• 대한한방부인과학회지
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• 제37권1호
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• pp.40-59
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• 2024

Objectives: Since infertility has been big social issue in Korea, this study aims to analyze the domestic study trends in Korean Medicine (KM) for female infertility treatment. Methods: Case studies applying KM treatment on female infertility were selected through 5 domestic journal databases. General characteristics, interventions, outcomes and results and the quality of the reports were analyzed. Especially, the quality assessments of studies were made using CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 14 studies (22 cases) were finally selected for the analyzation. The mean age of the participants was 35.1 and the most common factor of female infertility in this study was Uterine factor. Herbal medicine was applied in all studies, and acupuncture was also used frequently. Most cases reported pregnancy of the participants. According to quality assessment, 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', 'Patient perspective' and 'Informed consent' were showed low reporting rates. Conclusions: Korean Medicine treatment for female infertility is expected to be effective. In quality evaluation, there were some items with low reporting rates. Further clinical studies have to be conducted to establish the evidence for the treatment.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.627-634
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• 2023

In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• Tuberculosis and Respiratory Diseases
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• 제73권2호
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• pp.93-99
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• 2012

Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

• 대한가정학회지
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• 제24권4호
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• pp.57-68
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• 1986

The present survey was designed to investigate correlations among blood pressure, nutritional intakes, and various environmental factors in Korean adult males, and to observe the difference in dietary intakes between hypertensive patients and normotensive subjects. Two hundred forty-three adult men from Seoul and rural areas were interviewed about their food intakes, dietary patterns, food habits, and general environmental factors from December 20, 1982 to February 15, 1983. Their dietary intakes were surveyed by means of 24-hour recall diet method. Dietary score card was used in order to evaluate the quality of routine diet of the subject. Variables of environmental factors and factors related to hypertension were expressed as percentage, and the differences in nutrient intake and food score of each sub-group were examined by means of t-test. Correlation of all the variables were analyzed by Pearsons Correlation Coefficient. The results obtained are summarized as follows: 1. 38% of the subjects were between the ages of 40~49, and about one-half of the subjects were middle or high school graduates. 28% of the subjects earned 210, 000~350, 000 Won per month, and income distribution was almost identical to that of the urban population of Korea. 2. There was more overweight or obese found in the hypertensive patients than in the normotensive subjects. About 40% of the hypertensive patients reported a family history of hypertension, and their knowledge about hypertension was rather poor, but slightly better than the normotensive subjects. The patient group had less adherence to smoking and alcohol compared with the normotensive subjects, but no difference was observed in coffee drinking. The mean value of the blood pressure for the normotensive subjects was 127/86mmHg and 175/109mmHg for the hypertensive group. 3. Nutrient intake for the hypertensive group was lower for most of nutrients than in the healthy group. Hypertensive patients on diet therapy consumed less calories and carbohydrates compared with those who do not follow diet therapy. 4. There was no difference intake of these food groups between patients and the healthy group. Food score was strongly related to consumption of animal protein, saturated fats, Calcium, Iron, Vitamin A, Riboflavin, and Vitamin C, which are prone to be deficient in the typical Korean diet. 5. Blood pressure had a strong positive correlation with age, body weight, and socioeconomic level. In addition, monthly income was positively related with age and education level. 6. Three was a positive relationship between blood pressure and consumption of vegetable protein, and a negative relationship with consumption of Calories, Carbohydrates, Calcium, Iron, Vitamin A, Vitamin B1, Niacin, and Vitamin C. Animal protein intake increased as income and education levels increased, but this tendency was opposite for carbohydrates. In summary, nutritional intakes are strongly correlated with various environmental factors and the level of blood pressure. There was no difference between normotensive and hypertensive subjects with respect to the quality of food consumed except restricting energy and carbohydrate in the patient group.

