• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1021-1028
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• 2009

Purpose:Medical therapy is the initial treatment for children with Graves disease to avoid complications of other treatments. However, optimal treatment for childhood Graves disease is controversial because most patients require relatively long periods of medical therapy and relapse is common after medication discontinuation. Therefore, this study aimed to search clinical or biochemical characteristics that could be used as remission predictors in Graves disease. Methods:We retrospectively studied children diagnosed with Graves disease, treated with anti-thyroid agents, and observed for at least 3 years. Patients were categorized into remission and non-remission groups, and the groups were compared to determine the variables that were predictive of achieving remission. Results:Sixty-four patients were enrolled, of which 37 (57.8%) achieved remission and 27 (42.2%) could not achieve remission until the last visit. Normalization of thyroid-stimulating hormone-binding inhibitory immunoglobulin (TBII) after treatment was faster in the remission group than in the non-remission group (remission group, $15.5{\pm}12.07$ vs. non-remission group, $41.69{\pm}35.70$ months). Thyrotropin-releasing hormone (TRH) stimulation tests were performed in 28 patients. Only 2 (8.3%) of 26 patients who showed normal or hyper-response in TRH stimulation test relapsed. Binary logistic regression analysis identified rapid achievement of TBII normalization after treatment as a significant predictor of remission. Six percent of patients achieved remission within 3 years and 55.8% achieved it within 6 years. Conclusion:Rapid achievement of TBII normalization can be a predictor of remission in childhood Graves disease. The TRH stimulation test can be a predictor of maintenance of remission.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.393-401
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• 2019

The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

• Journal of Korean Society of Forest Science
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• v.101 no.4
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• pp.677-685
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• 2012

This study was conducted to evaluate the effect of forest environment and therapeutic program to the patients with major depressive disorder in antidepressant medication. The first group participated the four sessions of therapeutic program in the forest environment ("forest therapy"), the second group did in the program in a hospital environment, the third group did merely walking in the forest ("forest bath"), and the last group was controls. All the participants was diagnosed with major depressive disorder and had been taking antidepressant medication longer than 3 months. Depressive symptoms were measured by the Hamilton Rating Scales for Depression(HRSD), Montgomery-Asberg Depressin Rating Scales(MADRS), Beck Depression Inventory(BDI), and general health perception was measured by Short Form Health Survey Questionnaire(SF-36). Heart rate variability(HRV) were also examined to observe the physiological parameters before and after the program. In the results, HRSD score of forest program group was significantly lower than controls after the program. MADRS score of forest therapy group and hospital program group was also significantly lower than controls after 4 sessions of the program. The remission rate defined as below 7 points in HRSD was higher in the forest therapy group, hospital program group, forest bath group, and controls in order. These results reveals that the therapeutic program performed in forest environment may improve unremitted depressive symptoms of patients with major depressive disorder. Although not significant, the forest therapy program showed better outcome than hosptial program and forest bath.

• Journal of Pharmacopuncture
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• v.6 no.1
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• pp.33-34
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• 2003

배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.228-234
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• 2004

Primary cardiac tumors are rare disease and they present nonspecific symptom. They are divided in benign and malignant tumors and require surgical therapy and/or additional therapy. From March 1995 to March 2003, twenty one patients were diagnosed as having primary cardiac tumors. We analysed them retrospectively in terms of various perioperative factors and early and late results. 6 men and 15 women and their average age was 45.44$\pm$18.76. Pathology revealed eighteen benign (fourteen myxoma, two fibroelastoma, one hemangioma and one paraganglioma) disease and three malignant (one angiosarcoma, one mesothelioma and one myxofibrosarcoma) disease. There was one (myxoma) operative mortality and three late death (hemangioma, angiosarcoma and mesothelioma) during additional therapy and follow up. Surgical treatment of primary cardiac tumor is important and sometimes additional therapy is required but the prognosis of malignant cardiac tumor is still very poor.

• Tuberculosis and Respiratory Diseases
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• v.53 no.3
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• pp.349-353
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• 2002

Catamenial hemoptysis is syndrome characterized by bleeding from the bronchial trees and lungs that occurs synchronously with the female menstrual cycle. Etiologic mechanism of pulmonary endometriosis is still controversial, and the diagnosis is usually made on the basis of the clinical history and exclusion of other causes of recurrent hemoptysis. Serial computed tomograms of the chest during and in the interval between menstruations have been proved to be a useful confirmatory test. We experienced a 33-year-old female patient who had been previously diagnosed as pelvic endometriosis pathologically, experienced cyclic hemoptysis during menstruations. The diagnosis of pulmonary endometriosis was made based on her history and changes in the character of the lesions as documented on radiologic studies of the chest. She was treated successfully with GnRH analogue and there is no evidence of recurrence.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.51-58
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• 2018

Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Reproductive and Developmental Biology
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• v.29 no.1
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• pp.57-62
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• 2005

One of the critical problems to be solved in transgenic animal production is uncontrollable constitutive expression of foreign genes, which usually results in serious physiological disturbances in the transgenic animal. To circumvent this problem, we constructed and tested two retrovirus vectors designed to express the GFP(green fluorescent protein) gene under the control of the tetracycline-inducible promoters. To maximize the GFP gene expression at turn-on state, WPRE(woodchuck hepatitis virus posttranscriptional regulatory element) sequence was introduced into the retrovirus vectors at downstream region of either the GFP gene or the sequence encoding rtTA(reverse tetracycline-controlled transactivator). Transformed cells were cultured in the medium supplemented with or without doxycycline(tetracycline derivative) for 48 hours, and induction efficiency was measured by comparing the GFP gene expression level using fluorometry and western blotting. Higher GFP expression was observed from the vector carrying the WPRE sequence at 3' side of the GFP gene, while tighter expression control(up to 20 fold) was obtained from the vector in which the WPRE sequence was placed at 3' side of rtTA sequence. The resulting tetracycline inducible vector system may be used in transgenic animal production and gene therapy.

• Journal of Convergence for Information Technology
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• v.10 no.10
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• pp.253-258
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• 2020

This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.