PURPOSE: A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. MATERIALS AND METHODS: The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. RESULTS: The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. CONCLUSION: The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.
Aging ; Busan* ; Chronic Disease ; Humans ; Korea* ; Palliative Care* ; Pilot Projects ; Prevalence ; Public Health* ; Social Welfare

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin<10.5g/dL) and iron deficiency(serum ferritin<10ng/mL) were 5%(3/60), 11.7%(7/60) in 9-month-old healthy babies and 2.9%(2/70), 18.6%(18/70) in 15-month-old healthy babies, respectively. The incidence of hypercholesterolemia(serum cholesterol>200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.
Alkaline Phosphatase ; Calcium ; Cholesterol ; Diet ; Ferritins ; Hematocrit ; Hospitals, General ; Humans ; Incidence ; Infant ; Inpatients ; Iron ; Nutritional Status ; Phosphorus ; Prealbumin ; Reference Values* ; Weaning*

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin<10.5g/dL) and iron deficiency(serum ferritin<10ng/mL) were 5%(3/60), 11.7%(7/60) in 9-month-old healthy babies and 2.9%(2/70), 18.6%(18/70) in 15-month-old healthy babies, respectively. The incidence of hypercholesterolemia(serum cholesterol>200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.
Alkaline Phosphatase ; Calcium ; Cholesterol ; Diet ; Ferritins ; Hematocrit ; Hospitals, General ; Humans ; Incidence ; Infant ; Inpatients ; Iron ; Nutritional Status ; Phosphorus ; Prealbumin ; Reference Values* ; Weaning*

Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. METHOD: 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program. RESULTS: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breast-feeding and breast-feeding in the hospital after delivery (P<0.01). 2) The duration of breast-feeding was 5.2+/-4.4 months. It was significantly longer in the first successful breast-feeding (P<0.01). The earlier the first breast-feeding, the longer the breast-feeding duration (P<0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery (46.5%) and the rooming-in (57.4%) than in Cesarean section (37.1%) and the nursery (39.1%) (P<0.01). 4) The first time of breast-feeding was 64.8+/-62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery (P<0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education (P<0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk (37.1%), the physician' s recommendation (18.8%), the inverted nipple (12.1%), the baby's poor suckling power (10.5%) and thin breast-milk (7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work (25.1%), the convenience of formula-feeding (17.4%), the excellency of formula (10.0%) and maternal conveniency (6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying (38.7%) and poor sleeping with irritability (19.0%). The reasons to consider the breast milk thin were the loose stool (51.1%) and watery nature of breast milk (48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake (67.6%) instead of the frequent baby' s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis (11.1%), hepatitis B (4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby' s diseases such as jaundice (29.9%), loose stool (22.2%) and vomiting (2.8%) were inappropriate. CONCLUSIONS: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.
Breast Feeding ; Cesarean Section ; Crying ; Female ; Hepatitis B ; Hospitals, University ; Humans ; Jaundice ; Korea ; Logistic Models ; Mastitis ; Milk ; Milk, Human ; Mothers ; Nipples ; Nurseries ; Pregnancy ; Prenatal Education ; Return to Work ; Seoul ; Tuberculosis ; Vomiting

Epithelioid hemangioendothelioma (EH) is a rare borderline malignant tumor which originating from vascular endothelial cells and occurs in many organs such as soft tissues, lung, liver and bone. But, pulmonary EH which simultaneously involves pleura and liver is very rare. In the present report, we describe an uncommon case of EH involving the lung, pleura and liver in a 26-year-old woman. Chest CT showed single nodule in right upper lobe with large amount of pleural effusion at ipsilateral side and abdominal CT multiple round low densities in liver. The EH was confirmed by microscopic analysis and immunohistochemical staining of CD34+ from open lung biopsy specimen.
Adult ; Biopsy ; Endothelial Cells ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver* ; Lung* ; Pleura* ; Pleural Effusion ; Tomography, X-Ray Computed

