• Journal of Gastric Cancer
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• 제14권2호
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• pp.111-116
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• 2014

Purpose: The standard surgical procedure recommended to treat gastric cancer in advanced cases is dissection of D2 lymph nodes (LNs). However, the optimum number of LNs that should be retrieved in advanced gastric cancer (AGC) remains debatable. Therefore, this study aimed to investigate the optimum number of retrieved LNs and determine the clinical implications of retrieved LN numbers on the treatment of AGC. Materials and Methods: Of 575 AGC patients reviewed, 369 who underwent open curative gastrectomy with D2 or more extensive LN dissection at our institution were analyzed according to their clinicopathologic characteristics and number of LNs retrieved. Results: Multivariate regression analysis revealed that tumor size (P=0.006), depth of invasion (P=0.000), LN metastasis (P=0.000), and stage (P=0.000) were independent variables with predictive value. The 5-year survival rates were differed significantly according to the numbers of LNs retrieved ([1] 15~25 vs. >25 and [2] 15~39 vs. ${\geq}40$) in patients with differentiated carcinoma. Conclusions: Tumor size, depth of invasion, LN metastasis, and stage were independent predictive factors for survival. The number of retrieved LNs was significantly associated with a long-term survival benefit in patients with differentiated carcinoma. Therefore, our data suggest that the retrieval of a minimum of 15 LNs may not be sufficient to warrant a recommendation for further curative surgery and that extensive LN dissection should be considered in advanced carcinoma of the differentiated type.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6369-6374
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• 2014

Lung cancer (LC) is the leading cause of cancer mortality worldwide, predominantly due to the difficulty of early diagnosis and its high metastatic potential. Recently, increasing evidence suggests that circulating tumour cells (CTCs) are responsible for cancer metastatic relapse, and CTCs have attracted interest in cancer metastasis detection and quantification. In present study, we collected blood samples from 67 patients with bone metastasis, and 30 patients without such metastasis, and searched for CTCs. Then the association of CTC numbers with bone metastasis and other clinico-pothological variants was analyzed. Results demonstrated that when 5 or 1 was taken as a threshhold for the CTC number, there were significantly higher positivity of CTCs in the bone metastasis group than in the non-metastasis group. While the increase in CTC number was not significantly associated with any other clinicopathological factor, including age, gender, pathological type, intrapulmonary metastasis and lymph node metastasis, the CTC number in patients with positivity of the last above mentioned variants was obviously higher than in patients with negativity of the two variants. Taken together, the CTC number appears to be significantly associated with the bone metastasis from lung cancer.

• Journal of Acupuncture Research
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• 제26권6호
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• pp.121-132
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• 2009

Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.97-104
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• 2006

Purpose: Many factors influence the occurrence and severity of geriatric trauma, and regional weather is regarded as one factor that influences geriatric trauma. In this study, to predict the type, severity, and incidence of geriatric trauma patient, we analyzed the influence of regional weather on geriatric trauma. Methods: The subjects of our investigation were trauma patients over sixty-five years of age who visited the Emergency Department (ED) of Yeungnam University Hospital during a one-year period. We retrospectively reviewed the medical charts of 436 geriatric trauma patients, and the data were analyzed by using SPSS 12.0 for Window. The weather was based on data from the Korea Meteorological Administration. Results: The average age was 72.8 years old, and the ratio of males to females was 1:1.1. The mean spell out ISS was 10.8, and no difference was found between males and females. Slips were the most common cause of trauma. The largest numbers of aged trauma patients, 46, visited the ED in May, and the smallest number of such patients, 24, visited the ED in December. In addition to, summer saw the largest number of aged trauma patients. The type of trauma, the Injury Severity Score, and the number of patients had no relationship with season. On sunny days, the ISS was larger in patients who had hypotension and who had tachycardia. On rainy day, the ISS was larger in male patients and cultivator accident patients. The number of patients was larger on partly cloudy days. Conclusion: In spring and summer and on partly cloudy days, we must be prepared to treat aged traumatized patients in the E.D. On rainy days, visual sensation, tactual sense, and acoustic sense must be closely examined. In addition,on rainy day, aged male traumatized patients or cultivator accident patients must to be closely observation.

• 한방안이비인후피부과학회지
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• 제32권1호
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• pp.16-31
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• 2019

