• Journal of Korean Medical classics
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• v.17 no.4
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• pp.8-11
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• 2004

"황제내경(黃帝內經)"(간칭(簡稱)"내경(內經)")의 내용을 임상치료와 진단에서 사용하면서 얻은 체험을 종합해보면 다음과 같다. 1. "내경(內經)"에서는 병을 치료하는 방법과 기술에 있어서는 대부분 직접 어느 한 가지 질병에 어떠한 치료방법을 사용할 것과 그 치료방법의 구체적인 조작방법과 사용에 대하여 기록하고 있다. 이러한 기록은 저자가 진실로 보고 들은 것으로서 거짓됨이 없다. "내경(內經)"에는 치료 방법만으로도 침구(鍼灸), 약물요법(藥物療法)뿐만이 아니라 또한 방복수법(放腹水法)이 있으며, 물리강온법(物理降溫法), 단식요법(斷食療法), 수술절제법(手術切除法), 압추경동맥강온법(壓推頸動脈降溫法)(자절진사(刺節眞邪)), 견인(牽引), 자료(磁療) 및 "딸꾹질을 치료하는 세 가지 방법" 등 거의 30가지에 가까운 치료방법들이 기재되어 있다. 2. "내경('內經)"의 이론은 어느 한 사랑의 손에서 만들어진 것이 아니며 또한 어느 한 시기에 저술 된 것도 아니다. "각가학설(各家學說)"의 성격을 띠고 있다. 3. "내경('內經)"에서는 글귀가 간결하고 함축성이 아주 강하므로 한마디에 많은 뜻을 내포하고 있다. 그러므로 임상에서 사용할 때 그 뜻을 잘 이해하면서 사용해야 한다. 4. "내경(內經)"을 연구하는 사람들이 "내경(內經)"의 이론을 임상에서 사용할 때 가장 먼저 장중경선사(張仲景先師)를 본받아 여러 의학자들의 장점을 취해야 한다. "상한잡병론(傷寒雜病論)"에서는 곳곳에 내경(內經)"의 취지를 나타내고 있으며 내경(內經)" 에 나오는 방법을 치료의 원칙으로 삼고 있다. 치료원칙은 대부분 "음양응상대론(陰陽應象大論)의 기준으로 삼고 있다.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.20-27
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• 2007

Purpose : Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. Methods : The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. Results : Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. Conclusion : For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.127-134
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• 1990

NBCCS is a hereditary disorder characterized by multiple defects of ectodermal and mesodermal structure, which is chiefly affected on skin, jaws & skeleton, CNS, eye and sexual organ. It is well associated with multiple odontogenic keratocyst on the jaws. Thus, we intended to investigate other anomalies presenting on NBCCS in cases of multiple odontogenic keratocyst which were treated in our hospital from 1980 to 1989. Here we reported 6 cases of NBCCS.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.87-105
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• 2003

Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.2
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• pp.237-244
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• 2021

Dentinogenesis imperfecta (DI) is a hereditary disorder of dentinal defect. It is generally inherited as a single autosomal dominant trait. DI usually affects both the primary and permanent dentition. Affected teeth have various types of discolorations, rapid destruction of the dentin, and severe attrition. In radiologic view, the affected teeth have bulbous crowns, short roots and narrow or closed pulp chambers. The treatment objective is to prevent additional attrition and recover the vertical dimension of occlusion. The aim of this report was to present the long-term prognosis in 15 years in a pair of siblings. Both the patients had DI with tooth attrition and discoloration. Different treatment procedures were used, depending on the difference in the timing of intervention. The first patient saved most of his teeth. The second patient had all of her teeth extracted. This report could be helpful for early diagnosis and overall treatment of DI.

• Journal of Oral Medicine and Pain
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• v.25 no.3
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• pp.279-289
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• 2000

현대에는 날로 복잡해지는 생활양식의 변화에 따라 다양한 스트레스에 노출되고 그로 인한 면역계, 신경계 또는 각종 장기의 기능이상이 점차로 증가되고 있다. 최근 치과에 내원하는 환자들 중 구강건조증을 호소하는 환자들의 다수는 스트레스에 노출되어 있고, 임상적으로도 방사선 타액선 기능 검사에서 타액선, 특히 악하선의 기능이 현저하게 저하되어 있는 소견을 관찰할 수 있 다. 더욱이 이는 타액선 조영술에서 이미 보고된 바 있는 면역성 질환인 $Sj\ddot{o}gren$ 증후군과는 다른 양상으로 관찰되고 있어, 이에 본인은 백서에 스트레스와 관련이 깊은 내분비적 환경 변화를 유도함으로써 이와같은 변화가 악하선 조직의 병리적 변화와 어떠한 연관성을 갖는 지를 관찰하고자 본 실험을 시행하였다. 생후 7주된 Sprague-Dawley계 웅성 백서(165-209g/bw) 40마리를 2 개의 실험군(부신 제거군 : ADX 군, 부신 제거 후 dexamethasone 투여군 : DEX 군)으로 나누어 실험하였다. ADX 군은 외과적으로 부신을 제거한 후 다른 조건을 부여하지 않았고, DEX 군은 외과적으로 부신을 제거한 후 매일 dexamethasone($1.5*10^{-46}mg/g$ I.V./day)을 투여하였으며, 이들을 각각 실험 후 즉시, 1일, 3일, 5일, 7일에 희생시켰다. 그 후에는 즉시 악하선을 적출하여 면역조직화학법으로 Clusterin의 발현 정도 및 부위를 관찰하였다. 그 결과는 다음과 같았다. 1. 광학현미경 하에서, 양 군 모두 유의할만한 조직학적 변화는 관찰되지 않았다. 2. ADX 군에서는 실험기간 전반에 걸쳐 도관세포와 선포세포에서 clusterin이 발현되었다. 3. DEX 군에서는 소수의 선세포에서 국소적으로 clusterin이 관찰되었으나, 전반적으로 도관세포, 선포세포에서 공히 clusterin이 관찰되지 않았다. 부신을 제거한 군에서는 실험기간 전반에 걸쳐 clusterin이 발현되었는데, 이는 clusterin이 스트레스의 생리적 반응의 결과로서 세포보호작용을 한다는 사실에 기초하여 볼 때, 부신을 제거하였을 때도 스트레스를 받았을 때와 같은 영향이 백서의 악하선에 가해졌을 것으로 생각된다. 반면, 부신제거후 glucocorticoid agonist인 dexamethasone을 투여하였을 때, clusterin이 감소 내지 관찰되지 않았던 것은 부신제거에 의해 악하선에 가해졌던 영향을 dexamethasone이 길항하여 나타난 결과로 볼 수 있어, 스트레스에 의해 부신으로부터 분비되는 glucocorticoid가 타액선을 보호하는데 중요한 작용을 하는 것을 시사한다.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.1-14
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• 2005

Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.