• Radiation Oncology Journal
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• v.28 no.1
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• pp.50-56
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• 2010

Purpose: We report the results of an external audit on the absorbed dose of radiotherapy beams independently performed by third parties. For this effort, we developed a method to measure the absorbed dose to water in an easy and convenient setup of solid water phantom. Materials and Methods: In 2008, 12 radiotherapy centers voluntarily participated in the external auditing program and 47 beams of X-ray and electron were independently calibrated by the third party’s American Association of Physicists in Medicine (AAPM) task group (TG)-51 protocol. Even though the AAPM TG-51 protocol recommended the use of water, water as a phantom has a few disadvantages, especially in a busy clinic. Instead, we used solid water phantom due to its reproducibility and convenience in terms of setup and transport. Dose conversion factors between solid water and water were determined for photon and electron beams of various energies by using a scaling method and experimental measurements. Results: Most of the beams (74%) were within ${\pm}2%$ of the deviation from the third party's protocol. However, two of 20 X-ray beams and three of 27 electron beams were out of the tolerance (${\pm}3%$), including two beams with a >10% deviation. X-ray beams of higher than 6 MV had no conversion factors, while a 6 MV absorbed dose to a solid water phantom was 0.4% less than the dose to water. The electron dose conversion factors between the solid water phantom and water were determined: The higher the electron energy, the less is the conversion factor. The total uncertainty of the TG-51 protocol measurement using a solid water phantom was determined to be ${\pm}1.5%$. Conclusion: The developed method was successfully applied for the external auditing program, which could be evolved into a credential program of multi-institutional clinical trials. This dosimetry saved time for measuring doses as well as decreased the uncertainty of measurement possibly resulting from the reference setup in water.

• Women's Health Nursing
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• v.4 no.2
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• pp.217-230
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• 1998

The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.447-463
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• 1994

Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.227-241
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• 2005

Objective & Methods : The purpose of this study is to observe the effects of Asari Herba Cum Radice herbal-acupuncture solution(AHCR-HAS) on arthritis of mice induced by Collagen II at Joksamni(ST36). The author performed several experimental items. First, it is the cell survival rate of mice lung fibroblasts and expression of TNF-${\alpha}$ in synovial cells. Second, it is the incidence rate of arthritis and the weight of spleen. Third, it is the levels of IL-6, TNF-${\alpha}$, INF-${\gamma}$, IgG, IgM and anti-collagen II in serum Fourth, it is histological analysis of the mice joint. Fifth, it is expression ratio of CD3e+ to CDl9+ cell, CD4+ to CD8+ cell, CD69+/CD3e+ cells, CD11+/CD19+ cells and CD11b+/Gr-1+ cells. Result : 1. The highest survival rate of mice lung fibroblasts were measured in the 1% AHCR-HAS, and the expression of TNF-${\alpha}$ in synovial cells were significantly decreased in the 1% AHCR-HAS. 2. In the AHCR-HA I & AHCR-HAII groups, the incidence of arthritis and the weight of spleen were significantly decreased. 3. In AHCR-HAI & AHCR-HAII groups, the levels of IL-6, INF-${\gamma}$, TNF-${\alpha}$, IgG, IgM and anti-collagen II in serum of CIA mice were significantly decreased. 4. In histology, the cartilage destruction and synovial cell proliferation were decreased in the AHCR-HA I & AHCR-HAII groups, and the collagen fiber expressions in the AHCR-HA I & AHCR-HAII groups were similar with that of the Normal group. 5. In the AHCR-HA I & AHCR-HA II groups, the expression ratio of CD3e+ to CD19+ cell and CD4+ to CD8+ cell were similarly maintained as Normal group in lymph nodes, and CD69+/CD3e+ cells and CD11a+/CD19+ cells were decreased in Iymph nodes, and CD11b+/Gr-1+ cells were decreased in synovium. Conclusion : Taking all these observations into account, AHCR-HA is considered to be effective in prophylaxis and treatment of rheumatoid arthritis, and then more effective in prophylaxis than treatment, so put to practical use in future rheumatoid arthritis clinic.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.138-147
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• 1998

Authors surveyed intrafamilial child sexual abuse in the children under 15years old in clinical. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as follows. 1) The numbers of respondents who have had the experience of treating victims of intrafamilial child sexual abuses were 157(13.0% of total respondents). 2) Among the perpetrators, 58(36.9%) were siblings and 32(20.4%) 26(16.6%) were step-fathers, and respectively. The most common age bracket was 10s(39.5%), and the next was 40s and 50s (33.7%) Almost all(98.7%) of the perpetrators were male. 3) The mean age of victims was $12.1{\pm}3.3$ years old, and all of the victims were female, and the number of victims who had previous mental or physical handicaps and behavior problems were 5(3.2%) and 8(5.1%) respectively. 4) The ways by which intrafamilial child sexual abuses were found were abnormal behaviors 45(28.7%), victim's own report 40(25.5%), pregnancy 18(11.5%), pain complaint 13(8.3%), other person's report 13(8.3%), and detection during examination 12(7.6%). 5) Time lags between intrafamilial child sexual abuses and hospital visits were after 1 month 97(61.8%), from 1 day to 1 week 29(18.5%), within 1 day 21(13.4%), and from 1 week to 1 month 10(6.4%). 6) Physical complications were perineal wound 93(59.2%), hymen rupture 90(57.3%), pregnancy 68(43.3%), wound of other part of body 11(7.0%), and sexually transmitted disease 4(4.5%). 7) Treatment for victims were discharge 92(58.6%), admission, operation or transfer to a bigger hospital 25(15.9%), psychiatry consult 19(12.1%), report to police(10.9%) and social work consult 3(1.9%). These results suggest that considerable numbers of physicians have had the experience of treating victims of intrafamilial child sexual abuses, and intrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.127-137
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• 1998

