• Journal of Preventive Medicine and Public Health
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• 제45권2호
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• pp.90-97
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• 2012

Objectives: While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. Methods: We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socioeconomic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Results: Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. Conclusions: The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.818-826
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• 2021

Objective : The widely accepted treatment option of a traumatic carotid cavernous fistula (TCCF) has been detachable balloon or coils based fistula occlusion. Recently, covered stent implantation has been proving an excellent results. The purpose of this study is to investigate our experiences with first line choice of covered stent implantation for TCCF at level 1 regional trauma center. Methods : From November 2004 to February 2020, 19 covered stents were used for treatment of 19 TCCF patients. Among them, 15 cases were first line treatment using covered stents. Clinical and angiographic data were retrospectively reviewed. Results : Procedures were technically successful in all 15 cases (100%). Immediate angiographic results after procedure were total occlusion in 12 patients (80%). All patients except two expired patients had image follow-up (mean 15 months). Recurred symptomatic three patients underwent additional treatments and achieved complete occlusion. Mean clinical follow-up duration was 32 months and results were modified Rankin Scale 1-2 in five, 3-4 in five, and 5 in three patients. Conclusion : The covered stent could be considered as fist line treatment option for treating TCCF patients especially in unstable vital sign. Larger samples and expanded follow-up are required to further develop their specifications and indications.

• Radiation Oncology Journal
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• 제35권1호
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• pp.39-47
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• 2017

Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.177-182
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• 2021

Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

• Journal of Ginseng Research
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• 제43권4호
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• pp.600-605
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• 2019

Background: The leaves and roots of Panax ginseng are rich in ginsenosides. However, the chemical compositions of the leaves and roots of P. ginseng differ, resulting in different medicinal functions. In recent years, the aerial parts of members of the Panax genus have received great attention from natural product chemists as producers of bioactive ginsenosides. The aim of this study was the isolation and structural elucidation of novel, minor ginsenosides in the leaves of P. ginseng and evaluation of their antiinflammatory activity in vitro. Methods: Various chromatographic techniques were applied to obtain pure individual compounds, and their structures were determined by nuclear magnetic resonance and high-resolution mass spectrometry, as well as chemical methods. The antiinflammatory effect of the new compounds was evaluated on lipopolysaccharide-stimulated RAW 264.7 cells. Results and conclusions: Two novel, minor triterpenoid saponins, ginsenoside $LS_1$ (1) and 5,6-didehydroginsenoside $Rg_3$ (2), were isolated from the leaves of P. ginseng. The isolated compounds 1 and 2 were assayed for their inhibitory effect on nitric oxide production in LPS-stimulated RAW 264.7 cells, and Compound 2 showed a significant inhibitory effect with $IC_{50}$ of $37.38{\mu}M$ compared with that of NG-monomethyl-L-arginine ($IC_{50}=90.76{\mu}M$). Moreover, Compound 2 significantly decreased secretion of cytokines such as prostaglandin $E_2$ and tumor necrosis factor-${\alpha}$. In addition, Compound 2 significantly suppressed protein expression of inducible nitric oxide synthase and cyclooxygenase-2. These results suggested that Compound 2 could be used as a valuable candidate for medicinal use or functional food, and the mechanism is warranted for further exploration.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권12호
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• pp.702-704
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• 2018

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3921-3924
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• 2013

Background: To investigate the role of surgical treatment for locally advanced esophageal cancer, we compared the outcomes of chemoradiotheroy alone (CRT) to postoperative chemoradiotherapy (S/CRT), using, Regional Radiotherapy Center, database. Materials and Methods: This retrospective study was conducted in North-West of Iran, included of 255 consecutive patients with esophageal cancer. Eligible operable and non-operable, were treated with S/CRT and CRT respectively. Radiotherapy (RT) was delivered at 1.8-2 Gy/day for five consecutive days in a given week. Chemotherapy (CT) consisted of cisplatin and 5-fluorouracil. Results: From March 2006 to March 2011 255 patients: male/female 129/96, median age 68 (35-90), squamous/adeno 213/12, received CRT/S+CRT 166/59, median radiation dose $45{\pm}13.6Gy$, Median survival 13.5 (11-15), overall survival (OS) One/Two/Three 57/21/16%, Died/alive 158/97, Univariate analysis prognostic factors: age/stag/differentiation/dose of RT/fraction/treatment, Multivariate analysis predictor factor: dose of RT/fraction. Conclusions: Although this treatment offers some possibility for improvement of patients with esophageal cancer, there remains a significant need for development of new drug and new therapeutic approaches that can substantially impact survival.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.185-186
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• 1998

• 서비스연구
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• 제13권4호
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• pp.113-130
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• 2023

본 연구는 환자와 의료진의 경험을 중심으로 상급종합병원 권역응급의료센터의 서비스디자인을 적용한 단일 사례 연구이다. 서비스디자인 기법을 활용하여 의료 서비스 경험을 측정 및 개선하고, 그 효과를 검증하는 것을 목표로 한다. 환자와 의료진으로부터 심층적인 경험 데이터를 수집하기 위해 민족지학(ethnography)과 디자인 워크숍을 중심으로 한 질적 사례 연구를 진행했다. 이 연구는 응급 의료 서비스에서 직면한 문제에 특히 중점을 두고 환자와 의료진 간의 주요 경험 차이를 확인하였으며, 권역응급의료센터 환경의 복잡한 역학을 이해하기 위해 환자와 의료진 인터뷰, 디자인씽킹 워크숍을 통해 수집된 정성 데이터를 대해 종합적으로 분석하고 디자인에 반영했다.연구 결과, 환자와 의료진의 요구를 반영한 디자인 현황을 3가지 주요 측면인 소통 개선, 환자 흐름 관리, 환경 개선의 필요성이 강조되었으며, 환자와 의료진 두 그룹의 특정 요구 사항의 차이점을 분석하여 권역응급의료센터의 서비스 개선을 위해 디자인 주도의 실행 과정을 적용 할 수 있었다. 이 연구는 의료 분야에서 디자인의 역할과 중요성을 강조하며, 이론적인 연구와 실제 디자인 실행 간의 효율적인 방법을 제시하고 있다. 이를 통해 더욱 빠르고 효과적이며 만족도가 높은 의료 서비스 환경을 만드는 데 기여할 수 것이다. 그리고 서비스디자인이 환자와 의료진 모두의 만족을 위한 새로운 혁신 과정의 핵심으로 보는 새로운 계기가 되기를 기대한다.

• 대한한의학원전학회지
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• 제22권4호
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• pp.15-28
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• 2009

Traditional korean medicine which has long history and many clinical experiments stands out in bold relief because the medicine's point of view has been changed from medical treatment to disease protection and the wellbeing life through health care and complementary alternative medicine has been emerged for the incurable disease. Many traditional korean medical research has been conducted in the fields of preventive medical application, leading material drawing and medical service upgrade through eastern and western medical treatment and the more advanced project are being studied as time goes by. But because we have the hardship of manifesting traditional korean medicine's knowledge into detailed data and information in the field of analytical science and we don't have well arranged research trend data of it, researchers are using much time to survey the preceding research and planners needing more accurate research trend data to protect duplication and raise efficiency. So we have studied the traditional korean medicine's research trend to solve this problems by the method of bibliography applied for the preceding project results. Through the analysis of traditional korean medicine's 370 project reports we came to a conclusion that the R&D investment is concentrated on the university and research institute, the utilization projects are lower than basic and applied research, regional snobbism is excessive than the whole nation's R&D and advanced project has been started since 2006.