• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.351-368
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• 1999

The objective and subjective burden was evaluated toward 115 main caregivers in the family with schizophrenic patient by interview with structured questionnaire and self-report using Family Burden Scale (FBS) of family with schizophrenic patient in Korea. The results were as follows : 1) The mean age of onset by schizophrenic patient were 23 years old in male and 26 in female. 2) The mean scales of objective and subjective burden were 1.5 and 1.6. 3) By Logistic regression objective burden was significantly affected by family support (P<0.001), religion (P<0.05), occupation (P<0.05). 4) Subjective burden was significantly affected by family support (P<0.01) and family total income (P<0.05). 5) Total objective and subjective burden was significantly affected by family support (P<0.001), religion (P<0.05). In conclusion, this study suggests that main caregivers need family support from other family members. For them religion and social support are also helpful to cope with the burden to take care of the schizophrenic patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.93-97
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• 2012

Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.200-205
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• 2007

Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.507-514
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• 2005

Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.101-106
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• 1999

Purpose : Tuberculosis, a major public health problem, is an important cause of childhood infectious diseases. To decrease the tuberculosis morbidity rate, BCG vaccination and chemoprophylaxis are performed. Recently 2TU PPD skin test was introduced as a diagnostic method for tuberculous infection. We studied the positive conversion rate of 2TU PPD test after percutaneous multiple puncture BCG vaccination. Methods : Four hundred seventy six infants from well baby clinic of Samsung Cheil Hospital were enrolled. They were immunized with percutaneous multiple puncture technique BCG(Japan BCG laboratory, Japan) at 1 month of age. Approximately 6 months later, tuberculin skin test using RT23 2TU PPD was performed. Induration size, family history of tuberculosis and number of BCG scars were evaluated. Induration greater than or equal to 5mm was defined as positive conversion. Results : Among 476 infants, 248(52.1%) were male and 228(47.9%) were female. PPD skin tests were performed $6.2{\pm}0.5$($mean{\pm}S.D.$) months after BCG vaccination. Mean induration size was $7.3{\pm}3.2mm$ and positive conversion rate was 85.5%. Total number of BCG scars was $15.5{\pm}3.2$. Conclusion : The seroconversion rate by 2TU PPD test after percutaneous multiple puncture BCG vaccination was high. But, more comparative studies with various age groups may be needed for 2TU PPD test used as diagnostic method of tuberculosis in the hospitals.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.137-147
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• 2007

Background : Interpretative reporting is an important aspect of laboratory medicine. The large menu of laboratory tests available today makes it increasingly difficult for the non-specialist to order and interpret all laboratory tests. The aim of this study was to determine the usefulness of an expert system to interpret laboratory tests and help physicians order the appropriate tests. Materials and Methods : In order to interpret laboratory tests, a rules-based expert system was developed. In this module, if-then rules were used to interpret the given test result patterns (e.g. urinalysis, anemia, hepatitis B virus, hypercholesterolemia, glucose, syphilis, and tumor markers) and select matching text elements. The system was used to evaluate 535 subjects who visited a health-check program. Results : The overall abnormal rate was 50.5% in the expert system; 34% for cholesterol, 9.9% for urinalysis, 8.0% for anemia, 7.7% for thyroid function tests, 4.5% for tumor marker study, 4.7% for hepatitis virus antigen, 4.3% for serum glucose, and 1.1% for syphilis. Conclusion : These results indicate that the application of the expert system for the interpretation of laboratory tests may provide a useful method for the interpretation of reports. However more rules are needed for the application to in-patients.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.342-353
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• 2000

This study was performed to examine the effect of a 7-week comprehensive health promotion program for improving pain, depression, and disability by employing a quasi-experimental design. The subjects were regular out-patients of a RA aclinic in an University Hospital in Inchon from November 11. 1998 to December 24. 1998. The Experimental group included 18 patients who participated in an arthritis health promotion program, and the control group included 18 patients who did not. The 7-week health promotion program, which had the objective to enhance health promoting skills, was provided to patients. The effects of this program on the patients' pain, depression, and functional disability were examined. According to the study results, a significant group difference was found on these dependent variables (Hotelling's T =.30, F=3.11, p=.04). To examine which dependent variables had significant effects, one-way ANOVAs were performed. There were significant group differences in pain (F=4.35, p=.05) and in depression (F=4.22, p=.05) However, no significant group differences on functional disability (F=.04, p=.84) were found. Conclusively, the arthritis health promotion program, which was designed to enhance 11 health promoting skills, can be evaluated as successfully achieving the ultimate goal of enhancing the patients' quality of life. It can also be contended that the improvement of the patients' quality of life was enabled by relieving pain and reducing depression.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.171-178
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• 2016

In this study, a prediction model for depression among parents with disabled children was developed by verifying the effects of social support and family resilience. One hundred forty one parents with disabled children were recruited from three out-patient clinics of rehabilitation hospitals in D city between August and September, 2014. The instruments used were the QRS, CES-D, MSPSS, and KFSS-II. The average score of depression was 20.18/60. The levels of depression were significantly different among variables, e.g., sex, age, and monthly income. The mean scores of the item for social support and family resilience were 3.11/5 and 3.32/5, respectively. Family resilience differed significantly according to monthly income. Parental depression was negatively correlated with the social supports and family resilience. Social support was correlated positively with family resilience. In conclusion, family resilience and social support are predictable factors for depressed parents with disabled children.

