• Journal of agricultural medicine and community health
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• v.48 no.1
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• pp.28-40
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• 2023

Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.165-173
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• 2004

Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

• 한국유가공학회:학술대회논문집
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• 2007.09a
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• pp.49-58
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• 2007

Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.338-345
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• 1993

Mandibular discontinuity defect due to benign tumor, malignant tumor, infection, or truma results in major esthetic and biologic compromise. The primary goal of reconstruction is full restitution of function, which secondarily lead to normalization of the cosmetic deformity. The authors make a clinical study of 61 consecutive bone graft cases for mandibular reconstruction of discontinuity defect which were studied retrospectively using clinical data and radiographic findings. The cases were reviewed to evaluate the clinical success in the period from 1981 to 1990 in the Dept. of Oral & maxillofacial Surgery, Seoul National University Hospital. The criteria of the success in bone graft, are no residual infection, graft in with maintain its integrity, and remain over a half of its original size of graft in the radiographic features. The purpose of this clinical survey is to study of the mandibular discontinuity defects and success rate of free bone graft in mandibular defects. To summarize the clinical study of free bone graft, the main type of autogenous bone graft is iliac bone and corticocancellous type. Overall success rate is 80.3% in 61 followup cases over 6 months. Wire fixation and Extraoral approach has realtively better prognosis than other methods. It showed relatively poor prognosis in symphysis defects than other recipient site.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.101-106
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• 2019

Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.20-36
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• 2001

The debate about whether depressive disorders should be divided into categories or arrayed along a continuum has gone for decade, without resolution. In our review, there is more evidence consistent with the spectrum concept than there is with the idea that depressive disorders constitute discrete clusters marked by relatively discontinuous boundaries. First, "depression spectrum", "is there a common genetic factors in bipolar and unipolar affective disorder", "threshold model of depression" and "bipolar spectrum disorder" are reviewed. And, a new subtype of depression is so called SeCA depression that is a stressor-precipitated, cortisol-induced, serotonin-related, anxiety/aggression-driven depression. SeCA depression is discussed. But, there is with the idea that depressive disorders constitute discrete subtypes marked by relatively discontinuous boundaries. This subtypes of depressive disorder were reviewed from a variety of theoretical frames of reference. The following issues are discussed ; Dexamethasone suppression test(DST), TRH stimulation test, MHPG, Temperament Character Inventory(TCI), and heart rate variability(HRV).

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.36-43
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• 2003

Objectives: The purpose of this study was to evaluate the difference of cognitve function among patients with posttraumatic stress disorder according to severity of symptoms. Methods: The subjects were 90 psychiatric inpatients and outpatients with posttraumatic stress disorer(by DSM-IV criteria) after traffic accident. The severity of symptoms was assessed by MMPI subscales; depression, psychasthenia, schizophrenia. The impairment of cognitive function was assessed by Korean Wechsler Intelligence Scale(K-WAIS). Based on scores of the MMPI subscales, the patients were divided into high group(above 70 percentile) and low group(below 30 percentile). We estimated the difference of the K-WAIS score and subtest score in the low group and high group of the MMPI subscales by indedpendent t-test. Results: The scores of high group is significantly higher in the subtests of information, vocabulary, similarity, picture completion, and picture arrangement than the low group for psychasthenia subscale of MMPI. And the score of high group is significantly higher in full scale I.Q., verbal I.Q., performance I.Q., verbal subscales except digit span and simiarity, and performance subscales than low group for schiozphrenia subscale of MMPI. Conclusion: It was found cognitive function was more impaired in the group of PTSD with severe symptom compared to the group of PTSD with mild symptoms. We suggest that psychiatrist should consider various cognitive approaches as well as pharmacotherapy in the management of PTSD.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.275-307
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• 2010

