• 사상체질의학회지
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• 제25권2호
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• pp.108-114
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• 2013

Objectives This study was aimed to review a standardized method of retention enema by extracting elements associated with methods of retention enema from papers involved. Methods 1) Data sources : Retrieval was made, using 'Enema' or 'Retention Enema' as search words in MEDLINE, The Cochrane Library, KISS, RISS, and NDSL DB. 2) Study selection : Two authors excluded irrelevant papers and chose qualified abstracts in the rest of the papers. The chosen studies were reviewed fully by the authors so that they could screen the significant papers based on the exclusion criteria. 3) Data extraction : Data on the total number of subjects, the target disease, the type, quality, length, diameter of catheter, the insertion length of catheter, the sample, the sample volume, the process of retention enema and the number of performing retention enema were extracted from the selected studies. Results & Conclusions The retention enema can be applied to gastrointestinal diseases, genitourinary diseases, metabolic diseases such as hypertension and diabetes, headaches and neurological disorders. The standardized treatment method is as following: 1) inserting a rental tube of 18-28 Fr that measures 20 to 30 cm into the patient's anus, 2) injecting herbal medicines which have purgative action or benefit on stomach and intestinal tract at the rate of 4 ml/min, and 3) holding them for 10 to 15 minutes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.535-542
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• 2007

Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

• 대한소아치과학회지
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• 제28권4호
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• pp.547-552
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• 2001

교정치료를 목적으로 한 하악 전치의 발거는 교합에 부정적인 영향을 끼치는 것으로 여겨져 왔으나 적절히 사용한 경우에 부정교합 치료의 한 방향으로써 선택적으로 사용될 수 있다. 대개 총생에 대한 치료는 비발치와 4개의 소구치 발거 사이에 선택하는 경향이 있다. 총생이 있는 하악 전치의 치료를 위한 다양한 접근 방법은 구치의 원심이동, 견치의 외측이동, 전치의 순측이동, 인접면 법랑질 삭제, 소구치 발거, 한 개 또는 두 개의 전치 발거 및 이상의 복합적인 방법들이 있다. 전치의 발거는 총생이 있거나 전치부 치아크기의 불일치 및 상악 전치의 선천적인 소실이나 이소성 맹출 등에 의해 발거한 경우에 조화를 위해서이다. 하지만 수직피개가 크고 공간이 있는 경우는 피해야 하며 전치부 수직피개의 증가는 흔한 부작용이다. 본 증례에서는 상악 전치부에 심한 총생이 있고 상악 좌측 측절치의 매복과 우측 측절치의 구개측 이소성 맹출로 인해 발거한 경우로써 하악 전치부에도 심한 총생이 있었다. 따라서 요구되는 공간, 안모의 심미성, 전방교합관계, 견치간 폭경, 적은 치아이동, I급 교합관계, 발치시기 및 수직 수평피개 등을 고려하여 하악 양측절치를 발거하였다. 이에 본 증례는 상악 측절치의 매복 및 이소성 맹출을 동반한 상하악 전치부의 심한 총생이 있는 초기 영구치열기의 남아에서 상하악 양측절치를 발거하고 고정식 장치를 사용하여 공간 폐쇄 및 견치 shaping을 통한 교정치료를 하여 양호한 결과를 얻었기에 보고하는 바이다.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.109-116
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• 1976

Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamenta, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Wha County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5%), Skin (12.7%) , diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and. all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test or X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case, The Total average cost per visit was 870.

• 한국병원경영학회지
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• 제7권4호
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• pp.172-192
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• 2002

The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.

• The Korean Journal of Pain
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• 제20권2호
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• pp.116-122
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• 2007

Background: Lumbar zygapophysial joints are a common source of chronic lower back pain and radiofrequency thermocoagulation (RF) of the medial branches (MB) has been shown to be effective at providing substantial pain relief for chronic low back pain. Therefore, we carried out this study to determine the short term outcomes and prognostic factors of RF on the MB of patients with lumbar facet syndrome. Methods: We performed RF in fourteen patients who showed greater than 80% pain relief up to three times after a diagnostic MB block was conducted using 0.3 ml of 0.5% bupivacaine. Using 10 cm curved electrodes with 10-mm active tip, a 60 second, $80^{\circ}C$ lesion was made after electrical stimulation at 50 Hz for sensory and 2 Hz for motor nerve testing. The degree of pain relief was then assessed after 2 weeks, and again after 3 months using a visual analog scale (VAS) and a four point Likert scale. The outcome was regarded as 'success' if at least a 50% reduction in the VAS was observed. Possible prognostic factors between the two groups were also evaluated Results: The success rate was 71.4% (10/14) after three months of follow-up. However, there were transient complications, such as neuritis like syndrome, in 4 patients. In addition, short symptom duration and low minimal voltage (< 0.4 V) for sensory stimulation were shown to be the relevant prognostic factors for a successful outcome. Conclusions: RF may be an alternative to repeated MB block or intraarticular injection for palliation of lumbar facet syndrome. For better outcomes, early diagnosis and strict patient selection should be coupled with efforts to avoid anatomically incorrect RF.

