• 한국병원경영학회지
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• 제3권1호
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• pp.34-61
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• 1998

A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

• 한국산림과학회지
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• 제104권3호
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• pp.488-494
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• 2015

경영 표준진단표를 통해 재배자 스스로 경영 진단을 할 수 있도록 하고 이를 참고하여 임가 경영 개선에 도움이 되고자 떫은감 경영 표준진단표를 개발하여 주산단지의 임가를 대상으로 적용하였다. 떫은감 경영 표준진단표는 임가 일반 현황과 경영 성과 지표, 그리고 경영 진단을 위한 3개의 대분류 항목과 18개의 중분류 항목으로 구성되어 있다. 떫은감 경영 표준진단표 작성을 위해 떫은감 주산단지 10개 시 군 241임가의 경영 실태 조사를 실시하였으며 경영수준 진단을 위해서 18개 중분류 항목의 점수를 합산하여 총점을 산출하였다. 조사 결과 241임가의 평균 점수는 57.4점이었으며 전체 임가의 62%가 40점 이상 60점 미만에 해당하는 것으로 나타났다. 세부 진단항목 결과를 살펴보면 경영기반 지표에서는 나무높이 항목의 점수가 충남 지역에서만 평균 점수보다 현저히 낮은 점수를 나타냈는데 이는 조사 지역의 나무가 30년 이상 된 고령목들이 많아 영향을 준 것으로 생각된다. 생산기술 지표에서 결실조절 항목의 전국 평균 점수는 1.96점으로 상당히 낮은데 떫은감은 단감과 달리 적뢰 적과를 거의 하지 않고 자연 낙과를 통해 스스로 조절하는 경우가 많기 때문이다. 경영 및 판매능력 지표의 자재구입 항목에서는 전국 평균 점수가 2.01점으로 조사 임가의 60% 이상이 대부분의 자재를 개별적으로 선택하고 협상하여 구입한다고 응답하였다. 공동으로 구입한다고 응답한 임가들은 대부분 작목반 단체로 구입하는 경우인 것으로 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5923-5931
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• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.275-282
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• 2015

Background: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. Objective: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. Materials and Methods: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. Results: Mean age of the participants was $46.2{\pm}9.93$ (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. Conclusions: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.259-263
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• 2015

Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

• Interdisciplinary Bio Central
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• 제2권4호
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• pp.12.1-12.7
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• 2010

The National Bio Resource Project-Rat (NBRP-Rat) comprises the largest bank of laboratory rat (Rattus norvegicus) strains in the world. Its main focus is to develop infrastructure that will facilitate the systematic collection, preservation, and provision of rat strains. To breed effectively more than 180 rat strains in living stock, we establish the genetic control system in which a systematic set of genetic diagnoses and genetic monitoring are included. Genetic monitoring is performed by using 20 polymorphic markers. Monitoring is carried out when a living animal stock is re-established by using cryopreserved embryos or sperm or when a rat strain is first introduced to the NBRP-Rat by a depositor. Additional monitoring is then carried out on each strain every two years. Genetic diagnosis is performed largely by employing the Amp-FTA method. Protocols which detail how to perform a genetic diagnosis of 11 transgenes and 24 mutations have been made. Among the mutations, nine can be detected by simple gel electrophoresis of the PCR products, 11 by restriction enzyme treatment of the PCR products, and four by direct PCR product sequencing. Using this genetic control system, the NBRP-Rat can guarantee the genetic quality of its rat strains.

• 대한한방종양학회지
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• 제9권1호
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• pp.39-46
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• 2003

Objectives : The former study of Oriental Medicine on cancer has been mostly focused on lab studies with herbal medicine. Among this atmosphere, the aim of this study is to investigate the suitability of Oriental Medicine institutions to participate in cancer registry programme in R.O.K by investigating the type of treatments used for cancer patients in Oriental Medicine institutes. Methods : To investigate the actual conditions of cancer patients who visited Oriental Medicine institutes, a survey was done based on clinical charts of 258 patients of cancer. Results : The order for the percentage of the original tumor organ of the patients, the number of patients who recognized the outbreak on the year of the first visit was the biggest, and the number gradually decreased while the years passed. For the type of treatment, herbal medicine was the most for 92.6%, acupuncture 52.6%, moxibustion 16.7%, cupping 14.7%. It can be seen that multiple treatment was preferred to single treatment. Among the periods for herbal medication, 10 days was the most for 34.1%, 29.8% for within 50 days and 10.5% for within 100 days. The percentage of patients who took treatment of western medicine at the same time and those who took treatment of Oriental medicine only was 47.4% and 43.8% respectively. By surveying categories such as the symptoms, diagnosis of syndrome, principle of treatment from the chart by a free description, there was 841 names of symptoms, 207 diagnoses of syndromes and 206 principles of treatment. But no relation or connection between these could be found statistically. At there were even occasions which the doctor didn't record the cancer itself, precise investigatio for the actual condition of cancer patients in Oriental Medicine institutions appeared to be very difficult. Conclusions : It seems impossible to enroll cancer patients of Oriental Medicine institutions to the cancer registry programme in R.O.K as far as the patients are recorded only under the paradigm of Oriental Medicine. However, if the Oriental Medicine doctors keep a consistency in classifying categories such as cause of death, syndrome diagnosis, principle of treatment and prescriptions, and limit the choices, for each category, a pilot study for cancer registry programme in R.O.K. in Oriental Medicine could be carried out.

