• Structural Engineering and Mechanics
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• v.62 no.6
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• pp.725-737
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• 2017

An analytical method considering axial equilibrium is proposed for the short- and long-term analyses of shear lag effect in reinforced concrete (RC) box girders. The axial equilibrium of box girders is taken into account by using an additional generalized displacement, referred to as the longitudinal displacement of the web. Three independent shear lag functions are introduced to describe different shear lag intensities of the top, bottom, and cantilever plates. The time-dependent material properties of the concrete are simulated by the age-adjusted effective modulus method (AEMM), while the reinforcement is assumed to behave in a linear-elastic fashion. The differential equations are derived based on the longitudinal displacement of the web, the vertical displacement of the cross section, and the shear lag functions of the flanges. The time-dependent expressions of the generalized displacements are then deduced for box girders subjected to uniformly distributed loads. The accuracy of the proposed method is validated against the finite element results regarding the short- and long-term responses of a simply-supported RC box girder. Furthermore, creep analyses considering and neglecting shrinkage are performed to quantify the time effects on the long-term behavior of a continuous RC box girder. The results show that the proposed method can well evaluate both the short- and long-term behavior of box girders, and that concrete shrinkage has a considerable impact on the concrete stresses and internal forces, while concrete creep can remarkably affect the long-term deflections.

• Journal of Home Health Care Nursing
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• v.20 no.1
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• pp.16-23
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• 2013

Purpose: The purpose of this study was to analyze the relationship between cognitive function, self-esteem, and depression among patients in long-term care hospitals. Methods: The study participants were 159 patients from 2 long-term care hospitals in Kyungki province. Data were collected from January 2 to February 5, 2013, by conducting across-sectional descriptive survey using a structured questionnaire administered by researchers. Results: Cognitive function and depression were significantly different according to age, education level and marriage. Self-esteem was significantly different according to education level and economic status. Self-esteem was significantly positively correlated with cognitive function, which in contrast showed a significant negative correlation with depression. Among our subjects, those older than 80 years showed low cognitive function and those with low educational attainment showed high scores of depression. Conclusion: We conclude that, elderly patients in long-term care hospitals who have low educational attainment should be carefully monitored, especially by nurses, for cognitive function and depression. In addition, nurses should have constant communication with their patients. Moreover, long-term care hospitals should apply early detection of and a management system for cognitive impairment and depression among their patients.

• Research in Community and Public Health Nursing
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• v.29 no.4
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• pp.530-538
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• 2018

Purpose: This study tried to identify changes in family burden after the introduction of the long-term care insurance and to examine the factors influencing subjective and objective caring burden and depression of family caregivers of elders receiving home-based long-term care. Methods: Data were collected from 203 family caregivers of elders from August 1 to 31, 2015 using questionnaires. They were analyzed in descriptive statistics, t test, ANOVA test, and multiple regression analysis. Results: The mean score of depression was 7.24, which suggested mild depression level. The subjective family burden was 2.71 and the objective burden 3.04. The factors affecting depression included subjective burden (t=5.08, p<.001), objective burden (t=2.80, p=.006), time of elderly care per day (t=-3.61, p< .001), caregiving duration (t=3.33, p=.001), age (t=3.13, p=.002), family relationship (t=2.48, p=.014), and economic status (t=1.99, p=.047). Conclusion: The family burden was most important influencing factor on caregiver's depression. Therefore, services and supports to alleviate caregivers' burden in the home-based care should be added to long-term care.

• Journal of Korean Public Health Nursing
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• v.37 no.1
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• pp.97-110
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• 2023

Purpose: This study sought to determine the effect of the competence of nurses and their, work environment on the quality of nursing service in long-term care hospitals using the Donabedian model as a theoretical framework. Methods: This descriptive investigative study analyzed nursing competency, the work environment, and nursing service quality in a group of 182 nurses directly in charge of patient care at long-term care hospitals in special cities, metropolitan cities, and small and medium-size cities. The data were analyzed using IBM SPSS/WIN 27.0 version. Results: In long-term care hospitals, nurses' competence (r=.674, p<.001) and work environment (r=.444, p<.001) were correlated with quality of nursing service, and the nurses' competence was correlated with the work environment (r=.443, p<.001). The factors affecting the quality of nursing service in long-term care hospitals were competence, the work environment, and the age of nurses. Conclusion: In this study, both competence and the work environment of nurses were observed to be important factors in improving nursing service quality in long-term care hospitals. Therefore, efforts aimed at enhancing these factors are necessary to ensure the high quality of nursing service in these hospitals.

