• Journal of Sasang Constitutional Medicine
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• 제9권1호
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• pp.303-313
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• 1997

Disease depends on the three factors, agent, host and environment. According to history of disease, by early 1900s the case of deaths is infectious disease, in late 1900s care of infectious diseases and tremendous scale of chronic disease, i.e., heart disease, diabetes, cancers and etc, makes care of chronic diseases be a most important theme. Now, life-style of diet is being westernized and in high industry-oriented society, obesity makes attack fate remarkably increase and life-expectancy become short, so that it causes severe problem of health. Chronic disease, such as obesity, is not affected by specific agent, but depends of interaction between host and environmental factors. There is the theory of constitutional medicine in Korean Medicine. According to it, all the people have constitutional specificity and disease. Because obesity is a kind of disease, there is the corresponding constituent being apt to be fat. Oriental Medicine utilizes herb-medication, acupuncture, and massage-therapy in treating obesity. Therefore study on relationship between constituent and obesity for OPD patients of Sangji-Oriental Medicine Hospital is carried out. The results are summarized as followings. 1. 70.2% of obesity patients are Taeumin(太陰人), 26.9% of those are Soyangin(少陽人), 2.9% of thoese are Soeumin(少陰人). 2. Most cases, high value of Free Fat Acid and Triglyceride not that of Total Cholesterol and Low Density Lipoprptein is meaningful in obesity patient blood. The corelationship between lipid test and Constitution is meaningful in Triglyceride and Free Fatty Acid. 3. Obesity is not related with gene. 4. Obesity is not related with Boyak(Herb-Med : 補藥). 5. Obesity mostly happens after delivery, contraception and operation. 6. Obese Patients are apt to eat between meals, especially food of wheat flour such as a snack. 7. The aim of treating obesity is not persuit of beauty but of keeping healthy. 8. 2.2Kg of body weight is lost after 4 week-treatment. 9. Common cause of obesity is overeating of carbohydrate and lipid than meat.

• Radiation Oncology Journal
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• 제17권4호
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• pp.321-328
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• 1999

Purpose : Total body irradiation (TBI) or whole body irradiation is used to acquire immune suppression, to treat malignant lymphoma and leukemia, and as an conditioning regimen for bone marrow transplantation. For these purposes, many methods were developed to obtain homogenous dose distribution. The objective of this study was to analyze and confirm the accuracy and the homogeneity of the treatment setup, the parallel opposed lateral technique, currently used in Seoul National University Hospital. Materials and Metheods : Surface dose data, measured with a thermoluminescent dosimeter, of 8 patients among 10 patients, who were given total body irradiation with the parallel opposed lateral technique between September 1996 to August 1998, at Seoul National University Hospital were analyzed. Surface doses were measured at the head, neck, axilla, thigh, and ankle level. Surface and midline doses were measured with similar set-up and technique in the Humanoid phantom. Results : Measured surface doses relative to prescribed dose for the head, neck, axilla, thight, and ankle leve were $91.3{\pm}7.8,{\;}98.3{\pm}7.5,{\;}95.1{\pm}6.3,{\;}98.3{\pm}5.5$, and $95.3{\pm} 6.3\%$, respectively. The midline doses of the head, neck, axilla, thigh, and ankle level estimated from the surface-to-midline ratios in the Humanoid Phantom were $103.4{\pm}9.0,{\;}107.8{\pm}10.5,{\;}91.1{\pm}6.1,{\pm} 93.8{\pm}4.5,{\;}and{\;}104.5{\pm}9.3\%$, respectively. Measured surface doses and estimated midline doses ranged from $-8.9\%$ to $+7.8\%$. Midline doses at the neck and the axilia level deviated more than $5\%$ from the prescribed doses. The difference of the estimated midline doses at the neck and the axilla level and the actual doses were attributed to the thickness differences between the Humanoid phantom and the patients. Conclusion Distribution of the midline doses as well as the suface doses were measured to be within $-8.7\~{\pm}7.8\%$ range. Actual dose distribution in the patient is expected to be better than the measured dose range mainly attributed to thickness difference between the patient and the Humanoid phantom.

• Radiation Oncology Journal
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• 제21권1호
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• pp.27-34
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• 2003

Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.

