• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.618-632
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• 1994

The ultimate goal of periodontal therapy is promoting the regeneration of lost periodontal tissue. The purpose of this study is to evaluate the effect of treatment using decalcified freeze dried bone allograft as a bone graft material. 47 intrabony defects from 27 patients with clinical diagnosis of chronic periodontitis were selected among those 24 defects were treated via flap operation only and designated as the control group, the other 23 defects were treated with decalcified freeze dired bone allografting via flap operation and designated as the experimental group. Clinical parameters including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th months, and the significance of the changes has been analyzed. The results are as follows : 1. Probing depths were reduced significantly in both control group($2.75{\pm}0.99mm$) and experimental group($3.69{\pm}0.97mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p]0.01). 2. Loss of attachment showed statistically significant decrease in both control group($1.77{\pm}1.08mm$) and experimental group postoperatively($2.70{\pm}1.55mm$). Experimental group showed significantly higher decrease compared to the control group(p]0.05). 3. Probing bone levels were reduced with statistically significance in both control group($1.08{\pm}0.97mm$) and experimental group($4.00{\pm}1.41mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p<0.01). 4. Gingival recession showed statistically significant increase in the control group($1.21{\pm}0.72mm$) and experimental group($1.00{\pm}1.09mm$) postoperatively(p<0.01). There was no statistical significance between the control group and the experimental group. On the basis of these results, treatment using allogenic decalcified freeze dried bone is effective in reducing probing depth, loss of attachment and probing bone level. Therefore allogenic decalcified freeze dried bone is an effective bone graft material in periodontal regeneration.

• 한국환경보건학회지
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• 제39권4호
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• pp.312-321
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• 2013

Objective: In May 2011, an interview with three United States Forces Korea veterans revealed that chemicals believed to be 'Agent Orange' were buried at Camp Carroll (situated in Waegwan, Chilgok-gun, Gyeongsangbuk-do, Korea) in 1978. Many hazardous chemicals, such as perchloroethylene (PCE), trichloroethylene (TCE), and organochlorines were subsequently found in a joint US-ROK environmental investigation, although dioxins or burial evidence related to 'Agent Orange' have been not uncovered. This study was carried out to investigate the relevance of hazardous chemical exposure and health effects of the residents around Camp Carroll. Methods: The authors conducted a health questionnaire survey among residents around Camp Carroll regarding Waegwan groundwater ingestion, length of residence in Waegwan, and physician-diagnosed disease history (such as cancer, hypertension, diabetes and etc.). Logistic regression was performed to identify the associations between hazardous chemical exposure and physician-diagnosed diseases. Results: Among the 5,320 residents, excluding those living outside the Waegwan area, 3,430 subjects age 30 and over were analyzed. Among females, upon correction of age, smoking history and Camp Carroll working history, a higher distribution in the Waegwan groundwater ingestion group was demonstrated for patients with physician-diagnosed cancer and hypertension. The odds ratios have a tendency to increase with increased length of Waegwan groundwater ingestion. Conclusions: This study may be limited by not adopting a cohort study for the evaluation of factors that may confound environmental exposure. Yet it is meaningful that the correlation between Waegwan groundwater ingestion and chronic diseases were found through regression analysis in female; and further, this outcome may be used as a sampling basis for a secondary epidemiologic study.

• Tuberculosis and Respiratory Diseases
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• 제46권5호
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• pp.709-717
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• 1999