• Childhood Kidney Diseases
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• v.19 no.1
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• pp.31-38
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• 2015

Purpose: We evaluated the long-term results of endoscopic Deflux$^{(R)}$ injection for treating vesicoureteral reflux (VUR) in children. Methods: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux$^{(R)}$ injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. Results: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux$^{(R)}$ injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. Conclusion: Deflux$^{(R)}$ injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.129-135
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• 2015

Purpose: This study investigated the long-term clinical outcomes of patients with $p22^{phox}$-deficient chronic granulomatous disease (CGD) on Jeju Island and retrospectively evaluated the effects of interferon-gamma (IFN-${\gamma}$) prophylaxis. Methods: The medical records of 15 patients with CGD were retrospectively reviewed. The efficacy of IFN-${\gamma}$ prophylaxis was evaluated by comparing the frequency of severe infections before and after starting continuous prophylaxis with IFN-${\gamma}$. Results: At the time of the analysis, 14 patients were alive, with a median age of 14.3 years. The diagnosis of CGD was made at a median age of 2.4 years, and the median age at onset of severe infection was 0.3 years. Thirteen of the 15 patients had their first severe infection within the first year of life. The overall incidence of severe infection was 1.36 infections per patient-year; pneumonia, suppurative lymphadenitis, and skin and subcutaneous abscesses were the most common infections. Aspergillus species were the most frequently isolated microorganisms, present in 15.8% of isolates. IFN-${\gamma}$ did not significantly change the rate of severe infection. The survival rate for patients after 2 years of age was 93%; there was a prolonged survival plateau beyond the age of 2. Conclusion: Compared with cases of X-linked CGD reported in other studies, patients with CGD on Jeju Island did not show obviously different clinical manifestations, but they had a significantly higher survival rate. Further studies with a substantially longer period of observation, and with more patients under intensive surveillance are necessary to elucidate the prophylactic efficiency of IFN-${\gamma}$.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6557-6559
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• 2015

Background: Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population. Materials and Methods: A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study. Results: During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and-thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases. Conclusions: Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).

• Clinical and Experimental Pediatrics
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• v.63 no.6
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• pp.219-225
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• 2020

Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32⁺⁰ to 36⁺⁶ weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.75-80
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• 2007

Background: While restless legs syndrome (RLS) is a common disorder, many patients are still remained undiagnosed and clinical data on Asian RLS patients is still limited in amount. Thus, we aimed to describe the clinical spectrum of Korean patients with RLS. Methods: We assessed the clinical characteristics of 77 consecutive RLS patients (43 men, mean age $59.1{\pm}14.9years$; 34 women, mean age $59.3{\pm}14.7years$) followed up by us for at least one and a half years. Results: The mean age at onset of symptoms was $56.4{\pm}14.1$. Two patients (2.6%) developed RLS before the age of 20 years (early-onset RLS). In 44 patients (57.1%), no underlying cause of RLS was found (idiopathic RLS). Family history for RLS was positive only in two (4.5%) of the 44 idiopathic RLS patients. The mean age of patients with idiopathic RLS was $56.8{\pm}13.1$ and that of patients with symptomatic RLS was $60.9{\pm}14.3$. However, there was no statistically significant difference between two groups (p=0.196). All patients complained sensory and motor symptoms in legs, and additional patients (14.3%) also had symptoms in arms. Two significant complications of long-term treatment with dopaminergic agents, namely augmentation and rebound of symptoms, were only reported in two patients. No patient had been diagnosed as RLS before evaluated by us. Conclusions: Our study had some limitations because limited number of patients was enrolled during a fixed period of follow-up in single third referral hospital. However, our findings suggest there are differences in the clinical characteristics of RLS and long-term responses to dopaminergic agents between patients in Korea and western countries.

• Journal of Ginseng Research
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• v.19 no.1
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• pp.31-38
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• 1995

Antioxidant effect of Korean ginseng (Panax ginseng C.A. Meyer) was investigated in rats. Long-term administration of ginseng water extract protected the activity of liver cytosotic SOD, catalase and glutathione peroxidase from being significantly decreased with advancing age (p<0.05). It was more effective toward glutathione peroxidase than other antioxidant enzymes. However, the level of sulfhydryl compounds and its related enzymes such as glutathione reductase and glutathione-5-transferase was not significantly changed by the administration of ginseng. Liver microsomal formation of reactive oxygen species such as superoxide and hydrogen peroxide did not show a significant difference between two groups although it was slightly decreased with age, but lipid peroxidizability of microsomal membrane induced by a prooxidant was slightly lower in ginseng-treated rats. Interestingly, antioxidant capacity of plasma from ginseng treated rats on autooxidation of ok-brain homogenates was much higher than that of normal ones. However, resistance of RBC membrane against oxidative stress showed a similar tendency. The content of serum TBA reactive substances lowered consistently in the rats treated with r ginseng at all corresponding age and a significant difference between two groups was found at 24 months of age (p<0.05). Ginseng extract protected lipid peroxidation in brain and liver. This protection was more effective in the stressed rats imposed by immobilization than normal ones. In conclusion, ginseng water extract protected the age related deterioration of major antioxidant enzymes, and this effect was more striking with increasing duration of treatment. This comprehensive antioxidant action of ginseng seems to be bra certain action of ginseng other than a direct antioxidant action, which might be a long term normalizing effect through the harmony of various components.