• Journal of Preventive Medicine and Public Health
• /
• 제9권1호
• /
• pp.109-116
• /
• 1976

Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamenta, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Wha County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5%), Skin (12.7%) , diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and. all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test or X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case, The Total average cost per visit was 870.

• The Korean Journal of Physiology
• /
• 제29권1호
• /
• pp.13-27
• /
• 1995

single $K^{+}$ channels of skeletal muscle from the rat and frog were into planar lipid bilayers and their properties were studied. Fusion was induced by an osmotic gradient. Of the four types of $K^{+}$ channels recorded, the two most frequently observed were a voltage and $Ca^{2+}-activated$ $K^{+}$ channel and a $K^{+}$ channel with a prominent conductance substate. The first $K^{+}$ channel was identified as the large $Ca^{2+}-activated$ $K^{+}$ (BK) channel because the open-state probability was increased with depolarization (e-fold change per $10.6{\pm}3.5$ mV, n=8) and internal $Ca^{2+}$ (half-activation at $16.7{\pm}3.8$ mV, n=8, pCa 4) and its conductance was large ($247{\pm}4.9$ pS, n=24 in 0.1 M KCI). Lifetime distributions of open- and closed-states could be fitted with single exponentials of several milliseconds. The mean open- and closed-lifetimes were linearly dependent on the intracellular $[Ca^{2+}]$ and $1/[Ca^{2+}]$, respectively. The second $K^{+}$ channel showed a conductance substate at $30{\sim}60%$ of the open state. Its current-voltage relation was linear in the range of $-80\;{\sim}\;+80\;mV$. The slope conductance of the substate and open-state were 40 and 144 pS in 0.2 M KCl, respectively. The channel was highly selective for $K^{+}$ over Cl. The open-state probability was weakly voltage-dependent (e-fold change per 35 mV. The lifetime distributions of open- and closed-states were fitted with two exponentials and the major gating occurred slowly at several hundred milliseconds. Based on the above results, we think the second type of $K^{+}$ channel is the sarcoplasmic reticulum $K^{+}$ (SRK) channel. In addition, both types of channel were also incorporated into the lipids extracted from the skeletal muscle. The channel properties recorded in the bilayers termed from synthetic and extracted lipids were qualitatively similar. Our data indicate that BK and SRK channels are rich in the skeletal muscle and their properties and regulation could be effectively studied in planar lipid bilayer.

• 한국병원경영학회지
• /
• 제21권2호
• /
• pp.13-23
• /
• 2016

Purpose: The purpose of this study is to compare the user satisfaction between 4-bedrooms and 5/6-bedrooms in a single general hospital. Methodology: To measure and compare multiple-bed ward user satisfaction between 4-bedrooms and 5/6-bedrooms, questionnaires were collected from 916 inpatients and 129 nurses in a single general hospital. The patient satisfaction questionnaire categories included environmental conditions, protection of privacy, and medical services. The nurse satisfaction questionnaire categories included space, infection control, patient safety, work load and psychologic view point. Findings: Satisfaction of patient who admitted in 4-bedroom to the environmental conditions and protection of privacy was higher than that of 5/6-bedroom group (3.91 vs. 3.25, p<0.001). Satisfaction of nurse who worked in 4-bedroom was higher than that of 5/6-bedroom (3.05 vs. 1.92, p<0.001). By the multiple linear regression analysis, patient satisfaction to the environmental conditions and protection of privacy was related with multi-bedroom type and location of beds; 4-bedrooms were higher than 5/6-bedrooms(p<0.001), window side bed were higher than hallway side bed(p=0.001). There was no satisfaction difference in comparing medical services between the two groups. By the multiple linear mixed regression analysis, nurse satisfaction who were assigned for 4-bedrooms were higher than that of 5/6-bedrooms in all categories(p<0.001). Practical Implications: Even though no difference has shown in medical services satisfaction between the two patient groups, multi-bedroom type may affect patient satisfaction in environmental condition, protection of privacy and may also affect overall nurse satisfaction. This result suggests that to improve multi-bedroom user satisfaction, 4-bedroom is recommended over 5/6-bedroom.

• Tuberculosis and Respiratory Diseases
• /
• 제70권4호
• /
• pp.347-351
• /
• 2011

We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.