• 정신신체의학
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• 제16권2호
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• pp.103-111
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• 2008

연구목적 : 신체형 장애를 가진 한국 여성에서, 과연 산후조리를 잘 못한 것이 신체화 형성의 요인이 되는지를 알아보고자 하였다. 방법 : 대상자에게 반구조화된 설문지를 통하여 산후 조리와 관련된 내용에 대해 직접 면담하고, 이와 동시에 자가 평가 질문지를 작성하도록 하였다. 자가 평가도구로는 산후조리 평가지, SCL-90R의 SOM척도, 한국판 신체 증상목록, 산후병증상 평가지, Beck depression Inventory(BDI), State trait anxiety inventory(STAI), Visual analogue scale(VAS)을 사용하였다. 결과 : 환자군이 대조군에 비해 산후조리 기간이 짧았으며, 산후조리 평가 점수(K-DMP)가 낮았으며 본인이 평가한 산후조리의 만족도도 낮았다. 현재의 신체증상에 대한 이유에 대해 환자군에서는 43.9%, 대조군에서는 33.3%가 산후조리 때문이라고 답하였다. 산후조리 점수(K-DMP)와 신체화척도(SOM) 사이에는 유의미한 부적 상관관계를 보였다(Pearson correlation : r=-0.476, p<0.01). 다변량 회기 분석에서 현재 신체증상(SOM)에 대해 과거 산후 풍 정도와 산후조리 점수, 이 2가지 요인이 영향력을 가짐이 나타났다. 결론 : 부족한 산후조리는 이후의 신체화 형성과정에 영향을 주는 요인인 것으로 보인다.

• 대한방사선기술학회지:방사선기술과학
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• 제31권1호
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• pp.1-10
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• 2008

최근의 IT, BT와 NT의 발달로 U-헬스케어가 도입되고, 원격진료 및 전자의무기록(EMR), 의료영상저장전송시스템(PACS) 등의 보편화는 의료정보시스템을 때와 장소를 가리지 않는 유비쿼터스 의료 환경으로 진화시키고 있다. 이에 병원은 의료정보시스템의 활성화 및 보편화를 적극적으로 장려하며, 국가 차원의 디지털 의료정보의 통합 및 의료기관간 네트워크화가 구축하여 유 무선 의료 통신망이 개방되고, 환자의 진료 데이터 및 영상 공유가 실시되고 있다. 그리고 의료 산업 분야에서는 의료장비, 의료정보시스템, 의료 애플리케이션 등 관련 기술이 복잡화, 고도화되는 추세를 나타내고 있다. 이전의 의료정보 표준은 HL7, DICOM, IHE, ASTM 등의 많은 관련 기구가 독자적으로 기술 표준을 제정하는 상황으로 대부분의 기술들이 국가 간, 동일 국가의 지역 내, 업체 간 긴밀한 상호 관계없이 독립적으로 개발 및 구현이 되고 있어, 시스템의 통합 및 표준화에 어려움이 많이 있다. 이에 의료데이터의 적합성 및 상호운용성을 위하여 국제 표준화 기구는 긴밀한 협조로 관련 표준을 공동 개발하는 추세이다. 본 논문에서는 최근의 의료정보기술 표준화 동향을 살펴보고, 향후의 의료정보시스템의 전망을 예측하여 실제 국내에서 의료정보 및 애플리케이션 개발에 필요한 의료정보 표준을 제시하고자 한다. 특히 최근 각 선진국들의 의료정보 표준화를 기술 선점의 기회로 국가적 차원에서 지원이 증대함에 따라 의료산업 및 의료정보기술의 표준 연구가 절실하다고 생각된다. 결과적으로 환자 중심의 의료정보 환경에서의 국내 의료기관의 정보화 촉진 및 선진화를 도모하기 위하여 의료정보 표준의 국내 적용의 개발이 선행되어야 하며, 병원 및 의료 산업에서 의료정보 표준 정착과 공유 활용의 기반을 마련하는 의료정보시스템을 구축하여야 할 것으로 생각된다.

