• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.211-220
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• 1995

Though the endometriosis is not always related with infertility, endometriosis causes infertility in some patients. There are many treatment modalities of infertile patients who have endometriosis. In recent years, Assisted Reproductive Technology(ART) have been widely accepted as being a useful tool for the treatment of infertile endometriotic patients. The objective of this study was to evaluate the outcome of ART in infertile endometriotic patients who have been carried out IVF-ET from Jan, 1992 to Dec, 1994 and to compare the results between COH/IUI and IVF-ET in the patients with endometriosis stage I. Tubal disease only patients were grouped(308 patient, 956 cycles) as a control. Endometriosis group was subdivided into 4 groups according to American Fertility Society classification; endometriosis stage I (45 patients, 61 cycles), stage II (26 patients, 39 cycles), stage III (26 pateitns, 37 cycles), stage IV (33 patients, 50 cycles). The outcomes of IVF-ET in endometriosis patients were as follows; The oocyte recovery rates were significantly lower in stage III, IV endometriosis. In case of stage III endometriosis, the fertilization rate was significantly lower than other stages of endometriosis. Clinical pregnancy rates per cycle were not different between the tubal group(22%) and the endometriosis group(25%). According to endometriosis stage, the implantation rate and clinical pregnancy rate were significantly lower in stage IV (5.6%, 16%) compared with other stages (I; 10.0%, 26%, II;9.8%, 31%, III;12.6%, 32%). It suggests that some factor like autoantibodies may inhibit implantation of embryos in stage IV endometriosis. To evaluate the possibility that simply increasing the number of gametes at the site of fertilization might account for pregnancies attributed to IVF-ET, the authors retrospectively analyzed the outcome of couples undergoing IUI during hMG cycles and CC cycles between 1992 and 1994 in the women with endometriosis stage 1. In case of stage I endometriosis, though the COH/IUI group showed lower FSH level and lesser age profile than IVF-ET group, IUI group has resulted in lower pregnancy rates(19.2%) compared with the IVF-ET group(26.2%). In conclusion, endometriotic infertile patients can get comparable pregnancy rates with the tubal factor infertility patients during IVF-ET program. Moreover even in stage I endometriosis, IVF-ET may be an more effective treatment modality than COH/IUI.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.109-116
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• 1976

Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamenta, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Wha County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5%), Skin (12.7%) , diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and. all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test or X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case, The Total average cost per visit was 870.

• Journal of Gastric Cancer
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• 제8권4호
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• pp.204-209
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• 2008

목적: 위에 발생하는 신경내분비 종양은 국내에서도 그 보고가 드문 매우 독특한 조직형인데, 이 종양의 임상병리학적 특징들에 대해 알아보고자 하였다. 대상 및 방법: 1999년 1월부터 2007년 8월까지 고신대학교 의과대학 외과학교실에서 위암으로 수술받은 4,159예 중 신경내분비 종양으로 진단받은 13예를 대상으로 의무기록 및 조직 표본을 후향적으로 분석하였다. 결과: 위 신경내분비 종양은 남자 11예, 여자 2예였고, 평균나이는 54.9세(42~72)였으며, 주증상은 상복부 통증과 속쓰림이 많았다. 점막 또는 점막하 종양 2예를 제외하고 나머지 9예는 모두 근육층 이상을 침범한 진행성이었고, 종양의 평균 크기는 7.0 cm (0.7~15)였다. WHO 분류법에 의한 내분비 종양의 유형은 제 3형이 8예, 제 4형이 4예, 제 1형이 1예였다. 림프절 전이는 11예에서 있었고, 추적 기간내 재발한 4명의 환자 모두 제 3형과 제 4형이었고, 재발한 장기는 간이 2예, 다장기(복막, 폐) 1예, 다장기(간, 췌장, 십이지장) 1예였고, 생존 기간은 평균 12.8개월이었다. 결론: 위에 발생하는 신경내분비 종양은 진단 당시 진행된 경우가 많았고 간 전이를 잘 하였으며 예후가 나쁜 독특한 조직형이다.

• 대한방사선기술학회지:방사선기술과학
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• 제41권1호
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• pp.7-12
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• 2018