• Journal of Pharmacopuncture
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• v.6 no.1
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• pp.14-15
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• 2003

중의학은 서양의 의료 다원주의의 한 부분이 되었다. 특히 침과 같이 서양의 개념과는 분명히 다른 의료 기법에 있어서는 두드러진다. 그밖에 뜸, 안마, 기공, 중약 및 복합 처방들도 있다. 서양에서 전문직업인화는 보건의료 관련분야에서 중심적인 인력양성 방법이 되었다. 이는 대학이 기반을 다진 중세까지 거슬러 올라가는데, 19세기에는 법인들이 전문직업인 모임으로 바뀌어 가면서 개인적 환경을 변화시키고 직업의 체계를 개발하였다. 변호사, 교사, 사제, 의사가 그 예이다. 의료에 있어서 학교교육을 통해 수련된 의사들이 조산사나 안마사들을 지배하게 되었는데 이런 경향은 1950-60년대에 극에 달한다. 그러다가 이들의 지배는 대중매체, 환자, 다른 주변 의료 보조인력들에 의해 도전을 받는다. 이와 비슷한 양상을 이단적인 의료에서도 관찰할 수 있다. 전문직업인의 우세와 시점이 비슷한 생물의학의 우월적 지배는 많은 다양한 의료에 의해 도전을 받는다. 그러나 생물의학의 우월함의 약세가 시술자들의 전문직업인화 까지를 포함하지는 않았다. 실제로 침술과 같은 치료술들을 전문직업인인 의사나 의사가 아닌 시술자들이 함께 쓰고 있기 때문이다. 이는 직능간의 분쟁을 야기할 가능성이 높다. 이단적 개념을 기존 의료계로 통합하는 것이 전문직업인들인 의사들의 노력으로 이해되었다. 이 견해는 두 가지 문제를 내포하고 있는데, 첫째 의사들을 단일한 속성으로 보고 있다는 것인데, 실제로 현대의학을 배우고 가르치는 나라들 사이에도 매우 다양한 차이가 있음을 간과하고 있다. 둘째로 의료인이 아닌 시술자들도 다양한 분야로 통합되었는데, 통합은 어쩌면 하급의 전문인들의 노력의 결과로 설명되어야 하는 것이 더 알맞을 수 있다. 그러나 이들도 전문직업인의 조직구조를 가져야 만 하고, 그렇지 않으면 파편으로 남을 것이다. 전문직업인주의는 언제나 과학과 연계하고 있는데, 독일 정부와 직업인 조직은 의료과학 집단에게 이단적 시술들의 임상효과를 검증하게 하였다. 이것은 이단 의료계에 우호적인 단체나 적대적인 단체 모두에게 적용되었다. 매우 강한 힘을 가진 냉소적인 조직 가운데 하나는 National Committee of SHI-Physicians and Sickness Funds(Bundesausschuss der Arzte und Krankenkassen).2 인데, 2001년에, 이 단체에서 출판한 자료에는 침의 효용성은 침을 시술하는 사람에 달린 것 일뿐 시술자의 수련이나 침 시술의 배경 개념에 달려있는 것이 아니다. 그러므로 침은 무작위 표본추출 대조군 실험을 통해 효과를 검증받지 못한 다른 치료법들의 범주에 머물러 있다.(cf. Bundesausschuss 2001: 8). 1990년대, 무작위 표본추출 대조군 실험은 생물의학이 아닌 의료의 효과를 검증하는데 알맞지 않고 비윤리적이라고 강한 비판을 받았다. 한편 1995년에 WHO는 침의 유효성 평가를 위해 이 실험기법을 추천하며, 이어 2001년에, the International Council of Medical Acupuncture and Related Techniques(ICMART)는 침연구와 시술을 위한 헌장(Acupuncture Charter Berlin an Evidence Based Medicine (EBM)3 for acupuncture)을 채택 공표한다. 독일 보험 회사들도 침의 효과와 효율성을 검증하기 위해 대규모 실험을 시작했다. 100,000 명이 넘는 환자들이 무작위 표본추출 대조군 실험을 통해 평가되고 있는데 이 실험은 병원이나 일차의료기관의 외래에서 진행되고 있다. 영국에서는 이 분야의 유력한 Edzard Ernst가 위의 개념과 비슷한 구도를 설정 공표하는데 보완의학 분야의 많은 다른 전문가들의 견해를 무릎 쓰고, 그는 증거기반 의학에 대한 그의 신념을 표방한다. "무작위 표본추출 대조군 실험이 보환의학 분야의 시술을 검증하기 위한 알맞은 방법이 아니라고 끝없이 주장하지만 우리는 거의 모든 치료법을 포괄하는 분야에 이들 실험을 발견하였으니, 이는 보완의학도 엄정한 방법으로 검증할 수 있다는 것을 보여준다고 할 수 있다."(Ernst et al. 2001: xiii). 적어도 독일에서 진행중인 효과 검증 연구가 향후 아시아 의학의 기반 마련에 중요한 역할을 하게 될 것이다. 영국에서는 이에 대한 정치적 수렴이 전문 직업인화에 달려 있을 것이다. 여기에서 나는 아시아에서 유래한 의료의 서양에서 어떻게 사회학적 관찰의 대상으로 분류되고 정의되는지 소개하고자 한다.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.146-151
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• 2017

Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.