• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.278-281
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• 2010

Objective : For the treatment of osteoporotic vertebral compression fracture, percutaneous vertebroplasty (PVP) is currently widely used as an effective and relatively safe procedure. However, some patients do not experience pain relief after PVP. We performed several additional PVP procedures in those patients who did not have any improvement of pain after their initial PVP and we obtained good results. Our purpose is to demonstrate the effective results of an additional PVP procedure at the same previously treated level. Methods : We reviewed the medical records and the radiologic data of the PVP procedures that were performed at our hospital from November 2005 to May 2008 to determine the patients who had undergone additional PVP. We identified ten patients and we measured the clinical outcomes according to the visual analogue scale (VAS) score and the radiologic parameters, including the anterior body height and the kyphotic angulation. Results : The mean volume of polymethylmethacrylate injected into each vertebrae was 4.3 mL (range: 2-8 mL). The mean VAS score was reduced from 8 to 2.32. The anterior body height was increased from 1.7 cm to 2.32 cm. The kyphotic angulation was restored from 10.14 degrees to 2.32 degrees. There were no complications noted. Conclusion : The clinical and radiologic outcomes suggest that additional PVP is effective for relieving pain and restoring the vertebral body in patients who have unrelieved pain after their initial PVP. Our study demonstrates that additional PVP performed at the previously-treated vertebral levels could provide therapeutic benefit.

• Journal of Preventive Medicine and Public Health
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• 제43권5호
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• pp.377-386
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• 2010

Objectives: This study was carried out for the purpose of evaluating the blood mercury concentration of the residents of Busan, Korea, as well as the relationship between the mercury concentration and the pattern of fish consumption along with other epidemiological factors. Methods: Two hundred ninety-three subjects (147 men and 146 women), who were aged 40 years or more, were recruited into this study between June and October 2009. The mean age of the subjects was 54.3 years (with a range of 40-70 years). Mercury concentrations in blood samples were measured using a gold-amalgam collection method. Results: The geometric mean concentration of mercury in the total subjects was $8.63\;{\mu}g/L$ [range: $1.48{\sim}45.71\;{\mu}g/L$]. The blood mercury concentration of the men ($9.55\;{\mu}g/L$) was significantly higher than that of the women ($7.76\;{\mu}g/L$). The blood mercury concentration of those who eat fish more than 4 times per week was higher than others, and was statistically significant (male p = 0.0019, female p = 0.0002). According to the multiple analysis, the blood mercury concentration was significantly affected by the consumed fish but other epidemiological factors were not related. Conclusions: It was found that the subjects who have consumed a large amount of fish may have high blood mercury concentration. It appears that fish consumption can influence blood mercury concentration. Therefore, guidelines for fish consumption that will decrease blood mercury concentration might be necessary in Korea.

• 의학교육논단
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• 제12권1호
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• pp.23-31
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• 2010

Medical humanities has become a third area of medical education following basic and clinical medicine. Also, in the national evaluation of medical schools, medical humanities education is an important factor. However, there are many difficulties in teaching medical humanities in medical schools. First, it is still an unfamiliar education area to medical schools and professors. Second, still, there is no consensus on the definition and contents of this education. Third, it is usually very difficult to find professors who have interest and the ability to teach medical humanities. Fourth, even medical students do not understand why they should study medical humanities and sometimes do not eagerly participate in class. This paper suggests some solutions for these problems. First, medical humanities need to be divided into sections according to how easily the contents can be accepted by existing medical education system and apply these sections in the introduction of this education gradually and in stage. One example of the division can be as follows: Group 1) medical ethics and medical law which can be most easily accepted. Group 2) medical communication skills which can be relatively easily accepted. Group 3) medical history and medical professionalism which is relatively difficult to accept, and Group 4) medical philosophy, medicine and music, medicine and literature, medicine and art, medicine and religion, etc. which is the most difficult to accept. In this paper, four things are suggested. Second, divide the contents into mendatory courses and elective courses. Third, allocate the contents throughout the four years from the first year though the fourth year according to the spiral curriculum model. This paper reports some new ideas and methods for medical humanities education. First, to stimulate students' participation, several methods were applied in a large size lecture and student projects. Second, the emphasis of writing in class and evaluation were discussed. Third, the provision of hands on experience is more emphasized than lectures. Fourth, inviting some doctors who work in non-medical areas such as journalism, pharmaceutical industry, etc is suggested. Trial and error is inevitable in this education, but it is essential in molding a good doctor, so medical professors who are interested or in charge of this medical humanities education need to share their ideas and experiences.

• 보건행정학회지
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• 제20권3호
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• pp.138-156
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• 2010

Objective : The purpose of this study is 1) to understand the information-searching behavior of health care consumers ; 2) to examine the relationship between the information-searching behavior of health-care consumers and regulatory variables such as socioeconomic factors, characteristics of medical utilization, and perceived risks ; and 3) to determine the factors that affect consumer satisfaction, especially with respect to information-searching behavior. Method : The data for this study were collected from 838 respondents in five university hospital located in three areas?Seoul, Gyeonggi province, and Chungchong province. As the first step of the study, we conducted a preliminary survey from September 23?26, 2008. At the second step, we conducted a survey on the effect of information-searching behavior on those individuals who had visited. Furthermore, personal interviews were conducted through a face-to-face survey between September 30 and October 17, 2008. Results : The major research findings that were obtained from the study were as follows : First, the age, educational level, and residential district were associated with information source utilization. Second, the level of information searching effort and quality of service had a significant effect on consumer satisfaction. Conclusion : These results show that it is essential for marketers to have in-depth knowledge about the young and educated people who actively search for information and about those who are in the prime of their life and rely on word-of-mouth communication from personal and experi in-al informers. Therefore, marketers should develop different marketing strategies to meet the needs of such consumers.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.175-181
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• 2010

Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.219-225
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• 2010

Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

• 한방재활의학과학회지
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• 제21권3호
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• pp.45-55
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• 2011

Objectives : The main purpose of this study is to investigate the efficacy of Kyejibokryong-whan(Guizhifuling-wan) and examine the blood stasis for patients with motor vehicle accident. Methods : Of the patients who have visited Dong-Shin university oriental hospital for general pan due to motor vehicle accident from June 2010 to November 2010, we enrolled 29 patients and performed blood stasis diagnosis. Patients were divided into groups according to blood stasis findings. Patients who had more than twenty blood stasis diagnosis point were classified as blood stasis group. Patients who had under twenty blood stasis diagnosis point were classified as non blood stasis group. We administered Kyejibokryong-whan(Guizhifuling-wan) to all group. The effect was assessed by VAS(visual analogue scale), SF-MPQ(short form-McGill pain questionnaire) ODI(Oswestry disability index) & NDI(neck disability index). Results : The pain & function index decreased in both groups after treatment. Conclusions : The difference between blood stasis group and non blood stasis group were not significant at after treatment stage. This data suggested that the method of classifying blood stasis is useful and the Kyejibokryong-whan(Guizhifuling-wan) can be effective means that decrease pain caused by motor vehicle accident.

• 치위생과학회지
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• 제11권6호
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• pp.583-588
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• 2011

본 연구는 2010년 11월 충북지역 일부 중학생을 대상으로 흡연, 스트레스, 구강건강 및 분야별 건강증진행위 실천정도를 파악하고자 이루어졌으며 다음과 같은 결론을 얻었다. 1. 중학생의 33.8%가 흡연 경험이 있었으며, 처음 흡연시기와(24.1%) 습관적 흡연 시기가(10.4%) 초등학교 고학년 시기에 가장 많아 흡연연령이 점차 낮아지고 있는 추세이다. 2. 스트레스에 따른 중학생의 건강생활실천 수행정도를 비교한 결과, 스트레스가 낮은 그룹이 구강건강을 제외한 모든 항목에서 건강생활실천 수행정도가 높았으며 유의한 차이가 나타났다(p<.05). 구강건강상태도 스트레스가 낮은 그룹이 우식치아수도 적게 나타나 유의한 차이가 있었으며, 구강환경관리능력(PHP)은 유의한 수준은 아니었으나 스트레스가 높은 그룹이 구강환경관리가 잘 되지 않는 것으로 조사되었다. 3. 부모의 양육방식이 자율적일수록 스트레스가 낮은 것으로 조사되었으며(p<.05), 스트레스가 낮은 그룹이 학교생활 만족도가 높은 것으로 조사되었다(p<.05). 4. 중학생의 건강증진행위에 영향을 미치는 변인의 영향력을 살펴본 결과, 표준화 계수 ${\beta}$의 견지에서 정신 건강이 가장 영향력을 미치는 변인으로 나타났다.

• Journal of Gastric Cancer
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• 제10권3호
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• pp.106-110
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• 2010

Purpose: The purpose of this study was to analyze the clinical courses of patients with gastric cancer and positive resection margins after a gastrectomy for gastric cancer who did not undergo subsequent surgery. Materials and Methods: Among 4,452 patients who underwent surgery for gastric cancer from January 2001 to December 2007, 20 patients with positive resection margins after gastrectomy for gastric cancer who did not undergo subsequent surgery were included. The recurrence patterns were confirmed by postoperative computed tomography and gastroscopy, which were performed on a planned schedule. All recurrence patterns after gastrectomy were classified as loco-regional, peritoneal, or distant metastases. Results: The patients with confirmed recurrence all had advanced stage cancer (III-IV), and the recurrence sites were variable. However, peritoneal and distant recurrences were more common than loco-regional recurrences. The patients with loco-regional recurrence also had peritoneal and/or distant recurrence. Conclusions: Patients with gastric cancer and a positive resection margin showed more frequent peritoneal and distant metastases than loco-regional recurrence. In addition, patients with loco-regional recurrence also had peritoneal and distant recurrence. A positive resection margin of gastric cancer was related with poor histological differentiation, diffuse type, and advanced stage (III-IV).

• 한국콘텐츠학회논문지
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• 제13권9호
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• pp.322-333
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• 2013

외국인 환자 유치 활동을 통해 내원한 외국인 환자들의 데이터를 바탕으로 그들의 특성을 조사, 분석하여 차후 국가별 마케팅 전략 수립 시 필요한 근거자료로 사용하기 위하여 최근 3년 동안 W척추전문병원에 내원한 외국인 환자의 만족도를 연구하였다. 2010년부터 2011년 사이에 91명의 입원환자를 대상으로 조사를 실시하였다. 환자들은 국적에 따라 방문동기, 의료 및 의료외 서비스에 대한 이용 양태와 만족도에 차이가 있었다. 이 연구는 사회인구학적 특성, 방문목적, 한국 체류일, 총 한국 방문횟수, 동반자, 치료 계획 여부, W병원 선택이유, 의료비용, 총 한국 체류비용 등을 분석하였다. 분석결과, 한국을 더 많이 방문한 환자들, 한국 방문 이전에 치료계획을 세운 방문자들, 진료비가 적정했다고 생각하는 환자들의 만족도가 높았다. 외국인 환자를 더 많이 유치하기 위해서는 의료팸투어1, 진료비의 투명화, 의료서비스 수준의 향상과 더불어 척추전문병원의 육성이 필요한 것으로 분석되었다.