmonary tuberculosis positive point prevalence and pulmonary tuberculosis negative point prevalence on X-ray screening have declined steadily, beginning in 1981 and continuing to 1998 by region (city, county, district). Although the tuberculosis mortality rate steadily shows a declining trend by year and region, but Korea still ranks first among 29 OECD countries in 1998, with a tuberculosis mortality rate of 7.1 per 100,000 persons, according to the time-series analysis for fatal diseases. Conclusion : The results of the study will form the fundamental basis of future regional health care planning and the Korean Tuberculosis Surveillance System on 2000. Since the implementation of local autonomy through the Local Health Act of 1995, it has now become vita1 for each city, county, district public health centers to determine its own priorities for relevant health care management, including budget allocation and program goals.

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The Priming Effect of IFN-$\gamma$ and Numbers of IFN-$\gamma$ Receptors in Patients with Chronic Refractory Tuberculosis (난치성 결핵 환자의 단핵구에서 IFN-$\gamma$ 활성화 효과 및 IFN-$\gamma$ 수용체의 숫적 변화에 대한 연구)

  • Lee, Jae-Cheol;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.304-310
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    • 1999
  • Background: IFN-$\gamma$ plays an important role in host response to intracellular organisms such as mycobacterium. Human infection with mycobacterium leads to a wide variety of outcomes, ranging from asymptomatic infection to widespread and rapidly fatal disease. Recent reports suggest that alteration of the function of IFN-$\gamma$ caused by a defective IFN-$\gamma$ receptor gene can explain different host response to mycobacterium. In this study, we investigated the role of IFN-$\gamma$ in the development of chronic refractory tuberculosis. Methods: The LPS-induced TNF-$\alpha$ production with or without IFN-$\gamma$ priming was compared by using monocytes taken from recently diagnosed tuberculosis, chronic refractory tuberculosis patients and controls. And the IFN-$\gamma$ receptor was measured by indirect fluorescent antibody technique to know whether change in the priming effect of IFN-$\gamma$ is related to IFN-$\gamma$ receptor deficiency or not. Results: The ratio of TNF-$\alpha$ produced in response to stimulation with INF-$\gamma$ and LPS to LPS alone was $13.5{\pm}7.6$ in controls, $10.8{\pm}6.4$ in recently diagnosed tuberculosis patients and $6.7{\pm}3.9$ in chronic refractory tuberculosis patients. The priming effect of IFN-$\gamma$ significantly decreased in chronic refractory tuberculosis patients compared with that in controls(p=0.002). However, IFN-$\gamma$ receptor deficiency was detected in one of chronic refractory tuberculosis patients. Conclusion: The decrease of the priming effect of IFN-$\gamma$ may play an important role in the development of chronic refractory tuberculosis, and in some patients, this may be related to the IFN-$\gamma$ receptor deficiency.

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Study for Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Diseases (폐 비결핵향산균종의 임상적 특징에 관한 연구)

  • Pae, H.H.;Lee, J.H.;Yoo, C.G.;Lee, C.T.;Chung, H.S.;Kim, Y.W.;Shim, Y.S.;Han, S.K.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.735-746
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    • 1999
  • Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

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The Prognostic Value of Fibroblastic Foci Quantity in Patients with Usual Interstitial Pneumonia (UIP 환자에서 측정된 Fibroblastic Foci량이 예후에 미치는 영향)

  • Park, Sung-Woo;Lee, Young-Mok;Lee, June-Hyeuk;Kim, Ki-Up;Kim, Do-Jin;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Kim, Hyun-Jo;Youm, Wook
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.540-549
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    • 2001
  • Background : Usual interstitial pneumonia (UIP) is a progressive fibrous lung disease with occasional fatal outcomes. However, the extent and rate of progression varies markedly from one patient to another. As a result, it is difficult to determine the time of the initial treatment and assess the disease activity and course. Fibroblast foci (FF) is well known to synthesize collagen actively by their myofibroblasts component. However, the prognostic value of the FF have not been evaluated in patients with VIP. Therefore this study was undertaken to determine how the number of fibroblastic foci can reflect the disease activity and progression. Methods: Twenty patients with UIP(M : F=13 : 7), who were diagnosed by a surgical lung biopsy. The number of fibroblastic foci was analyzed in terms of its correlation with the clinical manifostations, pulmonary function test, arterial blood gas analysis, and a bronchoalveolar lavage(BAL). Results : The number of fibroblastic foci did not correlate with the various lung function tests and the other clinical parameters. Interestingly, the percentage of neutrophils in the bronchoalveolar lavage fluid did correlate with the quantity of the normalized Vv of FF(r=0.60, p<0.05). The patients were divided into 2 groups, group I and II, arbitrarily, according to the value of the normalized Vv. The clinical parameters and the PIT results were not different between the two groups. In particular, the survival rate between the two groups according to the Kaplan-Meier analysis were not different. Conclusion : A large number of FF does not imply a bad prognosis in patients with UIP.