The authors surveyed extrafamilial sexual abuse in the children under 15years old by the physician's reports. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as followings. 1) The number of respondents who have had the experience of treating victims of extraf/amilial child sexual abuse were 641(53.2% of total respondents). 2) 338(52.7%) of the perpetrators were known persons and 277(43.2%) were strangers, the most common age bracket were 20s, 30s and 10s, and almost all(99.8%) of the perpetrators were male. 3) The mean age of victims was $9.7{\pm}3.5$ years old, and almost all(98.6%) of the victims were female. 4) The ways by which extrafamilial child sexual abuses were found were victim’s own reports：273(62.6%), pain complaint, 156(24.3%) and abnormal behavior 96(15.0%), other person’s report 72(11.2%), detection during examination 19(3.0%), and pregnancy 4(0.6%). 5) Time lags between extrafamilial child sexual abuses and hospital visits were within 24 hours 332 (51.8%) and from 1 day to 1 week 232(36.2%), victims were rather quickly 6) Physical complications were perineal wound 571(89.1%), hymen rupture 349(54.4%), wound of other part of body 124(19.3%), pregnancy 37(5.8%), and sexually transmitted disease 18(2.8%), and other serious complications such as vaginal-rectal lacerations 8, intastinal bleeding 7, death 2, hypotensive shock 1. These results suggest considerable numbers of physicians have had the experience of treating victims of extrafamilial child sexual abuses, and extrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.677-692
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• 2005

The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed $65\%$ agreement to be classified into the same quartile and showed significant correlation (r=0.563 p<0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9mg, female: 6127.6mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9mg, female: 5107.4mg). The sodium intake estimated with DFQ55 (male: 4848.5mg, female: 4884.3mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed $39\~50\%$ agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was $62.5\%,\;81.8\%\;and\;53.2\%$, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were $73.8\%,\;84.0\%,\;62.0\%$, respectively. It seems the short DFQs using Na index 14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.66-74
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• 2012

Purpose: To compare the outcome of two methods of chronic calcific tendinitis (CCT) treatment, Multiple drilling alone versus combined drilling and extracorporeal shock-wave therapy (ESWT). Furthermore, to analyze the clinical and radiologic results of different energy level configurations of ESWT. Materials and Methods: Among the patients complaining shoulder pain who visited the clinic from June 2010 to August 2011, 98 were diagnosed with CCT of the supraspinatus and were divided into the following three groups. Multiple drilling alone (n=31), Multiple drilling followed by high-energy ESWT (n=31), Multiple drilling followed by low-energy ESWT (n=36). The study was conducted only with patients with chronic pain persisting longer than six months despite prolonged conservative therapy. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using the ASES, KSS, CSS system reflecting performance and symptom improvement, and in radiologic terms by studying the change in size of the calcific nodules. Results: All of three groups showed effects for improvement of clinical function and decrease of calcification and clinical improvement was significantly high in comparison between the group fulfilled by only multiple needling (the third group) and the group fulfilled by additional ESWT (the first and second groups) and in the radiological evaluation, calcification size and the rate of calcification decrease showed significant improvement statistically. For the comparison among the groups, degree of clinical function improvement and rate of calcification decrease showed significant difference between high energy group (the first group) and multiple needling group (the third group) as well as low energy group (the second group) and multiple needling group (the third group). But, in comparison between high energy group (the first group) and low energy group (the second group), there was no significant difference for the degree of clinical function improvement and rate of calcification decrease. Conclusion: For the treatment of chronic calcific tendinitis, additional ESWT showed more superior effects on clinical function improvement and radiological improvement regardless of the energy standard rather than the exclusive fulfillment of needling. But, as the result of ESWT by the energy standard, there was no significant difference for the decrease of calcification and degree of clinical function improvement.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• The Korean Society of Law and Medicine
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• v.22 no.3
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• pp.57-95
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• 2021

Korea's period for preservation of embryos is up to five years (the Bioethics Act). However, the study reviewed domestic and foreign laws and drew issues due to the recent demand that the development of related science and technology and the period limitation limit the rights of consent holder for embryo production. the first issue is that preserved embryos are intended for pregnancy, and it is important to ensure that the autonomy of the consent holder is protected through careful consideration based on information such as scientific evidence. the second is that regulations regarding the obligation to manage embryonic preservation institutions are needed. the third is to create a social atmosphere in which embryo creation, preservation, and disposal take place in a minimum range, considering the special status of embryos. based on this issue, the first of the proposals for rational improvement of the regulation and system about embryo preservation is the introduction of an environment in which sufficient explanation and appropriate consent can be exercised and to extend the reasons for the extension of the period, rather than specifying the specific period in law. the second is that institutionalization is necessary considering not only the obligation to manage preservation institutions but also the overall site, such as concerns that may arise as a result. lastly, we propose the introduction of a management method considering the future use of embryos, such as transfer to provide research purposes and donation of pregnancy purposes by others. this process should be a method of sufficient social discussion and consensus, as well as a general consideration of the family relationship with the born child.