• Journal of Korean Academy of Nursing Administration
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• 제3권1호
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• pp.93-106
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• 1997

By the increase of the rate of existence of the hemodialyzing patients, they were required the long run treatment. Regardless of medical insurance expansion, hemodialyzing cost much expenses so that hospital has been considering the reuse of hemodialyzer and flowing euqipments along with the diverse study and progress of the ways of hemodialyzing and medical instruments. This study was aimed to provide the basic materials regarding the reuse of hemodialyzer which is used for the patients of chronic renal disease. The reusing program in the artificial kidney center of K hospital has been used for this study from 50 patients aften one year result from Sep. 1995 through Aug. 1996. Automatic equipment of DRS-4 made by Seratronic Co., was used as the equipment and it was retreated with the function test simultaneously. Compliaction and confirmation of the infection were by the records of the hemodialysis of the patients. SPSS was used for the analysis of the materials by computerization. The character of the patients and the rate of removal was by mistake and percentage, function test and rate of complication by Ftest(ANOVA) and the rate of complication per items by ${\chi}^2$ and Ftest. As the post test the Duncan's test was used for the statistically significant different variables in the standard of p<.05 after Ftest. The followings are the summary of the result : 1) In the function test of the new hemodialyzer and the reused one, and in all of CA110 and CF15.11, the dialyzer ultrafiltration coeffient(KUf) was appeared to have been higher in the reusing groups than the first use ones. This has been the normal limit showing no troubles with them. 2) In the function test of the new and reused hemodialyzer, in all of CA110 and CF15.11, the total blood volume was appeared to have been the less value in the reuse groups than the new ones. This was the price within 80% of the first price that both showed possible for use. 3) The result of reuse hemodialyzer of CA110 was $29.48{\pm}7.83$ in average in the test of leak test while $17.3{\pm}7.96$ in reuse of CF15.11. The normal limit of <60 was the leak test result. So both of the hemodialyzer was normal for reuse. 4) The rate of removal of Blood Urea Nitrogen(BUN) was 72.25% in CA110 hemodialyzer by reusing 16-20 times as the highest rate showing the better result in the reuse hemodialyzer, while in CF15.11 hemodialyzer showed 71.16% by highest rate in the first use by the highest rate with no difference from the reuse. 5) The rate of removal of serum creatinine of CA110 was 64.08% by highest rate in reuse of 1-5 times by showing better result in reuse hemodialyzer. While in CF15.11 66.47% the highest by reuse of 16-20 times showing no difference from each other. 6) No patients were admitted or precribed by antibiotics in relation with reuse dialyzer and no reports were shown about hepatitis $B{\cdot}C$. AIDS in fection. 7) Of the total 248 episods of complication due to the hemodialyzing, 86 by first use, 73 by 1-5 times, 35 by 6-10 times, 35 by 11-15 times and 19 by 16-20 times have been shown which have had no significant difference between the groups. 8) In the comparison of the expense for the hemodialyzer, there was the effect of saving 11,597.6 Won between the first and reuse hemodialyzer. And by decreasing the extracted materials, they did the great role of disposing the waste matters.

• Journal of Oral Medicine and Pain
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• 제35권1호
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• pp.61-73
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• 2010

The aim of this study was to investigate clinical assessment and cephalometric characteristics in 10s patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients were 59. Female was 47 and male was 12, Females were predominant and patient's age ranged from 12 to 19. 2) Most of the patients had Grade II condyle resorption. 3) The number of who had Class I occlusion was 27, which was the largest group. The number of patients with openbite was 20. Average overjet was 3.58mm and average overbite was 0.97mm. 4) Most of the patients had parafunctional habit. 5) The patients of showing the pain in condylar resortion was 41 and the case of not showing the pain was 18. 6) Treatment duration of 23 patients were less than 1 month, 28 patients were treated with supported therapy. 2. Cephalometric Characteristics 1) A 16-year-old female patients showed smaller SNA, SNB and larger articular angle significantly as compared with those of normal group. 2) A 17-year-old female patients showed smaller SN, SAr, TPFH, ramus height and larger SN-GoMe, FMA, articular angle significantly as compared with those of normal group. 3) Over 18 years old female patients showed smaller SN, SNB, TPFH, ramus height and larger ANB, FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 4) Over 18 years old male patients showed smaller SN, TPFH, ramus height and larger FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 5) There was no significant difference between 10s and normal group in mandibular body length.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.115-124
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• 2001

