• Journal of the Korean Data and Information Science Society
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• 제28권1호
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• pp.75-86
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• 2017

본 연구는 의 한의 협진 진료의 발생 빈도가 높은 질환인 얼굴마비에 대하여, 2014년도 건강보험심사평가원 환자표본 자료 (HIRA-NPS, 2014)를 이용해서 진료 에피소드 단위의 분석을 시행하였다. 건강보험 급여 청구현황에 근거한 진료 에피소드 단위 분석결과, 의 한의 협진 빈도는 남성보다 여성에서 높은 것으로 나타났으며, 연령대는 50세 이상이 높은 것으로 나타났다. 얼굴마비 환자들에서 확인된 의료이용 패턴은 의과 단독 진료 군의 경우 진단 및 검사가 다 빈도로 확인되었으며, 한의과 단독 진료와 의 한의 협진 진료 군의 경우는 치료 항목들이 다 빈도로 나타났다. 치료 행태별 요양일수는 의 한의 협진, 한의과 단독 진료, 의과 단독진료 등의 순으로 다 빈도가 확인되었으며, 내원일당 요양급여 비용은 의과 단독 진료, 의 한의 협진, 한의과 단독 진료 등의 순으로 높게 나타났다. 본 연구에서 추정된 의 한의 협진 의료이용 행태는 향후 본 질환의 임상진료지침 개발과 의료 정책의 수립에 방향성을 제시할 수 있을 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.259-268
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• 1984

The Korean government launched the medicaid program for the poor people as a wing of the social development and welfare programs beginning in 1977 when the fourth 5-year national economic development program started. The charts of the medicaid recipients who visited Jonglo-Gu Health Center for the period from 1981 to 1983 were reviewed and analysed. Major findings from the analysis are as follows. 1. The medicaid recipients occupied 5.19% in 1981, 2.90% in 1982 and 2.00% among the total residents of Jonglo district in 1983, respectively. 2. The mean number of physician visits per person year of medicaid recipients who visited the Jonglo-Gu Health Center was 4.73 in 1981, 4.90 in 1982 and 4.41 in 1983, respectively. 3. The consultation/referral rate at the Jonglo-Gu Health Center was 2.65% in 1981, 1.77% in 1982 and 2.18% in 1983 while the rate at the department of family practice, Seoul National University Hospital was 3.18% in 1983. 4. Classifying into 17 major categories, the pattern of diseases of the poor outpatients who visited the Hallym College Medical Center both in 1981 and 1982 showed a statistically similar pattern of the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981 and 401 patients in 1983. 5. Classifying into 17 major categories, the disease of outpatient visits at the department of family practice, Seoul National University Hospital from 1st May, 1983 to 31s1 Oct., 1983 revealed statistically significant similarity with both the 5,169 medicaid patients in 1981 and the 401 patients sampled in 1983. 6. Classifying into 17 major categories, the diseases of community diagnosis at the Ihwa Dong, Jonglo-Gu also showed a statistically significant similarity with the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981. 7. Classifying into 17 major categories, the diseases of 5,169 medicaid patients at Jonglo-Gu Health Center in 1981 showed a statistically significant similar distribution with that of the 401 sampled medicaid patients at this center in 1983. 8. Among the medicaid patients who utilized the Jonglo-Gu Health Center in 1983, 401 sampled patients who are practicable routine urinalysis composed of 131 indigent group and 270 low-income group. The sample composed of 127 males and 274 females. There were more old patients than the young ones among the 401 sampled patients. 9. Age-adjusted prevalence rate of the hypertension computed by the direct method using estimated of midyear population of 1980 year as the standard is the highest in the Yonsei area and the lowest in the Shindongmyun. Furthermore age-adjusted prevalence rate was higher for males than that of females. 10. The group of hypertension patients using routine urinalysis profile composed of pyuria, hematuria, proteinuria and glycosuria is the most statistical significant, the pyuria alone is very significant, hematuria is significant and proteinuria is also significant.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.35-46
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• 2023