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Clinical Features of Tracheobronchial Foreign Bodies in Adults according to the Risk of Aspiration (기도 흡인 위험도에 따른 성인의 기도 내 이물의 임상적 특징)

  • Kim, Yee Hyung;Choi, Cheon Woong;Choi, Hye Sook;Park, Myung Jae;Kang, Hong Mo;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.356-361
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    • 2008
  • Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.

Study on Climate Change Impacts on Hydrological Response using a SWAT model in the Xe Bang Fai River Basin, Lao People's Democratic Republic (기후변화에 따른 라오스인민공화국의 시방파이 유역의 수문현상 예측에 대한 연구: SWAT 모델을 이용하여)

  • Phomsouvanh, Virasith;Phetpaseuth, Vannaphone;Park, Soo Jin
    • Journal of the Korean Geographical Society
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    • v.51 no.6
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    • pp.779-797
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    • 2016
  • A calibrated hydrological model is a useful tool for quantifying the impacts of the climate variations and land use/land cover changes on sediment load, water quality and runoff. In the rainy season each year, the Xe Bang Fai river basin is provisionally flooded because of typhoons, the frequency and intensity of which are sensitive to ongoing climate change. Severe heavy rainfall has continuously occurred in this basin area, often causing severe floods at downstream of the Xe Bang Fai river basin. The main purpose of this study is to investigate the climate change impact on river discharge using a Soil and Water Assessment Tool (SWAT) model based on future climate change scenarios. In this study, the simulation of hydrological river discharge is used by SWAT model, covering a total area of $10,064km^2$ in the central part of country. The hydrological model (baseline) is calibrated and validated for two periods: 2001-2005 and 2006-2010, respectively. The monthly simulation outcomes during the calibration and validation model are good results with $R^2$ > 0.9 and ENS > 0.9. Because of ongoing climate change, three climate models (IPSL CM5A-MR 2030, GISS E2-R-CC 2030 and GFDL CM3 2030) indicate that the rainfall in this area is likely to increase up to 10% during the summer monsoon season in the near future, year 2030. As a result of these precipitation increases, the SWAT model predicts rainy season (Jul-Aug-Sep) river discharge at the Xebangfai@bridge station will be about $800m^3/s$ larger than the present. This calibrated model is expected to contribute for preventing flood disaster risk and sustainable development of Laos

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Development of Teaching-Learning Plans Applying ARCS Motivation Strategies for Food Safety Education (ARCS 동기유발 전략을 적용한 식품 안전 교육 교수·학습 과정안 개발)

  • Kim, Yewon;Yu, Nan Sook;Lee, Gyeongsuk
    • Journal of Korean Home Economics Education Association
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    • v.31 no.3
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    • pp.135-153
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    • 2019
  • The purpose of this study was to develop teaching-learning plans applying ARCS strategies for food safety education, focusing on units related to the 'food selection and safe cooking'. To achieve this purpose, this study was conducted in the following order of analysis, design, development, assessment I, revision I, assessment II, revision II, and completion. In the analysis stage, 2015 revised curriculum and middle school technology-home economics textbooks(12 kinds) contents of 'food selection and safe cooking' among content elements of core concept 'safety' were analyzed. In the design and development stages, teaching-learning plans, teaching-learning materials, and evaluation rubric for teaching-learning outcomes using the ARCS motivation strategy were developed. In the phases of assessment I and revision I, evaluation items were selected as open-ended questions about food safety education factors and ARCS strategies, and their validities were verified by four experts. The teaching-learning plans for nine lessons were revised based on the feedbacks such as evaluation plans considering the correspondence between instruction and evaluation, strategy to reinforce intrinsic motivation, correction of improper contents composition, and so on. In the phases of assessment II and revision II, the validity of the three items, including relevance of each teaching-learning to food safety education, suitability of learning goals, and appropriateness of motivation strategy, was verified by seven experts. The final teaching-learning plans for 10 lessons were developed by revising and supplementing the data by compiling opinions of the assessment II. It is expected that this study can contribute to food safety education for middle school students, and that teaching-learning plans which apply ARCS strategies for food safety education will be used as good references for school teachers and curriculum developers.

