• Childhood Kidney Diseases
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• v.12 no.1
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• pp.99-104
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• 2008

Microscopic polyangiitis(MPA) is a systemic necrotizing vasculitis that involves many organ systems including the skin, joint, kidneys, and lungs. In spite of early diagnosis and intensive care, the five-year actuarial patient and kidney survival rates are 65% and 55%. We experienced a case in 7-year-old girl of microscopic polyangiitis presenting with rapidly progressive glomerulonephritis which was confirmed by renal biopsy and positive serum perinuclear antineutrophil cytoplasmic autoantibodies(p-ANCA). The diagnosis of patients first renal biopsy was MPA, p-ANCA-associated crescentic glomerulonephritis. The patients second renal biopsy was done 5 years 6 months later since first renal biopsy, and pathologic diagnosis was chronic sclerosing glomerulonephritis, advanced, due to MPA. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor, angiotensin II receptor blocker, and cyclophosphamide were used until now and the patients current age is 14 years old. On admission, the patients laboratory findings showed BUN 117 mg/dL and Cr 2.3 mg/dL, while on the hospital day BUN and Cr values fell to 20.8 mg/dL and 1.6 mg/dL. But renal function was progressed to chronic failure with latest laboratory data BUN 51.7 mg/dL and Cr 3.2 mg/dL. ACE inhibitor, angiotensin II receptor blocker and small dose of immunosuppressant with close observation is the key to maintain the patient survival.

• Journal of radiological science and technology
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• v.34 no.1
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• pp.35-41
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• 2011

Total implanted central venous port (TIAP, Chemoport) is widely used in oncology patients because it does not require external dressing and restricts patient activity. Chemoport only requires monthly flushes of heparinized saline to keep the patency of the catheter and probably less prone to infectious complications than tunneled catheter. Despite the extensive use of permanent central venous access in oncology patients, there are only few reports about clinical experience of the Groshong catheter. The purpose of this study is to compare the complication rate between the traditional open-ended (non-valved) chemoports and valved chemoports (Groshong catheter connected to TIAP). During 5 years (Jan 2006 to May 2010), 438 patients received chemoport insertion procedure in our interventional radiology department. Among them 30 patients was referred to our department for problematic chemoports. We compared the cause of problematic chemoports between two types of chemoports (valved, vs. non-valved). Valved chemoports had higher referral rates than non-valved chemoports. When there is a need to insert valved port, different method of insertion and maintenance procedure seems to be necessary. More than 20 ml of flusing with heparinized saline after blood sampling could be a good suggestion. Adequate care of chemoport is essential for long patency. Also following the guideline from the manufacturing company is necessary.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.101-107
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• 2003

Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.375-381
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• 2015

Digital Radiography is a big part of diagnostic radiology. Because uncorrected digital radiography image supported false effect of Patient's health care. We must be manage the correct digital radiography image. Thus, the artifact images can have effect to make a wrong diagnosis. We report types of occurrence by analyzing the artifacts that occurs in digital radiography system. We had collected the artifacts occurred in digital radiography system of general hospital from 2007 to 2014. The collected data had analyzed and then had categorize as the occurred causes. The artifacts could be categorized by hardware artifacts, software artifacts, operating errors, system artifacts, and others. Hardware artifact from a Ghost artifact that is caused by lag effect occurred most frequently. The others cases are the artifacts caused by RF noise and foreign body in equipments. Software artifacts are many different types of reasons. The uncorrected processing artifacts and the image processing error artifacts occurred most frequently. Exposure data recognize (EDR) error artifacts, the processing error of commissural line, and etc., the software artifacts were caused by various reasons. Operating artifacts were caused when the user didn't have the full understanding of the digital medical image system. System artifacts had appeared the error due to DICOM header information and the compression algorithm. The obvious artifacts should be re-examined, and it could result in increasing the exposure dose of the patient. The unclear artifact leads to a wrong diagnosis and added examination. The ability to correctly determine artifact are required. We have to reduce the artifact occurrences by understanding its characteristic and providing sustainable education as well as the maintenance of the equipments.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.57-62
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• 2010

Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.201-210
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• 2005