In the presidential new-year address in January 2, 2009, the President declared that 17 kinds of new driving force of growth that could create high-added value be selected to step up job creation and an increase in national wealth. The Ministry of Strategy & Finance announced plans for the 17 kinds of new driving force of growth after the presidential address. Specifically, that ministry announced an ambitious plan to select health care service named 'Global Health Care' as one of the five service industries that could create high-added value in a move to provide jobs to approximately 7,000 people and produce pervasive economic effects coming up to a trillion and 10 billion won. To attain the goal, several action plans were mapped out to globalize domestic medical institutions, to rearrange the relevant law and system for the purposes of raising awareness of domestic medical institutions among foreign patients and improving their accessibility and post-satisfaction level, and to lure lots of foreign patients through financial assistance. At the same time, the government announced plans to lure severe patients such as those in want of surgery or organ transplant, cancer patients or patients with heart diseases to create high-added value on a long-term basis. Thus, the government announced that it planned to formulate such strategies and to enter an agreement with foreign governments to attract plenty of foreign patients. In fact, however, there are little full-scale evaluation of medical tourism though it's been a year since it was introduced, and there are few actual efforts to implement what the government announced, either. According to the results of the evaluation of medical tourism, domestic hospitals are said to undergo little significant changes after the introduction of medical tourism, which shows that they take a dim view of medical tourism instead of having expectations for that. The medical tourism industries in major Asian countries have been dynamized, and there are several factors of their success. First of all, they are successful in creating new market opportunities by incorporating related industries such as medicine, tourism and IT and in developing medical tourism products and differentiated marketing by taking advantage of their competitive edge. They have offered full-fledged assistance to this sector, and another reason is the improved international credibility of their medical service. If our country fails to pinpoint our problems in consideration of the cases of the Asian countries or to provide appropriate financial aid, our country is bound to lag behind them. Given this reality, how to assess medical tourism and what challenges this sector is confronted with are discussed.

• Journal of radiological science and technology
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• v.36 no.3
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• pp.193-200
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• 2013

There are many concerns about radiation exposure in Korea after Fukushima Nuclear Plant Accident on 2011 in Japan. As some isotope materials are detected in Korea, people get worried about the radioactive material. In addition, the mass media create an air of anxiety that jump on the people's fear instead of scientific approach. Therefore, for curbing this flow, health, medical institute from the world provide a variety of information about medical radiation safety and hold the campaign which can give people the image that medical radiation is safe. At this, the Korean Food and Drug Administration(KFDA) suggested that make the alliance of medical radiation safety and culture on August, 2011. Seven societies and institutions related medical radiation started to research and advertise the culture of medical radiation safety in Korea. In this report, mainly introduce the activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) for spreading culture of medical radiation safety from 2011 to 2012.

• Progress in Medical Physics
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• v.11 no.1
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• pp.49-57
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• 2000

New method about the dose optimization problem in radiation treatment was researched. Since all conditions are more complex and there are more relevant variables, the solution of three-dimensional treatment planning is much more complicate than that of current two-dimensional one. There(ore, in this study, as a method to solve three-dimensional dose optimization problem, the considered variables was minized and researched by reducing the domain that solutions can exist and pre-determining the important beam parameters. First, the dangerous beam range that passes critical organ was found by coordinate transformation between linear accelerator coordinate and patient coordinate. And the beam size and rotation angle for rectangular collimator that conform tumor at arbitrary beam position was also determined. As a result, the available beam position could be reduced and the dependency on beam size and rotation angle, that is very important parameter in treatment planning, totally removed. Therefore, the resultant combinations of relevant variables could be greatly reduced and the dose optimization by objective function can be done with minimum variables. From the above results, the dose optimization problem was solved for the two-dimensional radiation treatment planning useful in clinic. The objective function was made by combination of dose gradient, critical organ dose and dose homogeniety. And the optimum variables were determined by applying step search method to objective function. From the dose distributions by optimum variables, the merit of new dose optimization method was verified and it can be implemented on commercial radiation treatment planning system with further research.