OBJECTIVES: Glucagon-like peptide-1 (GLP-1) is an intestinally secreted hormone and it plays an important role in the regulation of glucose homeostasis. However, the possible role of GLP-1 in the differentiation of adipose-derived stem cells (ADSCs) remains unknown. Therefore this study investigated the effect of GLP-1 on the differentiation of ADSCs into osteoblasts and adipocytes. METHODS: ADSCs were isolated from human adipose tissues of the abdomens, cultured and characterized by flow cytometry and multi-lineage potential assay. ADSCs were induced in osteogenic and adipogenic media treated with two different doses (10 and 100 nM) of GLP-1, and then the effect of GLP-1 on differentiation of ADSCs into osteoblast and adipocyte was examined. The signaling pathway involved in these processes was also examined. RESULTS: Isolated human ADSCs expressed mesenchymal stem cell (MSC) specific markers as well as GLP-1 receptor (GLP-1R) proteins. They also showed multiple-lineage potential of MSC. GLP-1 was upregulated the activity and mRNA expression of osteoblast-specific marker, alkaline phosphatase and the mineralization of calcium. In contrast, GLP-1 significantly suppressed the expression of adipocyte-specific markers, peroxisome proliferator-activated receptor gamma (PPAR-gamma), lipoprotein lipase (LPL) and adipocyte protein 2 (AP2). This decreased expression of adipocyte specific markers caused by GLP-1 was significantly reversed by the treatment of extracellular signal-regulated kinase (ERK) inhibitor, PD98059 (P < 0.05). CONCLUSION: This result demonstrates that GLP-1 stimulates osteoblast differentiation in ADSCs, whereas it inhibits adipocyte differentiation. The ERK signaling pathway seems to be involved in these differentiation processes mediated by GLP-1.
Abdomen ; Adipocytes* ; Adipogenesis ; Adipose Tissue ; Alkaline Phosphatase ; Calcium ; Cell Differentiation ; Flow Cytometry ; Glucagon-Like Peptide 1* ; Glucose ; Homeostasis ; Humans ; Lipoprotein Lipase ; Mesenchymal Stromal Cells ; Osteoblasts* ; Osteogenesis ; Phosphotransferases ; PPAR gamma ; RNA, Messenger ; Stem Cells* ; Glucagon-Like Peptide-1 Receptor

No abstract available.
Lung ; Lymphocytes ; Sjogren's Syndrome

BACKGROUND: Celiprolol is a beta-adrenergic blocker characterized by selective blokade of beta1 receptors and partial agonist activity at beta2 receptors. This study was designed to evaluate the antihypertensive efficacy, metabolic effects and safety of celiprolol in patients with essential hypertension. METHODS: Celiprolol 200mg was administered once daily in 20 hypertensive Korean adults(9 males and 11 females) for ten weeks with dose titration every 2 weeks. RESULTS: The supine blood pressure was decreased from 168.8+/-20.6/106.5/12.0mmHg(mean/S.D) to 131.2+/-12.8/88.2+/-7.9mmHg at the end treatment(P<0.05). Heart rate was not changed significantly throughout the period. Total cholesterol(TC) was decreased from 211.3+/-12.6mg/dl to 186.7+/-10.4mg/dl(P<0.05) and triglyceride(TG) from 223.7+/-24.5mg/dl to 198.4+/-12.9mg/dl after 10 weeks treatment(P<0.05). LDL(low-density lipoprotein)-cholesterol was decreased from 126.4+/-13.4mg/dl to 118.5+/-12.3mg/dl after 10 weeks treatment(P<0.05). During the period of the study, headache and fatigue developed in a few patient but were not troublesome enough to stop medication. CONCLUSIONS: Celiprolol 200mg once daily regimen was well tolerated and effective in the treatment of essential hypertensiove patients with favorable effects on blood lipids.
Blood Pressure ; Celiprolol* ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension ; Male

Henoch-Schonlein purpura(anaphylactoid purpura) is a necrotizing vasculitis of small vessels in which systemic manifestation include palpable purpura on the lower extremities and buttocks due to leukocytoclastic vasculitis of dermal vessels; arthralgia of large joints, usually the knees and ankles; gastronitestinal involvement with colic and bleeding; and renal ievolvement, usually with a focal necrotizing glomerulonephritis. Gastrointestinal involvement occurs in about two thirds of all pediatric cases and in about,one third of adult cases, Any bowel segment may be involved, but the jejunum and ileum are most frequently affected. With a brief review of the literature, we report a case of H-S purpura involving stomach and duodenum.
Adult ; Ankle ; Arthralgia ; Buttocks ; Colic ; Duodenum ; Glomerulonephritis ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Joints ; Knee ; Lower Extremity ; Purpura* ; Stomach ; Upper Gastrointestinal Tract* ; Vasculitis

PURPOSE: This study aimed to evaluate the outcomes of a community-based palliative care project conducted in Busan city, Korea, from 2013 to 2015. METHODS: We selected four outcome indices based on the project's outcomes derived from a logic model and used a longitudinal and cross-sectional comparative design approach depending on the outcome index. RESULTS: The utilization rate of palliative care increased from 9.2% in 2012 to 41.9% in 2015. Regarding symptom changes in 65 patients receiving palliative care at 3 and 6 months (mean age = 72 years, standard deviation = 9.64, 55.4% women), pain, anxiety, and depression had improved. Quality of life was higher among palliative care patients compared with patients who did not receive palliative care (t = 2.09, p = .039). Regarding recognition of palliative care, civil servants at public health centers who participated in the pilot project (2013–2014) scored higher than those at public health centers who began participation in 2015 (t = 2.67, p = .008). CONCLUSION: This is the first study in Korea that systematically evaluated community-based palliative care. The Busan Community-based Palliative Care Project improved the quality of life of palliative care patients by providing services at an appropriate level and by raising the recognition of palliative care in the community. To increase the utilization ratio of palliative care and the quality of service, strategies should be developed to supplement medical support systems.
Anxiety ; Busan* ; Depression ; Humans ; Korea* ; Logic ; Palliative Care* ; Pilot Projects ; Public Health ; Quality of Life