• Tuberculosis and Respiratory Diseases
• /
• 제70권4호
• /
• pp.301-306
• /
• 2011

Background: It is well-known that cell-free nucleic acids rise in patients with many types of malignancies. Several recent experimental studies using cancer cell lines have shown that changes in cell-free RNA are predictive of the response to chemotherapy. The objective of this study was to determine whether quantification of free RNA can be used as a biomarker for clinical responses to chemotherapy in patients with lung cancer. Methods: Thirty-two patients with lung cancer (non-small cell lung cancer, n=24; small cell lung cancer, n=8) were divided into 2 groups according to their responses to chemotherapy (response group, n=19; non-response group, n=13). Blood samples were collected before and after two cycles of chemotherapy. Real-time quantitative RT-PCR was used for transcript quantification of the glyceraldehyde-3-phosphate dehydrogenase gene. Results: The pre chemotherapy values (Response group $41.36{\pm}1.72$ vs. Non-response group $41.33{\pm}1.54$, p=0.78) and post chemotherapy values (Response group $39.92{\pm}1.81$ vs. Non-response group $40.41{\pm}1.47$, p=0.40) for cell free RNA concentrations, expressed as Ct GAPDH (threshold cycle glyceraldehyde-3-phosphate dehydrogenase gene) levels, was not different between the two groups. There was no significant relationship between changes in the cell free RNA level clinical responses after chemotherapy (p=0.43). Conclusion: We did not find a correlation between quantification of serum cell free RNA levels and clinical responses to chemotherapy in patients with lung cancer. Further investigations are needed to determine whether the cell free RNA level is a useful predictor of responses to chemotherapy in patients with lung cancer.

• Tuberculosis and Respiratory Diseases
• /
• 제76권2호
• /
• pp.75-79
• /
• 2014

Trichloroethylene (TCE) is a toxic chemical commonly used as a degreasing agent, and it is usually found in a colorless or blue liquid form. TCE has a sweet, chloroform-like odor, and this volatile chlorinated organic chemical can cause toxic hepatitis, neurophysiological disorders, skin disorders, and hypersensitivity syndromes. However, the hypersensitivity pneumonitis (HP) attributed to TCE has rarely been reported. We hereby describe a case of HP associated with TCE in a 29-year-old man who was employed as a lead welder at a computer repair center. He was installing the capacitors on computer chip boards and had been wiped down with TCE. He was admitted to our hospital with complaints of dry coughs, night sweats, and weight losses for the past two months. HP due to TCE exposure was being suspected due to his occupational history, and the results of a video-associated thoracoscopic biopsy confirmed the suspicions. Symptoms have resolved after the steroid pulse therapy and his occupational change. TCE should be taken into consideration as a potential trigger of HP. Early recognition and avoidance of the TCE exposure in the future is important for the treatment of TCE induced HP.

• Preventive Nutrition and Food Science
• /
• 제8권1호
• /
• pp.24-28
• /
• 2003

There is evidence to suggest that cranberry juice supplements improve the health of the urinary tract by inhibiting the binding of fimbriated uropathogenic E. coli to the bladder mucosa. In patients with neurogenic bladders, urinary tract infections (UTI) are particularly common and often poorly managed by antibiotic treatment. A double-blind, randomized, placebo-controlled trial was undertaken on 29 geriatric and spinal cord injured patients with dysfunctional bladders. They received three times daily at mealtimes a 4 oz bottle of cranberry juice (Ocean Spray Cranberries, USA) or a specially prepared synthetic placebo drink. Two episodes of UTI arose in week one of cranberry intake and none thereafter, compared to four episodes of UTI in 4 placebo patients in weeks four, six and 10. Mean bacterial adhesion counts on bladder cells of the patients rose during the first month of treatment in 71 % of the placebo patients compared to only 31 % of cranberry patients (p < 0.001). The difference persisted to some extent for the second and third months. Bacterial adhesion levels correlated with culture findings (higher adhesion and higher viable counts in urine) (p < 0.001), positive leukocyte nitrite tests (136$\pm$131 bacteria per cell versus 52$\pm$86 in negative tests) (p < 0.001), and higher white blood cell counts (> 10) per high power field (126$\pm$125 versus 48$\pm$85 bacteria per cell) (p<0.001). E. coli was the most frequently isolated organism (40% samples) followed by K. pneumoniae (17%) and a number of other uropathogens. Group B Streptococci, and coagulase negative Staphylococcus were recovered from urine in 4 samples but were not associated with any red blood cell presence. The daily intake of cranberry juice, in amounts which are not detrimental to long term compliance, appeared to have a role in reducing the risk of bladder colonization and infection in a highly susceptible patient population.

