• Korean Medical Education Review
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• v.26 no.1
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• pp.36-40
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• 2024

Chonnam National University Medical School has designed and implemented two career planning programs: a three-phase curriculum-based program and a longitudinal non-curricular program over the course of 6 academic years. The three phases of the curriculum-based career planning program are self-assessment, career exploration, and field experience. The non-curricular career counseling program operates through a faculty advisor system, with each faculty member guiding a group of students from each academic year, and students in each year forming a mentor-mentee relationship. The non-curricular career exploration program consists of a student research support program, an international practice program in basic and clinical medicine, and a specialty exploration fair. A survey conducted among 38 graduates (54.3%) working as interns at Chonnam National University Hospital revealed that graduates preferred autonomous elective subjects within the curriculum-based program. They also responded positively to the faculty advisor system, through which they maintained close relationships. A focus group interview with three interns indicated that subjects providing direct experience in fields of interest and courses that students could choose freely were helpful in career decisions. Through follow-up research, it is necessary to design and operate a systematic career planning program based on an analysis of the needs of graduates taking part in a residency training program after selecting a medical specialty.

• Korean Journal of Radiology
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• v.25 no.1
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• pp.86-102
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• 2024

Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

• Journal of Acupuncture Research
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• v.41
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• pp.160-167
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• 2024

The present study employs the Delphi method to devise a consensus-based protocol for utilizing integrated acupuncture in treating medial tibial stress syndrome (MTSS). Twenty acupuncture experts contributed opinions across six key themes, including diagnosis, acupuncture points, additional Traditional Oriental Medicine modalities, treatment rationale, treatment duration/frequency, and integration of yoga/naturopathic therapies. Consensus, defined as a 70% agreement or higher, was reached on all themes, reflecting a collective acknowledgment of the necessity for a holistic approach to MTSS management. The final protocol includes six diagnostic criteria, six acupuncture points, one additional modality, two Traditional Oriental Medicine therapies, four treatment rationales, and six yoga/naturopathic therapies. The present comprehensive protocol offers valuable guidance for healthcare professionals seeking an integrated approach to MTSS management.

• Korean Circulation Journal
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• v.52 no.1
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• pp.34-46
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• 2022

Percutaneous coronary intervention (PCI) is used to treat obstructive coronary artery disease (CAD). The role of PCI is well defined in acute coronary syndrome, but that for stable CAD remains debatable. Although PCI generally relieves angina in patients with stable CAD, it may not change its prognosis. The extent and severity of CAD are major determinants of prognosis, and complete revascularization (CR) of all ischemia-causing lesions might improve outcomes. Several studies have shown better outcomes with CR than with incomplete revascularization, emphasizing the importance of functional angioplasty. However, different definitions of inducible myocardial ischemia have been used across studies, making their comparison difficult. Various diagnostic tools have been used to estimate the presence, extent, and severity of inducible myocardial ischemia. However, to date, there are no agreed reference standards of inducible myocardial ischemia. The hallmarks of inducible myocardial ischemia such as electrocardiographic changes and regional wall motion abnormalities may be more clinically relevant as the reference standard to define ischemia-causing lesions. In this review, we summarize studies regarding myocardial ischemia, PCI guidance, and possible explanations for similar findings across studies. Also, we provide some insights into the ideal definition of inducible myocardial ischemia and highlight the appropriate PCI strategy.

• Korean Journal of Biological Psychiatry
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• v.31 no.1
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• pp.7-14
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• 2024

Objectives We conducted a meta-analysis of randomized controlled trials to investigate the therapeutic effects of mindfulness-based interventions on depressive symptoms in patients with major depressive disorder. Methods In February 2021, we searched Embase, MEDLINE, Cochrane Library, PsycINFO, CINAHL, and AMED. Under the guidance of the corresponding author, two evaluators independently reviewed and selected articles based on predetermined selection criteria. Results Based on the selection criteria, we systematically screened and included a total of 12 randomized controlled trials comprising 720 cases for the final analysis. Utilizing a random-effects model for data analysis, we determined the Hedges' g value to be 0.787, indicating a medium-sized effect according to Cohen's interpretation. The 95% confidence interval for the effect size ranged from 0.414 to 1.160 (p-value < 0.0001). Conclusions This study reveals the potential effectiveness of mindfulness-based interventions in treating depressive symptoms among patients with major depressive disorder.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.571-578
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• 1996

