• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.745-752
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• 2010

Purpose: There is currently little evidence to support intravenous immune globulin (IVIG) therapy for pediatric myocarditis. The purpose of our retrospective study was to assess the effects of IVIG therapy in patients with presumed myocarditis on survival and recovery of ventricular function and to determine the factors associated with its poor outcome. Methods: We reviewed all consecutive cases of patients with myocarditis with left ventricular dysfunction verified by echocardiogram who had visited 3 university hospitals between January 2000 and September 2009. These patients were divided into 2 groups. Group 1 consisted of 23 patients (69.6%) who received IVIG alone or IVIG in combination with steroids, and group 2 consisted of 10 patients (30.3%) who received neither IVIG nor other immunosuppressive agents. Clinical manifestations, laboratory results, echocardiographic findings, and outcomes were compared between these 2 groups. Results: One year after the initial presentation, the difference in the probability of survival did not show statistical significance in IVIGtreated patients ($P$=0.607). Of the echocardiographic parameters on admission, a shortening fraction of less than 15% was associated with unremitting cardiac failure. Furthermore, anemic patients were more likely to have elevated N-terminal fragment levels of the B-type natriuretic peptide (NT-proBNP) in the progressed group ($P$=0.036). Conclusion: There was no difference between the IVIG-treated patients and the control patients in the degree of recovery of left ventricular function and survival. Prospective, randomized, clinical studies are needed to elucidate the effects of IVIG treatment during the acute stage of myocarditis on ultimate outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.520-527
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• 2010

Introduction: This study examined the treatment patterns of temporomandibular disorders (TMD) including conservative and surgical procedures. Materials and Methods: Patients with TMD who visited Gangnam Severance Hospital from June 2007 to May 2008 were enrolled in this study. All patients were examined from the orthopantomogram, temporomandibular joint (TMJ) tomography, and a clinical examination. The patients who required a further evaluation were examined by magnetic resonance imaging and/or computed tomography. The treatment patterns were divided into counseling, medication, splint therapy, botulinum toxin injection (BTI) and surgical treatment. Results: Among the 2,464 patients, the average age was 31.8 years (ranging from 6 to 93); 764 (31.0%) were male and 1,700 (69.0%) were female. 2,355 (95.6%) patients were treated with conservative therapy; 1,460 (62.0%) patients were treated with medication, 931 (39.5%) patients were treated with splint, and 46 (2.0%) were treated with BTI. There were 109 (4.4%) patients treated surgically. Eight (0.3%) patients were treated with total temporomandibular joint replacement surgery. Conclusion: Almost all patients with TMD were treated using conservative methods. Those patients who received surgical treatment because of an ineffective response to conservative treatment had definite problems with the internal derangement and/or osteoarthritis or had severe clinical symptoms.

• Nutrition Research and Practice
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• 제4권2호
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• pp.136-141
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• 2010

North Korean defectors who settle in South Korea have experienced severe food shortage and transition of food environment which could affect their health status. However, little is known about their anthropometric measurements and dietary intake after settlement in South Korea. The purpose of this study is to compare anthropometric measurements and dietary intake between North Korean young adults who defected to South Korea and those of South Koreans. We hypothesized that North Korean young adults' physiques and dietary intake would be poorer than that of South Koreans. We compared anthropometric measurements and dietary intake from 3-day food records in a cross-sectional study of 103 North Korean young adult defectors, aged 12 to 24 and 309 South Korean subjects. North Korean subjects were significantly shorter (4.9 to 10.8 cm) and lighter (6.0 to 12.5 kg) than the control group. Body mass index were significantly different between North and South Korean groups only in men. North Korean young adult defectors had lower mean daily intakes of energy and most nutrients and food groups compared to the control group, while North Korean subjects had higher nutrient density diet than that of South Koreans. The proportion of subjects who had dietary intakes of nutrients of less than the Estimated Average Requirement was higher in North Korean subjects than in controls except for in the cases of vitamin A and vitamin C. In conclusion, we recommend providing nutrition support programs for North Korean young adult defectors to secure adequate nutrient intake.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.201-206
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• 2010

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

• 보건행정학회지
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• 제20권1호
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1155-1162
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• 2014