Objective：The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method：Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results：Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion：These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제4권1호
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• pp.147-162
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• 1997

This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

• Journal of dental hygiene science
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• 제7권1호
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• pp.1-7
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• 2007

This study aimed to provide basic information on dental hygienists' practicing the prevention of infections by figuring out their actual conditions in dental clinics. The subjects of the study were the dental hygienists who participated in the continuing medical education of Incheon & Gyeonggi-do association and Seoul city association in October and November 2005 and the self-administered surveys were used for the prevention of infections. The results were as below. 1. In terms of education experiences of infection prevention, those who answered "there were" were 72 persons (42.9%) and those who followed the educational route for infection prevention were "through the in-house education from the hospital" and they were 42 persons (58%), which were highest. 2. In terms of the injury experiences, those who answered "there were" were 147 persons (87.5%) and the number of annual injury out of 147 persons with injury experiences was 7.7 time. For the tools that were damaged, 125 persons (75%) damaged the "explorer," which was highest. 3. For the experiences of being infected with contagious diseases, those who answered "there were" were 6 persons (3.6%) and there were four persons for "hepatitis B", one person for "rubella" and one person for "TB." 4. The questions with high practice scores were as in the following: "2. I wash my hands after conducting medical examinations (1.86 points)," "7. I always close the lid of a shot of Novocain after doing local anesthesia (1.86 points)" and "20. I separate and collect the wastes and give them to those who treat accumulated materials (1.85 points)". Meanwhile, the questions with low practice scores were as below: "16. I change my medical gowns (doctor wears) once a day (0.24 point)" and "I wash my medical gowns every time after examining patients with contagious diseases (0.52 points)." 5. The question with high knowledge was as below: "1. The contagion during the dental treatment is determined by source of infection, infection methods, infection routes and the host that is prone to infection (0.95 point)" and the question with the lowest knowledge was "5. HBV(hepatitis B) is destroyed after adding 95oC of heat for more than 5 minutes (0.27 points)." 6. The question with the highest organization-related factors was "I am always ready to use a mask, gloves, etc. if necessary" (0.89 points)" and the question with the lowest score was "There is a guideline that I can refer when I am exposed to dangerous situations related to the contagion in my workplace (0.33 point)." 7. In terms of the equipment conditions of protectors in medical environments, 168 persons for (disposable) mask (100%), 167 persons for disposable gloves (Latex) (99.4%), which meant that most of them were equipped with them. On the contrary, 108 persons (64.3%) are equipped with the protectors for frontal faces, which is the lowest and 165 persons (98.2%) said that they had autoclave in their disinfecting and sterilizing devices.

• Progress in Medical Physics
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• 제22권2호
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• pp.61-66
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• 2011

In this study, we evaluated the effect of grid size on dose calculation accuracy using 2 head & neck and 2 prostate IMRT cases and based on this study's findings, we also evaluated the efficiency of a 2D diode array detector for IMRT quality assurance. Dose distributions of four IMRT plan data were calculated at four calculation grid sizes (1.25, 2.5, 5, and 10 mm) and the calculated dose distributions were compared with measured dose distributions using 2D diode array detector. Although there was no obvious difference in pass rate of gamma analysis with 3 mm/3% acceptance criteria for the others except 10 mm grid size, we found that the pass rates of 2.5, 5 and 10 mm grid size were decreased 5%, 20% and 31.53% respectively according to the application of the fine acceptance criteria, 3 mm/3%, 2 mm/2% and 1 mm/1%. The calculation time were about 11.5 min, 4.77 min, 2.95 min, and 11.5 min at 1.25, 2.5, 5, and 10 mm, respectively and as the grid size increased to double, the calculation time decreased about one-half. The grid size effect was observed more clearly in the high gradient area than the low gradient area. In conclusion, 2.5 mm grid size is considered acceptable for most IMRT plans but at least in the high gradient area, 1.25 mm grid size is required to accurately predict the dose distribution. These results are exactly same as the precious studies' results and theory. So we confirmed that 2D array diode detector was suitable for the IMRT QA.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.177-185
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• 2009

Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.