Background : Long abscess is an accumulation of pus within a destroyed portion of the lung. Antibiotic therapy and postural drainge has proven to be an effective method of treatment for the majority of patients with pyogenic lung abscess. When medical therapy fails, thoracotomy and pulmonary resection are the current therapies. empyema is pus in the pleural space, and this term is deserved for effusions on which the Gram stain of the pleural fluid is positive. Initially, such collection may be drained via chest tribe. Recently, in patients who are judged to be unsuitable for surgery are in poor condition, percutaneous drainage using pig-tail catheter has been performed. We report out experience with 10 cases of lung abscess and 23 cases of empyema who were treated by percutaneous pit-tail catheter drainage. Subjects and Methods : Our study included 10 patients with lung abscess and 23 patients with empyema who were treated by percutaneous pig-tail catheter drainage, from January, 1990, to May, 1996, at Hanyang University then a pig-tail catheter was inserted into the abscess or the site of empyema under fluoroscopic and ultrasonograpic guidance. Following aspiration, the catheter was sutured into the skin, and connected to the suction tip. Catheter drainage was discontinued when the abscess of empyema was resolved in radiologically and clinically. Results : There were 2 cases of lung abscess caused by Staphylococcus aureus and Klebsiella pneumoniae and 14 cases of empyema caused by M. tuberculosis. The others were unknown. The duration of drainage was 1-2 weeks in 7 cases of lung abscess and 14 cases of empyema. In the 29 of 33 patients, percutaneous drainage were carried out successfully 20 of the 29 Gases rapidly improved. Conclusion : Percutaneous drainge is effective and relatively saute for management of lung abscess or empyema refractory to medical therapy or poor candidates for surgical treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.109-113
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• 2010

Purpose: To evaluate the efficacy of ultrasound guided injection of prolotherapy and steroid mixture injection in patients with adhesive capsulitis. Materials and Methods: 53 patients with adhesive capsulitis were included in the study and in all the patients a mixture of steroid and prolotherapy agent was injected into the coracohumeral ligament under the sonographic guidance. The patients were evaluated using the VAS and ROM of the shoulder before the injection and at 8 weeks and at 1 year after the injection. Results: Forward flexion was 93.4 degrees before the injection and was 142, 153 degrees at 8weeks and 1 year after injection. Abduction was 79.2 degrees before the injection and was 125.4, 152.6 degrees at 8 weeks and 1 year after the injection. The VAS score was 6.7 before the injection and was 3.5, 3.7 at 8 weeks and 1 year after the injection. Conclusion: The ultrasound guided injection of prolotherapy and steroid mixture into the coracohumeral ligament in patients with adhesive capsulitis is allowing both tissue distension and inflammatory process controlling procedure. It is effective in improving the range of shoulder motion significantly and is also effective in decreasing the pain.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6491-6496
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• 2012

Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.743-751
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• 2014

This study aims to identify the effect of home physical therapy on patients who left the hospital after total knee arthroplasty, compared to the Daily living group, when it was applied to them, under the guidance of physical therapists. As research subjects, 20 patients that were scheduled to leave the hospital after unilateral total knee arthroplasty, were chosen, and they were randomly divided into a home physical therapy group(10 patients) and an Daily living group(10 patients) in order to conduct an experiment. During the 4-week research, home physical therapy was offered for 40 mins once for 5 days a week, and muscular strength, gait components were measured. For muscular strength, quadriceps muscle strength, hamstring muscle strength were measured, and as gait components, endurance, speed, step time, single-limb support were analysed. For this experiment, pre- and post-measurement were performed, and collected data were analyzed using SPSS ver. 18.0 statistical program. From the analysis of data, the following study results were obtained. Home physical therapy group and Daily living group both showed significant improvements in quadriceps muscle strength, hamstring muscle strength, and quadriceps muscle strength, hamstring muscle strength of home physical therapy group more significantly improved than Daily living group's. In relation to gait components, gait endurance, gait speed, step time significantly improved in both of home physical therapy group and Daily living group, whereas home physical therapy group only showed significant improvements in single-limp support. According to the comparison between two groups, gait speed, single-limp support and step time improved more significantly in the home physical therapy group than in the Daily living group. In conclusion, positive results were revealed in both home physical therapy group and Daily living group, with regard to muscular recovery of lower limbs of patients discharged from the hospital after total knee arthroplasty and walking, but considering the comparison results between two groups, it seems that applying home physical therapy is more effective than maintaining a daily life.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.570-577
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• 2017

The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.