• Korean Journal of Acupuncture
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• 제37권1호
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• pp.31-36
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• 2020

Objectives : The purpose of this study is to review needling depth and location of LU7, BL62 and KI6 by the medical classics' records. Methods : 1. We researched the medical classics describing LU7, KI6 and BL62, and reorganized data about the location and needling depth. 2. We compared the medical classics' records on LU7, KI6 and BL62 with description of WHO standard acupuncture point location. 3. We reviewed different location and needling depth of LU7, BL62, and KI6 recorded in the medical classics with the anatomical structure. Results : 1. The common needling depth of LU7 is about 0.2 chon. But in some medical classics, the depth of LU7 is 0.8 chon. Needling depth of LU7 varied depending on the patient's hand posture. In the 'half-up' position with the thumb upward, it is possible to stimulate acupuncture on LU7 by 0.8 chon because there is a space between the tendons. 2. In WHO standard acupuncture point location, the locations of BL62 and KI6 are just below the lateral and medial malleolus. But in some medical classics, the locations of BL62 and KI6 are between the bones and muscles below the malleolus. In the locations between the bones and muscles below the malleolus, it is possible to stimulate acupuncture on BL62 and KI6 by penetrating acupuncture because there is no bone structure. Conclusions : 1. By the 'half-up' position with the thumb upward, it is possible to stimulate vertically acupuncture on LU7 by 0.8 chon. 2. By the locations of BL62 and KI6 between the bones and muscles below the malleolus, it is possible to stimulate on BL62 and KI6 by penetrating acupuncture.

• 근관절건강학회지
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• 제14권2호
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• pp.137-148
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• 2007

Purpose: This study was performed to evaluate of practicum by using standardized patient(SP) for nursing assessment. Method: This study had 2 steps. The 1st-step was pre-intervention stage including selection of a learning title, formation of case scenario, training of SP and developing the evaluation tools for students' clinical competence to assessment, 6 categories 29 items. The 2nd-step consisted of intervention and evaluation stages. 34 nursing students divided 2 groups participated in assessing the SP. Evaluation of each group was performed by 2 nursing professors. All students recorded their feelings after assessing the SP. The SP also evaluated about nursing students' attitude toward the SP. Results: ICC(Interclass correlation coefficient) between 2 groups was over 0.7 all categories. Students' assessing score(range 0-1) was muscular-joint function status(0.41), nutritional status(0.39), history taking(0.38), IADL(0.18), ADL(0.15), and emotional status (0.07). The mean scores of the nursing students' attitude by SP was 4.03(range 1-6). Also most students showed positive reactions to the education using SP because they had the chance to experience what they could not practice in clinical setting. Conclusion: The evaluation tool revealed high reliability. Nursing students' clinical competence was below average. But they took a good attitude to SP. We recommended further research using SP with various disease.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.85-90
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• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• 한국사회복지학
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• 제51권
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• pp.93-118
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• 2002

우리나라에서 유방암은 여성암 중 두 번째를 차지하고 있고, 점차 증가하고 있으며 이들의 심리사회적 적응에 대한 욕구와 관심이 증대되고 있음에도 불구하고 아직 우리나라에서 유방암 환자들의 심리사회적 후유증을 감소시키기 위한 개입은 이루어지지 못하고 있다. 본 연구는 유방암 환자를 대상으로 서구에서 주로 실시되어 왔던 심리교육 집단개입이 우리나라에서도 심리적 디스트레스를 감소시키고 대처를 증진시킴으로써 심리사회적 후유증을 감소시키는데 효과가 있는지를 평가하고 이에 대한 합의를 논하는데 목적을 두었다. 유방암 수술을 받은 지 1년이 경과하지 않은 환자들 중 유방암 병기가 3기 B이상이거나 70세 이상의 환자, 거동이 불편한 환자, 지리적으로 참석이 불가능한 환자 등을 제외한 80명의 환자 중 연구에 참여를 희망하는 환자 70명을 실험집단, 대기자 통제집단 및 대기자 집단으로 무작위 할당하였다. 실험집단과 통제집단의 수는 각각 24명이었으며 최종 분석에 포함된 환자 수는 실험집단 22명, 통제집단 13명이었다. 이들에 대해 매 주 특정주제를 중심으로 8주간의 구주화된 집단개입을 실시하였으며, 프로그램은 교육과 심리적 지지를 결합한 심리교육적 전략을 사용하였다. 대상자들은 심리적 디스트레스와 대처에 대해 Beck Depression Inventory와 Ways of Coping Checklist-Revised(WCCL-R)를 실시하여 집단개입 전과 8주 후에 각각 평가하였다. 분석결과 실험집단은 통제집단에 비해 집단 개입 이후 BDI상에 나타난 우울에 대해서는 유의미하게 낮은 점수를 보였지만(p<.05). 대처에 대해서는 총점에서나 하위척도 상으로 유의미한 차이를 보이지 않았다. 연구결과와 관련하여 집단의 크기, 프로그램의 내용, 수술 후 경가 시기 등이 논의되었다. 몇 가지 한계에도 불구하고 본 연구는 우리나라에서도 단기 심리교육 집단개입이 유방암 환자들의 수술 후 심리사회적 후유증을 줄이고 삶의 질을 증진시키는 중요한 방법으로 활용될 수 있는 가능성을 보여주었다고 할 수 있다.