Purpose: Culture-based methods for microbiological diagnosis and antibiotic susceptibility tests have limitations in the management of orofacial infections. We aimed to profile pus microbiota and identify antibiotic resistance genes (ARGs) using a culture-independent approach. Materials and Methods: Genomic DNA samples extracted from the pus specimens of two patients with orofacial abscesses were subjected to shotgun sequencing on the NovaSeq system. Taxonomic profiling and prediction of ARGs were performed directly from the metagenomic raw reads. Result: Taxonomic profiling revealed obligate anaerobic polymicrobial communities associated with infections of odontogenic origins: the microbial community of Patient 1 consisted of one predominant species (Prevotella oris 74.6%) with 27 minor species, while the sample from Patient 2 contained 3 abundant species (Porphyromonas endodontalis 33.0%; P. oris 31.6%; and Prevotella koreensis 13.4%) with five minor species. A total of 150 and 136 putative ARGs were predicted in the metagenome of each pus sample. The coverage of most predicted ARGs was less than 10%, and only the CfxA2 gene identified in Patient 1 was covered 100%. ARG analysis of the seven assembled genome/metagenome datasets of P. oris revealed that strain C735 carried the CfxA2 gene. Conclusion: A metagenomics-based approach is useful to profile predominantly anaerobic polymicrobial communities but needs further verification for reliable ARG detection.

• 대한방사선치료학회지
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• 제28권1호
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• pp.65-75
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• 2016

목 적 : 유방보존술 이후 부분 유방 방사선 치료를 시행한 환자들의 치료 전후 장액종의 체적 변화를 분석하여 방사선 치료 효과 향상에 기여하고자 한다. 대상 및 방법 : 본원에서 ViewRay MRIdian System을 이용하여 부분유방방사선 치료를 시행한 환자 20명을 대상으로 하였다. 대상 환자들의 수술시 제거된 검체 크기를 구하고, 장액종의 체적 변화를 주(week)단위로 획득하였다. 획득한 체적을 바탕으로 나이, 수술 후 첫 치료시작까지의 기간, 체질량지수(BMI), 수술시 적출된 검체 크기 등을 기준으로 하여 비교하였다. 그리고 부분 유방 방사선 치료의 특정용적을 구하기 위해 PTV(=seroma volume + margin)를 기준으로 ViewRay MRIdian RTP System을 이용하여 분석하였다. 결 과 : 모의치료 MRI 촬영 후 첫 치료 시까지 1주일간 나타난 장액종의 체적 변화는 0~5%가 8명, 5~10%가 2명, 10~15%가 3명, 15~20%가 2명, 그리고 20% 이상이 5명 이었다. 가장 큰 변화를 보인 2명의 환자 중, A환자는 기존 치료계획에서 처방선량 100%의 용적이 213.08 cc, PTV는 181.93 cc, 장액종의 체적은 15.3 cc였으나, 보정치료계획에서 장액종의 체적이 5.3 cc로 65.36% 감소하면서, 처방선량 100%의 용적은 205.83 cc, PTV는 102.54 cc로 각각 3.4%, 43.6% 감소하였다. B환자는 장액종의 체적이 20.2 cc에서 11.6 cc로 42.57% 감소하였고, 이로 인해 처방선량 100%용적은 8.1%, PTV는 40% 감소하였다. 결 론 : 장액종의 체적 변화는 고령일수록, 수술 후 치료가 시작되는 기간이 짧을수록, 검체의 크기가 100 cc이하 일수록 큰 것을 확인하였다. 부분유방방사선치료 환자의 경우 전체유방방사선치료의 환자보다 체적 변화에 따른 Dose conformity가 더욱 민감하므로, 지속적인 관찰을 통해 각 환자의 장액종 체적 변화에 따른 보정치료계획을 수립하여 치료하는 것이 바람직하다고 사료된다.

• 기본간호학회지
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• 제17권2호
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• pp.220-230
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• 2010

Purpose: This study was done to identify differences in three groups of operative patients (Forced Air Warming, Electrical Blanketrol, Control) for discomfort and pattern of body temperature during surgery and post operatively. Methods: The sample consisted of 3 randomized 3 groups of abdominal surgery patients admitted to an university hospital in D-city : The Bair Hugger and upper body blanket were used with the first group, electrical blanketrol with PVC Film with the second, and the third group was the control. ANOVA was used with the WIN SPSS 17.0 program to analyze the data. Results: Significant differences were found among the three groups for tympanic and esophageal body temperature at 1 hour after starting surgery. There was significant difference in tympanic body temperature during the 15 minute stay in the post anesthetic room. There were no significant differences in thermal discomfort while in the post anesthetic room. or There among the three groups for serum cortisol during surgery. Conclusion: According to the results of this study, application of a Bair Hugger or electrical blanketrol improves maintenance of body temperature of operative patients as well as body temperature of post operative patients, and is a clinically significant warming method providing a more consistent body temperature.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9753-9757
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• 2014