Background: Despite mixed survival data, the utilization of contralateral prophylactic mastectomy (CPM) for the prevention of a contralateral breast cancer (CBC) has increased significantly over the last 15 years, especially among women less than 40. We set out to look at our own experience with CPM, focusing on outcomes in women less than 40, the sub-population with the highest cumulative lifetime risk of developing CBC. With an extended follow-up, we hoped to demonstrate differences in the long-term disease free survival (DFS) and overall survival (OS) among groups who underwent the procedure (CPM) versus those that did not (NCPM). Materials and Methods: We performed a retrospective review of all breast cancer patients less than age 40 diagnosed at Mount Sinai Medical Center between January 1, 1980 and December 31, 2010 (n=481). Among these patients, 42 were identified as having undergone CPM, while 195 were confirmed as being CPM-free during the observation period. A univariate and multivariate analyses were performed. Results: The CPM group had a significantly higher percentage of patients who were diagnosed between 2000 and 2010 (95.2% vs 40%, p=0.0001). The CPM group had significantly smaller tumors (0-2cm.: 41.7% vs 24.8%, p=0.04). Among the entire group of patients, the overall five- and 10-year DFS were 81.3% and 73.3%, respectively. CPM was significantly associated [HR 2.35 (1.02, 5.41); p=0.046] with 10-year OS, although a similar effect was not observed for five-year OS. Conclusions: We found that CPM has increased dramatically over the last 15 years, especially among white women with locally advanced disease. In patients less than 40, who are thought to be at greatest cumulative risk of secondary breast cancer, CPM provided an OS advantage, regardless of genetics, tumor or patient characteristics, and which was only seen after 10 years of follow-up.

• 한국콘텐츠학회논문지
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• 제10권6호
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• pp.236-248
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• 2010

이 글을 통해 코엔 형제의 범죄 영화에 속하는 <블러드 심플>, <바톤 핑크>, <파고>, <그 남자는 거기 없었다>, <노인을 위한 나라는 없다>를 중심으로 감독의 연출 스타일을 분석하다. 코엔 형제 영화 구성의 특징은 서사적 구성, 내레이션의 활용, 해피엔딩의 거부다. 주제에 있어서는 인간본성을 탐구하고, 탐욕이 가져온 허무와 비극을 주로 다룬다. 극적인 요소로는 오해, 엇갈림, 추격의 모티프를 주로 활용하고 있다. 그의 작품의 캐릭터들은 어긋난 욕망으로 파괴되는 보통사람의 단순함이 대부분이고, 전형적인 캐릭터를 거부한다. 형식을 분석해 보면, 촬영은 스테디 캠을 자주 사용하고, 고정 숏에 광각렌즈를 애용한다. 초기 범죄영화는 표현주의적인 조명을 많이 사용했으나 나중엔 사실적인 자연조명을 주로 썼다. 고전적인 편집, 사운드는 음악보다 음향효과를 주로 사용했고, 실제 현장 사운드, 사실적인 연기와 개성을 중요 시 하였다. 분명 그의 영화는 크게 범죄 영화와 코미디로 분류할 수 있지만, 범죄가 우월한 느와르 스타일의 영화야말로 코엔의 독특한 연출 스타일을 느낄 수 있다.

• 대한간호학회지
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• 제40권3호
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• pp.423-432
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• 2010

Purpose: This study was done to examine effects of Nei-Guan acupressure on nausea, vomiting and level of satisfaction for gynecological surgery patients who were using a patient-controlled analgesia (PCA). Methods: For this study, 51 patients were assigned to one of three groups, a control group (17 patients), experimental group 1 (finger acupressure group) (17 patients), and experimental group 2 (relief band group) (17 patients). The data were collected for 24 hr in the recovery room of a university hospital located in Seoul. The 6 hr-intervals including the time of leaving the recovery room were taken into consideration. Results: The occurrence of nausea between the experimental group with Nei-Guan acupressure treatment and the control group was different. However, there was no difference in nausea and vomiting control or level of patient satisfaction between the finger acupressure group and the relief band group. Conclusion: Nei-Guan acupressure is recommended for nursing practice as a way for alleviating the opioid-induced nausea and accelerating the recovery of patients who are using PCA after surgery.

• Journal of Preventive Medicine and Public Health
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• 제43권4호
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• pp.309-318
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• 2010

Objective: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. Methods: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. Results: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). Conclusions: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.

• Journal of Preventive Medicine and Public Health
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• 제47권2호
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• pp.84-93
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• 2014

Objectives: The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service. Methods: Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs. Results: The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively. Conclusions: Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention.