• Title/Summary/Keyword: 대체 요법

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The analysis of stress reactions ana coping patterns of cancer patients who perceived stress by radiotherapy. (방사선요법을 받는 암환자의 스트레스 지각에 따른 반응과 대체유형의 분석)

  • BANG DONG WAN;KIM JIN SU;PARK GIL YONG;SON MI SUK
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.1-13
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    • 2001
  • I. Purpose This study is performed to encourage cancer patients to identify, relieve and effectively overcome the stress caused by radiotherapy, by analyzing stress reactions and coping patterns of cancer patients who perceived stress due to radiotherapy. II. Materials & Methods The study group was composed of 85 cancer patients of the age 20 or higher who were undergoing radiotherapy in four hospitals located in Seoul and Kyonggi-do. The survey questionnaire was used, which had 161 questions inquiring respondents of general status, perceived stress, stress reactions and coping patterns. The surveyed data were analyzed by a SAS program, which employed descriptive statistics. Pearson Correlation Coefficient, t-test, ANOVA and Stepwised Multiple Regression. III. Results The stress perception and reaction rates were low in cancer patients comparing to patients of the other study. In the coping patterns. the problem-focused coping patterns were significantly higher than emotion-focused coping patterns. The statistically meaningful differences were observed in the stress perception and reactions depending on the time of diagnosis and perceived health level. As for the problem-focused coping patterns, significant differences were found depending on age, marital status, education, income and the number of family members as well as perceived health level of patients. The level of perceived stress and that of stress reactions was found to have positively significant correlation(r=.764, p<.001) while the perceived stress and the problem-focused coping patterns was correlated negatively (r=-.288, p<.01). The stress reactions and the problem-focused coping patterns was found to have negatively significant correlation(r=-.289, p<.01). IV. Conclusion The problem-focused coping behavior, which cooperated with doctors, technologists, nurses and families of cancer patients, is advisable for the cancer patients to overcome uncertainty and uneasiness by effectively release the stress.

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Utilization and Out-of-pocket Expenditure of Complementary and Alternative Medicine in Low-income Patients with Osteoarthritis in a City (일개 시지역 저소득 골관절염 환자의 보완대체요법 이용실태 및 비용 -의료급여 및 건강보험하위 20% 대상자를 중심으로-)

  • Kam, Sin;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.33 no.2
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    • pp.181-192
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    • 2008
  • Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.

A patient with stress induced cardiomyopathy that occurred after cessation of hormone replacement therapy for panhypopituitarism (범뇌하수체저하증의 호르몬 대체요법 중단 후 발생한 스트레스 심근병증)

  • Nam, Seoung Wan;Lee, Jun-Won;Sim, Jeong Han;Pack, Hyun Sung;Im, Changjo;Lim, Jung Soo;Ahn, Sung Gyun
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.125-129
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    • 2016
  • Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.

Directed Differentiation of Pancreatic Islets from Human Embryonic Stem Cells and Cell Therapy of Diabetes Mellitus (인간배아줄기세포를 이용한 췌장세포의 유도 분화 및 당뇨병의 세포치료)

  • Kim, Suel-Kee;Shim, Joong-Hyun;Woo, Dong-Hun;Kim, Jong-Hoon
    • Development and Reproduction
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    • v.11 no.2
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    • pp.67-77
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    • 2007
  • Replacement of insulin-producing cells represents an almost ideal treatment for patients with diabetes mellitus type 1. Transplantation of pancreatic islets of Langerhans is limited by the lack of donor organs. Therefore, generation of insulin-producing cells from human embryonic stem cells represents an attractive alternative. The present review summarizes the current knowledge on the differentiation of insulin-producing cells from human embryonic stem cells and their application to the cell therapy for treating diabetes mellitus.

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The Effect of Hormone Replacement Therapy for Cognitive Function of Postmenopausal Depression (단기 호르몬 병합 치료가 폐경 후 우울증 환자의 인지 기능에 미치는 영향)

  • Lee, Sang Hoon;Ko, Young-Hoon;Joe, Sook-Haeng;Jung, In-Kwa;Kim, Seung-Hyun;Lee, Moon-Soo
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.173-180
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    • 2005
  • Purpose:We investigated the effect of menopausal duration on cognitive function using adjunctive hormone replacement therapy(HRT) in postmenopausal women with depression. Method:Twelve postmenopausal women with depressive disorder were enrolled. Six patients having menopausal duration of less than 3 years was assigned to the short duration group and six patients of more than 3 years to the long duration group. Each patient was treated with conjugated equine estrogen(1.25mg) plus medroxyprogesterone(5mg) for 8 weeks. Cognitive performance was measured by the Verbal Memory Test, Visual Memory Test, Trail Making Test, Digit Symbol Test, and Attention Shift Test. The Beck Depression Inventory was used for evaluation of depressed mood. The reproductive hormone levels were also measured. Results:The long duration group showed the lower performance only in Trail Making Test B compared with the short duration group at baseline. After 8 weeks, the long duration group performed significantly better in the Trail Making Test B compared with the short duration group. The differences in change of depressive mood and gonadal hormone level between two groups were not significant. Conclusion:Menopausal duration before HRT may influence the effect of estrogen on cognition in some cognitive domains. This might be related with estrogen receptor hypersensitivity which induced by the longer estrogen deficiency.

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A Study on the Cost and Proportion of Complementary and Alternative Medicine in Total Healthcare Cost among Elderly in the Last 6 Months of Life (사망전 노인의 전체보건의료비용에서 보완대체요법 비용과 비용분율에 관한 연구)

  • Yi, Jee-Jeon;Ohrr, Hee-Choul;Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.141-149
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    • 2004
  • Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.

Diabetic Nephropathy in Childhood and Adolescence (I) : Clinical Features (소아청소년기 당뇨병성 신병증(I); 임상 소견을 중심으로)

  • Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.1-13
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    • 2009
  • Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

Korean Medicine, Complementary and Alternative Medicines (CAM) Therapy after Gastrectomy of Gastric Cancer in a Hospital (위암 환자의 위 절제수술 후 한의학과 대체요법 사용실태 - 지방소재 일개병원의 경험 -)

  • Kim, Chan-Young;Yang, Doo-Hyun;Kang, Jun-Won;Hwang, Eui-Hyoung
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.86-99
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    • 2007
  • Objectives : Cancer patients who are afraid of unpleasant therapy and doubt a perfect cure often seek out traditional Korean medicine or many other kinds of complementary and alterative medicine (CAM) instead. This study was carried out in order to learn the prevalence and kinds of the traditional Korean medicine and CAM to evaluate awareness of and attitude toward it. Methods : 213 patients with gastric cancer who had undergone surgery in the department of gastrointestinal surgery and visited for routine follow-up from November to December of 2004 were included. A questionnaire survey was done by trained interviewers for CAM and demographic information. Results : 96.7% of patients had experience with CAM. The kinds and frequencies of CAM were diet and nutrition 21.0%, folk remedy 21.0%, pharmacological treatment 13.5%, oriental medicine 5.3% and mind-body intervention 1.4%. 56.8% of patients had experienced 2-6 kinds of CAM, 37.4% more than 7. Among diet and nutrition, ginseng (62.9%) was highest, followed by ox leg bone soup (50.8%) and pumpkin (31.5%). Among the folk remedies, elm tree was highest at 46.5%, followed by phellinus linteus (Sang-Whang) at 26.8% and ganoderma lucidum (Young-Gee) 20.7%.satisfaction with CAM was relatively low (43.2%), many patients (78.2%) replied that they would use it continuously. Conclusion : Most patients had experience with many kinds of CAM, but didn't discuss it with medical doctors. If scientific study proves whether or not each kind of CAM is actually effective ondisease, it will help to improve the health of patients and prevent the inappropriate usage and cost.

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Long-Term Result of Surgical Treatment for Esophageal Cancer -500 cases- (식도암에서 외과적 요법의 장기성적에 대한 임상적 고찰 -500예 보고-)

  • 임수빈;박종호;백희종;심영목;조재일
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.148-155
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    • 2001
  • 배경: 본 연구는 1987년부터 1997년까지 원자력병원에서 수술을 시행한 500명의 식도암환자를 대상으로 하여 휴향적 방법을 통해 조기 및 장기성적, 재발양상, 예후인자 등을 보고하고자 한다. 대상 및 방법: 대상환자 중에서 발병암이 있는 경우, 인두식도 경계부위나 위식도 경계부위 암, 고식적 우회술 또는 인공식도 삽입예 그리고 시험적 개흉술이나 개복술 만을 시행한 경우는 제외 시켰다. 식도 절제는 대부분 우측 개흉술을 이용한 Ivor Lewis 술식을 사용하였고 대부분의 문합은 stapler를 사용하였다. Extended lymph node dissection은 1994년 8월부터 시행하였고 그 이전에는 standard lymph node dissection을 하였다. 96.8%에서 위를 식도 대체장기로 사용하였고 경부에서 절제 및 재건술을 시행한 경우를 제외한 모든 식도재건은 후종격동을 통해 시행하였다. 결과: 474예(94.8%)가 편평상피 세포암이었고 대부분(58.2%)은 중부식도에 위치하였다. 술후병기는 47.4%가 stage III이었고 25%가 stage IIA이었다. 392예에서 근치적 절제가 가능하였고 74예는 고식적 절제를 시행하였으며, 식도열공을 통한 식도절제술과 경부에서의 유리공장 이식술을 시행한 34예는 위분류에서 제외하였다. 술후 유병율은 38.4%이었고 수술 사망률은 5.8%로 호흡기 감염, 문합부 유출이 주요 원인이었다. 대상환자의 99.8%에서 추적은 가능하였고 수술사망 예를 포함한 전체환자의 1, 2, 5년 생존율은 각각 63.5%, 38.9%, 19.4% 이었다. Standard lymph node dissection 그룹에서의 1, 2, 5년 생존율이 60.7%, 35.9%, 16.9%이었으나 extended lymph node dissection그룹에서는 1, 2, 4년 생존율이 70.2%, 46.5%, 30.9%이었다. 근치적 절제의 경우는 1, 2, 5년 생존률이 69.4%, 43.9%, 21.9%이었고, 고식적 절제의 경우는 37.8%, 17.6%, 7.3%이었다. 수술사망을 제외한 근치적 절제술과 extended lymph node dissection을 함께 시행한 경우의 4년 생존율은 35.6%이었다. 수술후 재발은 226예에서 발견되었고 주로 국소임파절(69%; 경부, 종격동, 복부)이었으며, 전신재발은 간, 폐, 뼈, 뇌 등의 순이었다. 결론: 저자들은 적절한 술후 환자관리가 선행되어야 하지만 근치적 절제와 광범위한 임파절 절제가 장기성적의 향상에 필수적 요소이고, 진행된 식도암에 있어서는 보다 효과적인 보강적 복합치료가 연구되어야 할 것으로 생각된다.

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Mobile Telecommunication Policy Analysis of Moon Government In Korea (문재인 정부의 이동통신정책 분석)

  • Shin, Jin
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.12
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    • pp.2387-2393
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    • 2017
  • The Moon government, launched in May 2017, regards telecommunication service as part of people's welfare and is trying to save telecommunication costs. However, the direction of policy presented is assessed as symptomatic approach. This is largely attributable to the a partial improvement approach from the framework of the present mobile telecommunication industry. However if we restart from an essential point of view, the result is likely to be much better. The nation's mobile communication costs are not adequate because the government's role was not sufficient. There is a problem with the mobile phone supply chain, the subsidy payment mechanism, and the billing system. Addressing these complex issues requires the establishment of an independent system of handset distribution from telecommunication companies, ban on discriminative subsidies payment, and adoption of volume rate system. Telecommunications Business Act that defines the service charges to normalize the market might be somewhat useful, but the normal application of the Fair Trade Act is more important.