• 대한치과보철학회지
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• 제37권5호
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• pp.698-713
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• 1999

Adherence of Candida albicans(C. albicans) to the surface of a denture is believed to be an initial and essential step in the formation of denture-induced stematitis. Previous studies have provided enormous infomation on the relationship between composition of palatine gland/parotid saliva and upper denture stomatitis. Relatively little information is available on the correlation between lower denture stomatitis and sublingual-submandibular ( SLSM ) saliva. The plaque samples were collected from the two sites($100mm^2$) on the inner surface of lower partial denture corresponding to the stematitis and healthy region of the lower partial dentures of 12 denture stomatitis patients and 6 nor-mal persons who wore lower partial dentures. The samples were plated to isolate C. albicans on a selective Saboraud's dextrose agar plate and the isolates were identified by germ tube test and gram staining. The subjects were divided into group I (stomatitis with C. albican), group II (lesion without C. albicans), group III (no lesion but C. albicans), and group IV (normal and healthy denture wearer). Individual SLSM saliva($20{\mu}g$ of protein) was analyzed by SDS-PAGE (SDS -poly-acrylamide gel electrophoresis) with Coomassie brilliant blue and PAS(Periodic Acid Schinff) stain-ing. The salivary proteins separated in the polyacryamide gels were subjected to immunoblot anaysis using anti-lactoferrin, anti-sIgA, and anti-secretory component of sIgA. In this study using custom made acrylic denture resin beads(5mm in diameter) coated with stimulated individual SLSM saliva, the binding ability of individual C. albicans strains to the beads was observed. Levels of C, albicans adhered to the acrylic resin beads were determined by measuring the optical density of the bound C. albicans to the beads at 580nm. The results showed that a higher number of C. albicans was observed in the lesion site than healthy site. The saliva of group I contained more high molecular weight glycoprotein(mucin, MGI) as compared to group II, III and IV. And lactoferrin and sIgA affected to the binding ability of C. albicans to acylic resin beads. Binding ability of individual C. albicans to the acrylic resin coated with respective individual saliva was found to be greater in group I than the other 3 groups. And when bound cells of C. albicans isolated from individual subject #2 to the saliva coated beads were used binding ability of subject #2 saliva coated beads was founed to be greater than the other sutjects. These results suggested that denture induced stomatitis is related to individual patient's salivary protein composition, especially MG-1. Future studies will be directed toward saliva exam-ination of patients who have general disease and analysis of pellicles formed on prosthesis with respect to oral disease.

• Journal of Chest Surgery
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• 제38권11호
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• pp.746-760
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• 2005

배경: 인공심장판막 시술 후에 환자들은 혈전색전증의 위험성을 감소시키기 위해서 평생 warfarin투여를 받게 된다 한국인 환자에서 목표 INR 2.0-3.0을 유지하는 것은 여러 가지 이유로 어려움이 따른다. 이 연구의 목적은 약사에 의해서 운영되는 anticoagulation service (ACS)을 받는 한국 인공심장판막 외래환자에서 치료 범위를 벗어난 INR의 원인을 분석하고 warfarin치료에의 복약불이행과 관련된 요인들을 확인하고자 하였다. 대상 및 방법: 1997년 3월에서 2000년 9월까지 서울대학교병원에서 ACS를 방문한 모든 환자의 의무기록을 후향적으로 검토하였다. 수술 후 6개월이 경과된 화자로 INR 2.0 미만과 INR 3.0초과가 한 번 이상 있는 환자 866명(5,304회 방문)을 대상으로 치료 범위를 벗어난 INR의 가능한 모든 원인들을 환자 방문 때마다 분석하였다 성별, 연령, ACS 상담을 받은 기간 및 warfarin 치료 기간과 복약불이행과의 상관성은 단변수 분석으로 확인하였다. 걸과· 비치료범위의 INR의 원인은 다음과 같았다: 부적절한 용량 조절$(21\%)$, 복약불이행$(13\%)$, 약물-약물/한약 상호작용$(12\%)$, 식이의 변화$(7\%)$, 확인불가$(42\%)$. 낮은 연령, 짧은 ACS 상담 기간, 장기간의 warfarin 치료가 복약불이행과 관련이 있었다 결론: 이 연구에서 복약불이행, 약물과 식이의 상호작용이 비치료범위의 INR의 중요한 요인임이 확인되었다. 낮은 연령과 장기간의 warfarin치료 기간이 복약불이행과 상관이 있었던 반면 ACS 등록된 기간이 길수록 warf arin에 대한 치료 순응도가 높아졌다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.