Objective : The purpose of this study is to analyze the charcateristics of inpatients in Ophthalmology, Otolaryngology & Dermatology Clinic by gender, age, season, and department of medical care after hospitalization from March, 2012 to February, 2018. Method : From March 1, 2012 to February 28, 2018, patients who were admitted to the Ophthalmology, Otolaryngology & Dermatology Clinic of Korean Medical Hospital were classified by gender, age, department, and season, and their relationship, hospitalization period, number of outpatient visits Differences were analyzed objectively using various statistical methods using IBM SPSS 18.0. Results : 1. The number of inpatients was 432, including duplication. Of these, 317 were female and 115 were male. The number of female patients was 2.8 times higher. 2. The average age of the inpatients was 43.9 years and the number of middle-aged 40-50 patients was 48.6%. 3. The number of inpatients in the departments was in the order of dermatology, otology, laryngology, rhinology, and ophthalmology. The most hospitalized diseases were eczema in the dermatology department, sudden hearing loss in the otology department, tonsillitis/peritonsillar abscess, rhinitis in the rhinology department, and dry eye syndrome in ophthalmology. 1) The effect of gender on the difference in the number of inpatients by subdivision was statistically significant. 2) The effect of age on the difference in the number of inpatients by subdivision was statistically significant. 3) The effect of seasons on the difference in the number of inpatients was not statistically significant. 4. The number of inpatients by season was in the order of winter, spring, summer, autumn, and the number of inpatients decreased significantly in autumn. 1) The effect of gender on the difference in the number of hospitalized patients by season was not statistically significant. 2) The effect of age on the difference in the number of hospitalized patients by season was not statistically significant. 5. The average length of hospital stay for inpatients was 10.7 days. 1) The effect of gender on length of hospital stay was not statistically significant. 2) The effect of age on hospital stay was not statistically significant. 3) The effect of the subdivision on hospital stay was statistically significant. 4) The effect of the season on hospital stay was not statistically significant. Conclusion : As a result of this study, the most distinctive feature of the present study was the high rate of inpatients with otic disease like idiopathic hearing loss and Meniere 's syndrome and the high rate of female patients. This may be related to the increased prevalence of the disease and the severity of the disease. In addition, the high rate of female patients suggests that women are more likely to be affected by illnesses, as well as to have more medical use and severe symptoms requiring hospitalization. In the future, it would be better to provide various treatment plans and policies for patients with otic diseases and female patients. Also it would be good if studies on these fields are made in the future.

• Journal of Acupuncture Research
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• 제37권2호
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• pp.118-122
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• 2020

Background: Compared with conventional closed therapy, acupotomy has the advantages of lower cost, convenient application, and better single and long-term effects. The aim of this study was to explore the clinical effect of acupotomy in the treatment of Tarsal Tunnel syndrome. Methods: There were 80 patients enrolled into the study who were randomly assigned to either the acupotomy or closed therapy group, with 40 patients in each group. The acupotomy group was treated once every 6 days, on 3 occasions for the duration of treatment, and the closed therapy group was treated twice a week, for 3 weeks as the course of treatment. The effects of treatment were analyzed and evaluated according to the standard of curative effect. Results: The "cure rate" of the number of patients in the acupotomy group whose symptoms had completely disappeared (13 patient out of 39) was higher than the closed therapy group (1 patient out of 39), and this difference was significant (p < 0.01). The number of patients in the acupotomy group who did not benefit from the therapy (5 patients) was significantly lower than the closed therapy group (15 patients; p < 0.05). The total number of patients in the acupotomy group who benefitted from the therapy (34 patients) resulted in an effective rate of 87.18%, which was higher than the closed therapy group (24 patients; 61.53%). The difference was statistically significant (p < 0.05). Conclusion: Acupotomy is effective in the treatment of Tarsal Tunnel syndrome, was superior to traditional closed therapy, and is worthy of clinical application.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.130-137
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• 2022

Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

• Annals of Coloproctology
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• 제34권6호
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• pp.299-305
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• 2018

Purpose: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. Methods: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. Conclusion: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

• 한국병원경영학회지
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• 제19권4호
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• 동의신경정신과학회지
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• 제25권4호
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• pp.411-422
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• 2014

Objectives: A large number of patients require psychiatric therapy. We attempted to determine the present situation regarding psychotherapy and neuropsychological tests for dementia in Korean medicine for the benefit of the Health Insurance Review and Assessment Service (HIRAS). The aim of this study was to aware of the current status about psychotherapy and neuropsychological test for dementia in Korean medicine. Methods: We searched the medical practice records for psychotherapy and neuropsychological tests in oriental neuropsychiatry between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRAS) database. The search categories were: IJeongByunGi (Medical practice code:59001), JiUnGoRoen (59002), Kyungjapyungji (59003), OhJiSangSeung (59004), neuropsychological test for dementia (29005). Results: 1. The number of patients treated with Korean Medical Psychotherapy increased annually by 151%. The total number of patients treated with Korean Medical Psychotherapy was 4,289 in 2013. 2. The total cost for patients treated with Korean medical Psychotherapy in the public health medical insurance budget was 268,032,000 won in 2013. The average medical cost for one therapy was 17,000 won in 2013. 3. The number of patients in local clinics is increasing faster than the number in Korean medical hospitals. 4. The age group between 20~30 years of age, for both men and women, is the group with the greatest density in Korean Medical Psychotherapy. 5. Neuropsychological Testing for Dementia in Korean Medicine is slowly decreasing. Conclusions: The prevalence of mental illness in Korea is increasing, therefore, the demand for Korean Medical Psychotherapy has increased recently. Authorizing Korean Medical psychiatrists to utilize Korean mental Health resources is essential. This study could be helpful in understanding the current status for the purpose of expanding Korean Medical Psychotherapy.