Patients who visit the emergency room with urinary stones have difficulty lying down in a supine position due to severe pain when performing the KUB test. The purpose of this study was to find methods to reduce the patients' pain and image distortion, and obtain medical images with high diagnostic values. After checking the standard classification of disease and cause of death, the target group consisted of 121 patients who had clearly distinguished stones from computed tomography. Patients with stones in the ureteralvesical junction were excluded. Qualitative image evaluation was performed by confirming the location of the stone in the computed tomography images. and evaluated the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray. Quantitative image evaluation was performed on the KUB, abdominal plain X-ray images. The transverse process of the first lumbar vertebrae served as the standard point, and the length from this point to the lower part of the stone was measured. Results from looking at the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray showed: 94 patients (77.6%) for KUB images and 91 patients (75.2%) for computed tomography images. The standard deviation for KUB and abdominal X-ray was 3 (2.4%). Comparing and analyzing the location from KUB images and abdominal plain X-ray images, the stone position was 10.1 mm in the kidney, 10.5 mm in the ureteropelvic junction, and 9.7 mm in the ureters. It was shown that the stone moved 10 mm on average with significant statistical difference (P<0.05). In cases where the pain is so severe that it is impossible to perform the test in the supine position, an alternative may be to check the stone position by performing a modified KUB test by having the patient stand in a vertical position. In the future, this will provide convenience to both the examiner and the patient when performing the examination, and it will contribute with its reproducibility.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.36-45
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• 2008

Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

• 대한한방내과학회지
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• 제22권3호
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• pp.285-290
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• 2001

Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

• 동의신경정신과학회지
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• 제28권2호
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

• 대한핵의학회지
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• 제33권4호
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• pp.381-387
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• 1999

목적: 직업성 질병은 원인 규명과 함께 병의 진행정도를 정확히 평가하는 것이 중요하여 ILO에서 흉부 X-선 소견을 기준으로 국제표준화를 시행하여 왔으나 사진의 질에 영향을 받을 수 있고, 초기 병변을 발견하기에는 어려움이 많다. 본 연구자들은 Ga-67의 섭취정도를 규폐증의 진행 정도를 나타내는 지표로 이용하기 위하여 폐기능검사 및 흉부 X-선 소견에 의한 임상적 병기 분류와의 상관관계를 보고자하였다. 대상 및 방법: 25명의 규폐증 환자를 대상으로 Ga-67 신티그라피를 분석하였으며 10명의 정상인을 대조군으로 하였다. 검사방법은 Ga-67 citrate, 5 mCi를 정맥 주사한 후 48시간 후 전신 스캔 및 흉부, 복부 스캔 영상을 얻어 후면상에서 간과 폐병변의 최대 섭취 부위의 관심영역을 설정하여 픽셀당 방사능 섭취 정도의 비를 구하여 임상적 병기 분류와의 상관관계를 비교 분석하였다. 결과: L/L Ratio 값은 정상군 0형(n=10): $0.3948{\pm}.0692$0, 1형(n=10): $0.5763{\pm}$0.1837, 2형(n= 11): $0.6849{\pm}0.1459$, 3형(n=4): $0.9913{\pm}0.0712$였으며 흉부 X-선의 분류형과 서로 유의한 상관관계를 보였다(r=0.618, p<0.05). 그러나 L/L Ratio 값과 폐기능검사 지표와는 통계적으로 유의하지 않았다. 결론: 저자들의 연구에 따르면 규폐증의 진행과정을 평가하여 환자의 병기를 결정하는 데 Ga-67 신티그라피의 정량적인 분석이 도움을 주었다. 그러나 폐기능과는 상관관계가 없어 폐기능을 평가하는 지표가 되지 못하였다.

• 대한두경부종양학회지
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• 제19권1호
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• pp.9-15
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• 2003

Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

• 농업생명과학연구
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• 제43권2호
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• pp.39-46
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• 2009

동물병원에서 행해진 진료현황, 총 41,305건에 대해 WHO의 질병분류법(ICD)에 따라 검증한 결과 예방의학이 42.2%, 피부질환이 16.4%, 소화기계가 12.0%, 이과(耳科)가 8.5%, 호흡기계 질환이 4.3%이었다. 내과질환에서는 내원한 진료 중에서 소화기계 질환이 호흡 52.9% 기계 질환이 18.9%, 순환기질환이 13.2%, 종양이 4.4%순이었다. 피부질환 총 6,774건 중에서 농피증이 50%, 외부기생충증이 12.2%, 피부사상균증이 11.0%, 알레르기성 피부병이 9.8%이었다. 동물병원의 수입을 진료부분과 용품 판매, 애견 미용 등 크게 3부분으로 구분하였을 때 전체 매출의 71.6%가 진료부분, 용품의 판매가 16.9%, 애견 미용이 11.5%를 차지하였다. 동물병원의 홍보 형태는 인터넷 웹사이트를 통한 홍보가 47%로 가장 많았으며, 지역광고지가 23.5%, 전단지와 전화통신 서비스가 11.8% 순이었다. 동물병원의 인적구성에서는 수의사가 절반정도인 45.5%를 차지하였으며 전문적인 교육과정을 거친 수의테크니션은 없었다. 동물병원의 시설구획에서는 평균 진료실은 2.7실, 입원실은 1.7실, 격리입원실은 0.5실이었고 이외 수술실과 방사선촬영실을 병용하는 동물병원도 있었고 일반 처치실의 시설은 미흡하였다.