• Journal of Gastric Cancer
• /
• 제12권2호
• /
• pp.81-87
• /
• 2012

Purpose: The aim of the present study was to assess the association between the pre-operative plasma fibrinogen level and the adjacent organ involvement in advanced gastric cancer. Materials and Methods: A total of 923 pre-operative plasma samples were obtained from 923 patients diagnosed clinically as having advanced gastric cancer, and fibrinogen levels were measured by immunoassay. Associations between fibrinogen levels and clinicopathologic findings (depth of tumor, adjacent organ involvement, and lymph node metastasis), along with survival were examined by univariate and multivariate analyses. Results: Tumor size, tumor depth, and the presence of lymph node metastasis were found to be positively correlated with the preoperative plasma fibrinogen levels (P<0.001). Fifty (5.4%) patients had adjacent organ involvement. Lymphatic invasion (P<0.001), tumor size (P<0.001), clinical T (depth of invasion) stage (P<0.001), and clinical nodal stage (P=0.018) were found to be associated with adjacent organ involvement. Univariate and multivariate regression analyses showed that a preoperatively elevated plasma fibrinogen level was associated with adjacent organ involvement (P<0.001, 0.028), and Kaplan-Meier analysis showed that it was associated with poorer survival (P<0.001). Conclusions: Plasma fibrinogen was found to be a clinically useful marker of adjacent organ involvement and overall survival. When a high fibrinogen level is encountered, preoperatively, adjacent organ involvement should be suspected in clinically advanced gastric cancer.

• 대한의용생체공학회:의공학회지
• /
• 제21권3호
• /
• pp.311-320
• /
• 2000

본 연구에서는 새롭게 설계한 인공폐 모듈을 사용하여 인공폐의 효율을 평가하기 위한 압력손실과 산소전달에 대한 실험을 수행하였다. 또한 증류수, 아황산나트륨용액을 혈액대용물질로 사용하여 다른 인공폐의 성능을 평가하였다. 혈액대용물질은 압력손실과 산소운반력을 연구하는데 전혈(whole blood)에 비해 장점이 많다 즉. 이들은 상대적으로 값이 저렴하고 조절하여야 할 변수가 적다. 또한 이 용액을 사용하게 되면 탈산화장치가 필요 없으며 실험결과의 분석이 상대적으로 쉽다. 전혈과 같은 산소분압을 갖는 아황산나트륨용액을 사용하는 경우 아황산나트륨 용액의 산소전달속도는 전혈을 사용하는 경우의 산소전달속도와 거의 일치하였다. 이 실험에서 중공사모듈의 산소전달속도를 측정하는데 아황산나트륨용액이 혈액대용물질로 이용될 수 있음을 보였다. 이 인공폐 모듈에서는 용액이 중공사의 바깥쪽으로 흐르도록 설계하였는데 이 실험용 인공폐는 압력손실이 안쪽으로 흐르도록 하는 흐름에 비해 $1/3\~1/6$였다.

• 대한의용생체공학회:의공학회지
• /
• 제21권3호
• /
• pp.273-277
• /
• 2000

순 티타늄(공업용 순 티타늄, 2급)의 0.5M에서 0.7M 농도의 $H_3PO_4$ 용액에서 $0.3\~l.0 A/dm^2$의 정전류 밀도변화에 따른 anodizing 거동을 관찰하였다. 이때 형성된 산화피막을 SEM과 XRD로 관찰, 분석하였다. 실험결과 0.05M $H_3PO_4$ 용액의 조건에서 전압-시간 (V-T)곡선의 초기에는 직선적인 관계를 보였고, 전류밀도가 증가함에 따라 포물선의 형태를 나타내었다. 그리고 V-T곡선의 형태는 전해질의 농도의 증가에 따라 큰 변화가 없었지만, 최종적인 전압은 감소하였다. 티타늄의 산화피막은 전해질 농도와 전류밀도가 증가할수록 미세한 입자 형태에서 눈꽃과 같고 층을 이룬 입자들로 구성된 구조를 나타내었다. 산화막과 전해질의 계면에서의 방전에 의해 산화피막의 국소적인 침착과 용해를 동반하였다. 산화피막의 결정성은 anodizing 전압이 증가할수록 증가하였고 전해질의 농도가 증가할수록 감소하는 경향을 보였다.