• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.453-459
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• 2019

Purpose: Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates. Methods: In this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant. Results: The mean total serum bilirubin in the SG was lower than that in the CG ($9.38{\pm}2.37$ and $11.17{\pm}2.60mg/dL$, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG. Conclusion: Use of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.

• 융합보안논문지
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• 제15권6_2호
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• pp.79-87
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• 2015

최근 허위입원을 이용한 보험범죄가 증가하여 사회문제화 되고 있다. 급격하게 증가하고 있는 허위 과다입원을 통한 보험범죄에 민간보험회사가 대응하는 데에는 한계가 있고, 실제 적발하기에 어려움이 있다. 보험범죄의 증가는 보험회사의 경영악화 뿐만 아니라 보험계약자의 손해를 야기하고, 결국 국가 전체적인 피해로 귀결된다. 보험범죄의 위법성을 분명하게 인식시키기 위해서는 현행법에서 보험범죄에 대한 규정을 명시하는 것이 바람직하다. 일반 사기죄의 구성요건과 차별화된 '보험사기죄'를 신설하고, 보험범죄의 행위태양이나 조직적 가담의 정도 등에 따른 차별화가 요구된다. 또한 민사제재의 도입과 조직적 보험범죄에 대한 가중처벌 규정의 신설이 요구된다. 중복보험사실을 생명보험 가입시에 고지하도록 법규의 개정이 요구된다. 그리고 불필요한 장기입원을 제한할 수 있는 입원기준 마련이 필요하다. 아울러 보험회사 조사요원에게도 조사권을 부여하는 방안으로 민간조사원 제도의 도입이 필요하다. 또한 보험회사와 수사기관 등 유관기관 사이의 정보공유관련법을 마련하고 보험범죄 적발이 가능한 정보 데이터베이스를 구축하며, 보험범죄인지시스템에 SNA기법을 도입하여 조직적 공모사기를 찾아낼 수 있도록 해야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.147-152
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• 2008

Objectives : Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Methods : Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. Results : The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the non-fluoridated cities. Conclusions : We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

• 대한의생명과학회지
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• 제25권1호
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• pp.32-39
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• 2019

Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• 사상체질의학회지
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• 제24권2호
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• pp.61-70
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• 2012

1. Objectives : The aim of this study was to report significant improvement of chronic diarrhea and hematochezia after treatment with Dojeokgangki-tang in a Soyangin Patient with Crohn's Disease. 2. Methods : The patient's subjective and objective symptoms were observed daily throughout the hospitalization period, and the Crohn's disease activity index(CDAI) was calculated to gauge the progress or lack of progress. 3. Results : The symptoms of diarrhea and hematochezia disappeared by the end of the hospitalization period without recurrence, and the CDAI score dropped from 92.5 to 47. 4. Conclusions : A patient with Crohn's disease, who was in the state of repetitive relapse and remission after long term clinical courses was treated with Dojeokgangki-tang in a short period and the the symptoms of diarrhea and hematochezia disappeared without recurrence. Then the patient could stop taking corticosteriods and taper off immune-suppressing drugs.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Journal of the Korean Data and Information Science Society
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• 제27권3호
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• pp.773-789
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• 2016

본 연구는 노인요양병원 입원노인의 수면양상 및 영향요인을 파악하여 이들의 수면의 질 향상을 위한 중재프로그램 개발 시 기초자료로 활용하고자 시도된 서술적 조사연구이다. G시 노인요양병원에 입원한 65세 이상의 노인환자 142명을 대상으로 구조화된 설문지와 24시간 수면기록지를 사용하여 자료 수집하였다. 요양병원 입원노인의 일일 평균 수면시간은 10.7시간이었으며 낮 수면시간은 평균 3.9시간, 밤 수면시간은 평균 6.8시간 이었다. 총 수면규칙성은 71.7%였고, 낮 수면규칙성은 평균 58.1%, 밤 수면규칙성은 평균 80.5%였다. 요양병원 입원노인의 수면시간에 영향을 주는 예측요인은 병실 내 치매환자 유무로 10.3%의 설명력을 나타냈고, 수면 규칙성에 영향을 미치는 예측요인은 통증, 병실 내 치매환자 유무, 신체기능으로 16.1%의 설명력을 나타냈다. 따라서 요양병원 입원노인의 수면양상에 영향을 미치는 추가요인 규명을 위한 후속 연구의 필요성과, 본 연구에서 확인된 요양병원 입원노인의 수면에 영향을 미치는 요인을 고려한 중재프로그램 개발 및 적용이 필요하다.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.150-155
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• 2001

Between January 1995 and May 1998, 177 patients with proven lumbar disc herniation were treated by microdiscectomy or by percutaneous endoscopic discectomy(PED). Among them, 43(24.2%) patients underwent PED and were followed for long term outcome. We included only those patients who were followed up more than 13 months. Three patients who did not improved immediately after PED and underwent microdiscectomy were excluded for this study. Of remaining 40 patients, there were 22 men and 18 women who ranged in age from 23 to 68 years (mean 38.1 years). The disc herniations were located at L1-2(1), L2-3(1), L3-4(1), L4-5(26) and L5-S1(11). Three patients were treated by biportal approach. The mean follow up period was 34.7 months(range 13-47 months). Overall, excellent and good results were achieved in 12(30%) and 19(47.5%) patients, and fair and poor results in 7(17.5%) and 2(5%) patients, respectively. Thirty-eight(95%) patients returned to their previous works and the mean duration was 5.7 months. Thirty-three(82.5%) patients answered that they would recommend this procedure to others. There was no complication except for one patient who suffered from discitis. The indication of PED is restricted to contained or small subligamentous lumbar disc herniation without stenosis, spondylolisthesis and sequestration. PED can be performed under local anesthesia and tissue trauma, risk of epidural scarring, hospitalization time and postoperative morbidity are minimal. The result of the present study justify the assumption that PED can be a surgical alternative for patients suitable for its indications.