• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.94-99
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• 2015

Purpose: A mother's working environment is believed to be a major determinant of exclusive breastfeeding (EBF) practice. We aimed to define the influence of a facility dedicated to breastfeeding and a breastfeeding support program at the workplace on breastfeeding practice. Methods: A cross-sectional study was performed in five workplaces. The inclusion criteria were female workers whose last child was between 6 and 36 months old. Observational data were obtained and a questionnaire was filled out. The World Health Organization definition for EBF was used. Results: Data from 186 subjects (74 office workers and 112 factory workers) were collected. Just over half (52%) of the mothers were between 20 and 46 years old, 75.3% had graduated from high school and university, 12.9% had more than two children and 36.0% owned a house. The prevalence of EBF during the last 6 months was 32.3%. A proper dedicated breastfeeding facility was available for 21.5% of the mothers, but only 7.5% had been in contact with a breastfeeding support program. The presence of a dedicated breastfeeding facility increased EBF practice almost threefold, by an odds ratio (OR) of 2.74 and a 95% confidence interval (CI) of 1.34-5.64 (p<0.05). Knowledge of the breastfeeding support program increased EBF practice by almost six times (OR, 5.93; 95% CI, 1.78-19.79) (p<0.05). Conclusion: Our findings suggest that Governments should make it obligatory for employers to offer a breastfeeding support program and a dedicated breastfeeding facility at the workplace as these simple measures significantly increase EBF.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.141-149
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• 2004

Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.95-98
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• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.536-544
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• 2019

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1092-1100
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• 1989

Since May 1987 to April 1989, fifteen patients have been subjected to coronary artery bypass graft [CABG] including coronary thromboendarterectomy in 3 patients at Hanyang University Hospital. The correlation between the preoperative coronary angiography, electrocardiography, clinical status, operative finding and postoperative blood flow, complication and degree of clinical improvement were evaluated. 1. Ten patients [67 %] were male and five patients [33 %] were female, Ages ranged from 30 to 68 years. [average 52.2 years] 2. The angina by types of presentation was stable in 3 patients, unstable in 12 patients with resting, postinfarction and progressive angina as the criteria of unstability. 3. The number of involved vessels were single in 6 cases, double in 4 cases, triple in 5 cases including 1 case of left main coronary arterial disease. 4. The distribution of sites of distal anastomosis revealed predilection to left coronary arterial system [83 %], especially left anterior descending arterial system. 5. The author performed 4 cases of single bypass, 4 cases of double bypass, 5 cases of triple bypass and 2 cases of quadruple bypass. Of these 15 patients, 3 patients received coronary thromboendarterectomy, LAD in 2 patients and right coronary artery [RCA] in 1 patient. 6. The distal anastomosis were performed first with using saphenous vein grafts as conduits in all cases except 1 case using Gore-Tex conduit because of deficient in length and narrowed internal mammary artery and sequential bypass methods were employed in last 6 cases. 7. One operative death occurred and therefore, mortality rate was 6.7%. The perioperative myocardial infarction were occurred in 3 cases [20%] and its cause was supposed that they were triple vessel disease and therefore, aortic cross clamping times were relatively long. 8. All survivors were followed for 17.7 months on an average [range 5-28 months] and they have had symptomatic improvement except 1 case having mild degree of angina at 1.5 months after operation.

• Parasites, Hosts and Diseases
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• v.37 no.2
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• pp.77-83
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• 1999

To ascertain residual sonographic and histopathological findings of clonorchiasis after treatment, the present study evaluated sonographic findings in rabbits which were infected with 500 metacercariae of C.sinensis every 6 months for 18 months after treatment with praziquantel. The sonographic findings were analyzed in terms of intrahepatic bile duct dilatation and periductal echogenicity, and histopathological findings were observed after the last sonographic examination. Compared with the sonographic findings before treatment, dilatation of the intrahepatic bile ducts became mild to some degree in four of the seven cases and increased periductal echogenicity resolved in four of them. The histopathological specimens after 18 months showed that periductal inflammation has almost resolved but moderate dilatation of the intrahepatic ducts and mucosal hyperplasia persisted. The periductal fibrosis minimally resolved. The log-lasting sonographic findings in cured clonorchiasis make sonography less specific.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• Journal of Oriental Neuropsychiatry
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• v.7 no.1
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• pp.1-13
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• 1996

1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.63-69
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• 2005

Purpose: The purpose of this study was to analyze the clinical results after Steindler flexoplasty. Materials and Methods: We analyzed 6 cases who had nearly normal finger and wrist joint flexion function, but could not flex elbow joint actively because of upper arm type brachial plexus injury. We performed operation during the period from February 1997 to July 2003. There were 5 males and 1 female with mean age of 28 years (range: $19{\sim}51$ years) when Steindler flexoplasty was done. The average follow-up period was 3 years 11 months (range: 12 months${\sim}$7 years 4 months). We assessed active range of motion of elbow joint, muscle power and elbow function by Mayer & Green grade scale at last follow-up. We assessed how much they were favorable for Steindler flexoplasty and had improvement of upper extremity function and correction of deformity. Results: Postoperative, flexion range of elbow joint improved to average $111.7^{\circ}$ (range: $90{\sim}130^{\circ}$). $25.8^{\circ}$ (range: $15{\sim}45^{\circ}$) in flexion contracture and $16.6^{\circ}$ (range: $10{\sim}35^{\circ}$) in pronation contracture were remained. Range of motion of elbow joint improved to average $85.3^{\circ}$ (range: $45{\sim}105^{\circ}$). Flexion power of elbow joint improved to Grade 5 in all cases. Postoperatively on Mayer & Green grade scale, there were excellent in 3 cases(50%), good in 2 cases(33.3%), fair in 1 case(16.7%). On patient's own assessment of functional improvement, there were excellent in 4 cases(66.6%), good in 1 case(16.7%) and fair in 1 case(l6.7%). Conclusion: Steindler flexoplasty can reserve good clinical results with being improved to active flexion of elbow joint in cases who have functional hand and wrist, but paralysis upper arm muscle in brachial plexus injury.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.793-807
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• 2006

This study was performed to estimate the effect of alphacalcidol supplementation or nutrition education on the nutrient intakes, bone mineral density and bone markers in continuous ambulatory peritoneal dialysis (CAPD) patients. The 90 CAPD subjects were randomly assigned to 3 groups (alphacalcidol group: AG, nutrition education group: NG, and control group: CG). Alphacalcidol supplementation($0.5{\mu}g/day$) was carried out for 8 months. Nutrition counseling was performed according to the patient s individual question for the first 6 months and scheduled nutrition education with individual counseling was carried out for the last 2 months. In baseline data. there were no significant differences in age, sex, family number, education years and monthly income except the NG showed significantly less duration of CAPD (p< 0.05) compared to other two groups. After intervention all three groups showed tendency of lower intakes. NG revealed less decrease in protein, especially in animal protein calcium from Ca-P binder, dietary calcium, dietary iron and niacin. NG showed significantly more increase in dry weight (p<0.05) and AG in waist circumference (p<0.001) after intervention. The groups did not show significant differences in the changes of biochemical indices related to bone metabolism. NG revealed more increase in trochanter BMD(p < 0.05) compared to other two groups. It seems that nutrition education is more effective in preventing deterioration or improving the bone and general nutrition status.