Purpose: To study the quality of life and to identify associated factors among breast cancer patients undergoing treatment in national cancer centers in Nepal. Materials and Methods: One hundred breast cancer patients were selected and interviewed using a structured questionnaire. European Organization of Research and Treatment of Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified Medical Outcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales of EORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were applied to analyze differences in mean scores. Results: The score of global health status/quality of life (GHS/GQoL) was marginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social function while best performed scales were physical and role function. In BR-23, most of the patients fell into the problematic group regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did not demonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good social support were found to have good GHS/GQoL. Of all the influencing factors, social support was established to have strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function (<0.001), cognitive function (0.020), social function (<0.001) and body image function (0.011). Body image was significantly associated with most of the influencing factors: monthly family income (0.003), type of treatment (<0.001), type of surgery (<0.001), stage of cancer (0.017) and social support (0.011). Conclusions: Strategies to improve social support of the patients undergoing treatment should be given priority and financial difficulties faced by breast cancer patients should be well addressed from a policy making level by initiating health financing system.

• Korea-Australia Rheology Journal
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• 제17권3호
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• pp.117-123
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• 2005

Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

• 셀메드
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• 제10권2호
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• pp.15.1-15.9
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• 2020

Introduction: Buthūr Labaniyya (Acne vulgaris) is a multifactorial disorder of the pilosebaceous units characterized by non-inflammatory and inflammatory clinical lesions. Several Unani medications have been used for centuries to treat acne. Objectives: Evaluation of safety and efficacy of Tila-i Muhāsā in patients with acne vulgaris Materials and Methods: This clinical study was conducted in patients with acne vulgaris. Patients applied Tila-i Muhāsā or 5% Benzoyl Peroxide (BPO) once daily for 6 weeks. Assessment of efficacy was carried out by Global Acne Grading System (GAGS) and Patient Global Assessment (PGA) scores. In addition, overall severity of acne was evaluated on a 5-point Cook's acne grading scale using photographic standards. Assessment of safety was performed through adverse drug reactions, local dermal tolerability, vital signs, and routine laboratory investigations. Results: A total of 60 patients (30 in each group) completed 6 weeks of treatment. The mean percentage reduction in GAGS score at 6 weeks from baseline in Unani group (66.97%) and BPO group (59.09%) was statistically significant (P<0.0001). After 6 weeks of therapy, the mean percentage reduction in PGA score compared to baseline in Unani group (57.44%) and BPO group (50.23%) was statistically significant (P<0.0001). No serious adverse events were reported in both groups; however, mild adverse events occurred more frequently in BPO group (30%) compared to Unani group (10%). Conclusion: Tila-i Muhāsā was found to be effective and safe in the treatment of acne vulgaris. However, further clinical studies with larger sample size and longer duration of therapy need to be conducted.

• 대한한의학회지
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• 제36권3호
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• Journal of Periodontal and Implant Science
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• 제43권2호
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• pp.87-95
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• 2013

Purpose: The purpose of this study was to analyze the expression of inducible nitric oxide synthases (iNOS), tissue inhibitors of metalloproteinase $(TIMP)_{-3}$, and $TIMP_{-4}$ in the gingival tissues of periodontal patients with or without type 2 diabetes mellitus (DM). Methods: Depending on the patient's systemic condition and clinical criteria of the gingiva, each gingival sample was classified into one of three groups. Sixteen clinically, systemically healthy patients (group 1), 16 periodontal patients (group 2), and 16 periodontal patients with DM (group 3) were included. Tissue samples in each group were collected, prepared, and analyzed by western blotting. Quantification of the relative amount of $TIMP_{-3}$, $TIMP_{-4}$, and iNOS was performed. Results: The expression levels of iNOS and $TIMP_{-3}$ both increased in group 1, group 2, and group 3 in increasing order, and were significantly higher in both group 2 and group 3 as compared to group 1 (P<0.05). The expression levels of $TIMP_{-4}$ increased in the same order, but significantly increased in group 2 as compared to group 1, in group 3 as compared to group 1, and group 3 as compared to group 2 (P<0.05). Conclusions: This study demonstrated that iNOS, $TIMP_{-3}$, and $TIMP_{-4}$ might be involved in the progression of periodontal inflammation associated with type 2 DM. It is thought that further study of these factors can be applied practically for the diagnosis and control of periodontitis in diabetics.