Purpose: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. Materials and Methods: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. Results: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life ($R^2=0.633$ F:16.959, p=.000). Cancer stage, symptom distress, mood disturbance, social support(family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. Conclusion: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.169-208
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• 2016

"Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.2
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• pp.397-402
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• 2008

The purpose of this study is to prepare black Panax ginseng leaf (PGL) and evaluate its antioxidative effect. In order to make black PGL, the raw PGL was successiely steamed at $95^{\circ}C$ for 3 hr nine times. The antioxidant activities of total saponins (Sa) from PGL and black PGL against peroxyl radicals and peroxynitrites were determined by the total oxy-radical scavenging capacity (TOSC) assay. Specific TOSC values for black PGL-Sa against peroxyl radicals and peroxynitrites were 2.3-fold and 2.1-fold of PGL-Sa, respectively, and 2.2-fold and 5.2-fold of glutathione, a positive control antioxidant, respectively. The black PGL-Sa exhibited stronger antioxidative effect than PGL-Sa. The main ginsenosides of black PGL were $Rg_3,\;Rk_1\;and\;Rg_5$. Among the saponins in black PGL, the amount of ginsenoside $Rg_3$ was examined by HPLC. 22.12 mg of ginsenoside $Rg_3$ was obtained from 1g of dried black PGL.

• Neonatal Medicine
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• v.17 no.1
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• pp.84-93
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• 2010

Purpose : This study was performed to estimate the incidence of nosocomial sepsis and to identify the most relevant risk factors for nosocomial sepsis in high-risk very low birth weight (VLBW) infants. Methods : A retrospective review of 341 VLBW infants, admitted to the Neonatal Intensive Care Unit of the Eulji University Hospital (Daejeon & Seoul) between January 2002 and June 2009, who survived more than 72 hours was performed. The incidence, causative organisms, risk factors and prognosis of nosocomial sepsis in VLBW infants were analyzed. Results : The incidence of nosocomial sepsis was 16.1% and the onset date of nosocomial sepsis was 21.5$\pm$15.9 days (mean$\pm$SD) after delivery. Staphylococcus aureus (21.3%) was the most common organism in the patients with nosocomial sepsis in VLBW infants. The multiple logistic regression analysis showed that, gestational age [odds ratio (OR), 0.87; 95% CI, 0.83-0.91], umbilical artery catheter use for more than 5 days (OR, 2.2; 95% CI, 1.15-4.46), umbilical venous catheter use for more than 5 days (OR, 2.1; 95% CI, 1.11-4.16), peripheral arterial line use (OR, 2.1; 95% CI, 1.14-4.04) and intravenous intralipids (OR, 4.3;95% CI, 1.13-14.32) were identified as risk factors. Conclusion : The limited usage of intravascular catheter related procedures and the short providence of intravenous nutrition may decrease the incidence of nosocomial sepsis in VLBW infants.

• Health Policy and Management
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• v.17 no.4
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• pp.113-133
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• 2007

The present study was conducted to measure health-related utility for post-menopausal symptoms among Korean woman. A survey questionnaire was developed to measure utility based on visual analogue scale(VAS) and time trade-off method (TTO). From January 29 to February 3, 2007, a face-to-face interview was conducted with 274 women aged 45 to 60 to ask about their subjective utility for hypothetical health status of mild or severe post-menopausal symptoms. Among the participants, 160 were recruited from outpatient departments of 3 hospitals and 114 from 2 sports centers located in Seoul. For mild symptom, the average utility score of the respondents was $0.63{\pm}0.14$ based on VAS and $0.61{\pm}0.26$ based on ITO. For severe symptoms, the average utility was $0.39{\pm}0.16$(VAS) and $0.44{\pm}0.27$ (TTO). For severe symptom, a higher utility score was observed for TTO than for VAS, which is consistent with earlier studies and thus supports the validity of the utility measurement in this study. Overall, the severity of post-menopausal symptoms of the respondents themselves was not significantly associated with the utility score that the respondents answered for hypothetical health status. Multiple regression analysis results showed that the utility score was significantly higher among respondents with older age, higher education, higher family income, and from hospitals. It is expected that the utility score measured in this study will enhance the understanding of the quality of life of women after menopause and will be used to conduct cost-utility analysis of health care interventions to treat post-menopausal symptoms.