The Correlations between Renminbi Fluctuations and Financial Results of Venture Companies in the Floating Exchange Rate (변동환율제도하의 위안화 환율변동과 벤처기업의 재무성과 간 상관관계 연구)

  • Sun, Zhong Yuan;Chang, Seog-Ju;Na, Seung-Hwa
    • 한국벤처창업학회:학술대회논문집
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    • 2010.08a
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    • pp.139-160
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    • 2010
  • On July 21st in 2005, People's Bank of China (PBOC) turned the currency peg against the U.S. dollar into managed currency system based on a basket of unnamed currencies under China's exchanged rate regime. This change means that China's enterprises are not free from currency fluctuations. The purpose of this study is to analyze the relations between Renminbi fluctuations in the floating exchange rate and financial results of venture companies. The process and outcomes of this study are as follows, First, in order to measure the financial results of venture companies, I choose venture companies in Shandong Province listed on the Shanghai Stock Exchange (SSE) at random and several quarter financial sheets according to safety ratios, profitability ratios, growth ratios, activity ratios. Second, I arrange the daily Renminbi exchange rate data announced from July 21st, 2005 to December 31st, 2008 by PBOC into the quarterly data. Third, in order to confirm the relations between Renminbi fluctuations and financial results of venture companies, I carry out Pearson's correlation analysis. As a result, the revaluation of the Chinese Renminbi has weakly negative effects on debt ratio, total assets turnover ratio and equity turnover ratio in statistics. But the revaluation of the Chinese Renminbi is not related to other financial index in statistics. The result of this study is that the revaluation of the Chinese Renminbi has little influence on the export and import of Chinese venture companies and certifies the fact that Chinese venture companies have much foreign currency assets. In addition to avoid the currency exposure risk, this study shows the effective method about currency exposure risk which adjusts proportion of Renminbi to foreign currency.

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Dosimetric Advantages of the Field-in-field Plan Compared with the Tangential Wedged Beams Plan for Whole-breast Irradiation (유방암 환자의 방사선치료에 있어서 순치료계획 세기변조방사선치료법과 쐐기접선조사기법의 선량측정 비교)

  • Kim, Suzy;Choi, Yunseok
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.199-204
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    • 2014
  • The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

Efficacy and Safety of Red Ginseng on Women's Health Related Quality of Life and Sexual Function (여성의 건강관련 삶의 질과 성기능에 대한 홍삼의 효과 및 안전성 연구)

  • Kim, Dong-II;Choi, Min-Sun;Alm, Hong-Yeop
    • Journal of Ginseng Research
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    • v.33 no.2
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    • pp.115-126
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    • 2009
  • To evaluate the efficacy and safety of red ginseng on women's health-related quality of life (QOL) and sexual function. A randomized, double-blind, placebo-controlled, crossover clinical study was performed. The main efficacy was measured using the Female Sexual Function Index (FSFl) and the 36-Item Short-Form Health Survey (SF-36). Twenty-four healthy, married women aged 30-45 years with FSFl scores below 25 were randomly divided into two groups: the red-ginseng group (N=12) and the placebo group (N=12). During the first six-week period (Study 1), each group was given red ginseng or placebo twice a day. Before the start of the second six-week period (Study 2), a crossover design was chosen with a two-week break (washout period). Interchanging the two groups after the washout period, red ginseng and placebo were given to each group. The outcomes were measured before and after each six-week period. Overall, 23 participants completed the study. In Study 1, the changes relative to the baseline in the FSFl total score were 22.50% and 22.99% for red ginseng and placebo, respectively. In Study 2, the relative changes were 8.14% for red ginseng and 6.29% for placebo. The results showed a greater improving trend in Study 1 with respect to all of the participants' sexual functions, but no significant difference was found between the groups (P=0.9567). After taking red ginseng, all the participants exhibited an improving trend in the desire domain of FSFl, but no significant difference was shown. In the measurement of SF-36, no significant difference was likewise shown. After taking red ginseng, though, all the participants exhibited an improving trend in the physical functioning (PF) domain of SF-36, with no significant difference. Moreover, there was no significant adverse event related to red ginseng. The QOL and sexual function of the study participants in the red-ginseng group were mostly improved, but no statistically significant effect of red ginseng was shown. It is supposed that this result was partly due to the affirmative impression of red ginseng in Korea. Thus, it is anticipated that a long-term clinical trial will show a significant effect of red ginseng on the QOL and sexual function.