연구배경 및 방법 : BOOP는 미만성 간질성 폐질환의 일종으로 기질화폐렴의 특별한 한 형태로도 구분되는 아주 특별한 임상병리 소견을 가진 질환이다. 임상적으로는 내원 수주전부터 감기 유사증상을 앓다가 점차 악화되는 호흡곤란 증세로 내원하여 마치 폐렴양 소견을 보이며, 병리학적으로 폴립형의 육아 조직이 세기관지내에 충전되어 관강내 용종양 조직을 형성하고 폐포관에까지 침범된 기질화된 폐렴의 소견을 보인다. 최근, 저자등은 본원에서 경험한 다섯 증례와 국내의 학술지상에 증례 보고된 19예를 합하여 그 임상적 특성에 대해 분석해 보고 국외의 문헌보고 결과들과 비교분석하고자 하였다. 결 과 : 국내 환자들의 평균연령은 54세이었으며 여성에서 약간 더 많이 발생하였다. 병원에 내원한 주증상은 호흡 곤란 및 기침이었으며 그 지속기간은 평균 41일이었다. 흉부진찰에서 흡기시 악설음이 흔히 관찰되었고 여러 혈액학적 검사소견은 저산소혈증외에는 비특이적이었으며 이들 소견만으로는 폐렴과 구분하기 어려웠다. 폐활량검사에서는 제한성 혹은 폐쇄성과의 혼재형 환기장애가 주소견이었으며 방사선학적으로는 양측성, 반상의 비엽성 폐포침윤을 보였고 고해상 컴퓨터단층촬영에서 잘 확인되었다. 다른 간질성폐질환과는 달리 부신피질호르몬의 치료에 잘 반응하여 양호한 예후 및 경과를 보였다. 상기 국내의 결과는 국외 문헌보고에서 얻은 결과와 비교시에 대체적으로 유사 소견을 보였으나 국내는 여자에서 더 흔히 발생한 차이가 있었으며 엑스선 소견 및 임상경과 등에 대해서는 좀더 추적조사를 하여 비교해야 할 것으로 판단된다. 결 론 : 폐렴양 소견을 보이는 환자에서 적절한 치료에도 불구하고 임상양상이 비전형적이고 진행시에는 임상소견 및 방사선학적 소견 등을 BOOP의 관점에서 재점검해야 할 것이다. 이 질환은 부신피질호르몬제에 비교적 빠른 반응을 보이며 조기 진단으로 완치가 가능하지만 성급한 치료종결시 재발이 잘 되며 급격한 호흡부전으로 사망할 수도 있는 질환이므로 BOOP가 의심되고 치료에도 병이 진행성일 때 적기에 조직검사를 통해 확진함이 중요하다.

• Tuberculosis and Respiratory Diseases
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• 제46권5호
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• pp.729-734
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• 1999

저자들은 객혈을 주소로 내원한 35세의 남자 환자에서 기관지경, 식도내시경 및 식도조영술로 기관지확장증에 의한 식도기관지루를 진단하고, 수술적 치료를 시행한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Tuberculosis and Respiratory Diseases
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• 제66권6호
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• pp.467-470
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• 2009

CA 125의 상승은 난소의 악성종양에 나타날 수 있지만 비특이적이다. CA 125의 상승은 다양한 양성 질환 혹은 악성 종양에서 나타날 수 있다. 저자들은 최근 지속적으로 혈중 CA 125 수치가 증가되어 있지만 경질 초음파, 흉부 CT, PET-CT 등에서 악성 종양이 발견되지 않은 기관지확장증 1예를 경험하였다. 14개월의 추적 관찰 기간 중에도 난소암과 같은 악성 종양은 발견되지 않고 기관지확장증에 병발된 폐렴 이외에는 특이 소견이 없어, 혈중 CA 125의 상승은 기관지확장증에 의한 급성 폐 손상에 의한 것으로 추정된다. 혈중 CA 125 수치의 상승은 환자의 임상 양상과 연관하여 조심스럽게 판단하여야 될 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.50-55
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• 2009

목 적 : 최근 신생아 집중치료의 발전으로 미숙아의 생존율이 증가하면서 미숙아 망막병증도 증가하는 추세이다. 재태 연령 및 출생체중과 미숙한 망막이 중요한 위험인자이지만, 이 외에 무호흡, 패혈증, 인공호흡기의 사용, 장기간의 산소사용 역시 유의한 위험 인자로 알려져 있다. 이에 본 연구는 만성 폐질환 환아에서 nasal cannula를 통한 저농도 산소($FiO_2$ 25% 미만)의 사용 기간이 미숙아 망막병증의 진행에 미치는 영향을 알아보고, 미숙아 망막병증의 예방 및 진행의 완화에 도움을 주고자 본 연구를 시행하였다. 방 법 : 2001년 2월 1일부터 2006년 1월 31일까지 본원 출생아중 재태 연령 37주 미만이면서 출생체중 1,750 g 미만의 생존한 미숙아들로, 안저 검사를 받고 최소 6개월 이상 추적관찰이 가능했던 273명의 미숙아를 대상으로 의무기록을 기초로 후향적 분석을 통해 미숙아 망막병증의 발생에 영향을 미치는 여러 위험인자들을 검토하고, 저농도 산소의 사용 기간이 미숙아 망막병증의 발생과 임상경과 및 예후에 미치는 영향을 조사하였다. 만성 폐질환은 생후 28일 혹은 재태주령 36주가 되는 시점에 산소 의존도가 있었던 경우로 정의하였다. 결과 : 미숙아 망막병증의 발생에 가장 큰 영향을 미치는 인자로는 짧은 재태연령과 적은 출생체중이었고, 기타 무호흡, 표면활성제의 사용, 인공호흡기, 신생아 호흡곤란 증후군, 뇌실내 출혈 등의 순으로 상대적 위험도가 높았다. 저농도 산소 사용 기간이 길어질수록 미숙아 망막병증의 발생률은 높아지고, 미숙아 망막병증의 발병 시기는 지연되는 경향을 보였다. 수술적 치료를 받은 환아들에서 일단 미숙아 망막병증이 발병한 후에는 수술적 치료가 필요한 정도의 심각한 미숙아 망막병증으로 진행하는 기간 간격은 짧아지는 경향을 보였으며, 특히 만성 폐질환 환아군에서 산소를 투여하고 있는 기간 중보다는 산소를 중단한 이후에 미숙아 망막병증이 급격하게 진행되는 경향을 보였다. 결론 : 심각한 미숙아 망막병증의 발병 및 급속한 진행을 예방하기 위하여 가능한 한 저농도 산소라도 사용기간을 줄이고, 산소 사용 중단 이후에는 좀 더 적극적인 추적 안저 검사를 해야 할 것으로 생각된다.

• 대한예방한의학회지
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• 제4권1호
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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• pp.3-6
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• 2001

Inflammation is an outcome or an end effect of disruption of complex immunological balance. A variety of approaches to control immunological unbalance have been tried, and some of them are in practice in the clinic. Since inflammatory disorders are reflection of very complex immunological responses, it should be difficult to have such disorders under complete control. Thus, most of the drugs, being marketed and under development, possess some degrees of undesired side offsets originating from disruption of immunological balance. Steroids are excellent drugs suppressing inflammation in short term, however, long-term use of steroids would incur a serious side effect of "rebound". Another example is TNF-${\alpha}$-neutralizing agents, such as enbrel and infliximab. TNF-${\alpha}$ has been known to play a key role in the exacerbation of inflammation, and knock-out of TNF-${\alpha}$ is regarded essential to control of chronic inflammation. The TNF-${\alpha}$-neutralizing drugs in the market are regarded very efficient in the management of rheumatoid arthritis. Upon long term use, however, those drugs cause sepsis to a certain proportion of patients. It is ironical that a high plasma level of TNF-${\alpha}$ is known to be responsible for sepsis, and that the drugs scavenging TNF-${\alpha}$ cause sepsis. The above two examples illustrate well the difficulty of discovering an anti-inflammatory drug without unwanted immunological side effects. An anti-inflammatory drug would make a case in the market, as long as the drug has huge therapeutic benefits compared to its expected but unwanted immunological side effects, where cyclooxygenase-2 inhibitors are positioning. In this presentation, will be discussed general aspects of cyclooxygenase-2 inhibition in conjunction with 3(2Η)furanone derivatives, a novel class of COX-2 inhibitors.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.