• Clinical and Experimental Pediatrics
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• 제55권7호
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• pp.232-237
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• 2012

Purpose: With feasibility in the diagnoses of congenital heart disease (CHD) in the antenatal period, we suspect changes have occurred in its incidence. No data have been reported about the current incidence of simple forms of CHD in Korea. We have attempted to assess the recent incidence and characteristics of CHD in the neonatal care unit of a secondary referral medical center. Methods: Medical records of 497 neonatal care unit patients who underwent echocardiography in the past 5 years were reviewed. Preterm infants with patent ductus arteriosus and other transient, minimal lesions were excluded from this study. Results: Although the number of inpatients remained stable, the incidence of simple forms of CHD showed a gradual decrease over the 5-year study period; a markedly low incidence of complex forms was seen as well. CHD was observed in 3.7% full-term and 6.8% pre-term infants. CHD was observed in 152 infants weighing >2,500 g (3.5% of corresponding birth weight infants); 65 weighing 1,000 to 2,500 g (9.3%); and 6 weighing <1,000 g (8.0%). The incidence of CHD was higher in the pre-term group and the low birth weight group than in each corresponding subgroup (P<0.001); however, the incidence of complex CHD in full-term neonates was high. The number of patients with extracardiac structural anomalies has also shown a gradual decrease every year for the past 5 years. Conclusion: Findings from our study suggest that the recent incidence and disease pattern of CHD might have changed for both complex and simple forms of CHD in Korea.

• 한국산학기술학회논문지
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• 제21권1호
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• pp.223-231
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• 2020

본 연구는 간호학생을 대상으로 HPS를 활용한 뇌경색환자 간호과정 시뮬레이션 시나리오를 개발하고 적용하여 전통적 강의방식과 그 효과를 비교·평가해 보고자 함이다. 본 연구는 2018년 11월 27일부터 12월 26일까지 간호대학의 4학년 학생을 대상으로 하였으며, 실험군 38명, 대조군 39명으로 최종 77명을 대상으로 하였다. 본 연구는 분석단계와 연구 설계단계를 거쳐 개발단계에서 시나리오를 개발하여 적용하는 과정을 거쳤다. 실험군과 대조군의 중재 전, 후의 자신감, 이론적 지식, 임상수행기술은 t-test를 통해 분석하였다. 본 연구결과 뇌경색 환자에 대한 간호과정을 기반으로 한 시뮬레이션 시나리오가 개발 되었으며, 이는 3가지 간호진단을 유추할 수 있도록 설계되었다. 연구결과 두 그룹 모두 임상수행기술을 제외한 사전사후 점수가 통계적으로 유의하였으며, 실험군과 대조군간 사후점수 및 사전, 사후의 차이검증에서 실험군이 유의하게 높게 나타났다. 본 연구는 표준화된 뇌경색환자 간호과정 시뮬레이션 시나리오를 개발하였다는 점에서 의의가 있다. 또한 개발된 시나리오가 실습 뿐 아니라 이론적 학습까지 통합할 수 있는 교수학습방법으로의 가능성을 보여주고 있다.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.534-540
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• 2012

Objective : Brainstem arteriovenous malformation (AVM) is rare and radiosurgical management is complicated by the sensitivity of the adjacent neurological structures. Complete obliteration of the nidus is not always possible. We describe over 20 years of radiosurgical procedures for brainstem AVMs, focusing on clinical outcomes and radiosurgical techniques. Methods : Between 1992 and 2011, the authors performed gamma knife radiosurgery (GKRS) in 464 cerebral AVMs. Twenty-nine of the 464 patients (6.3%) reviewed had brainstem AVMs. This series included sixteen males and thirteen females with a mean age of 30.7 years (range : 5-71 years). The symptoms that led to diagnoses were as follows : an altered mentality (5 patients, 17.3%), motor weakness (10 patients, 34.5%), cranial nerve symptoms (3 patients, 10.3%), headache (6 patients, 20.7%), dizziness (3 patients, 10.3%), and seizures (2 patients, 6.9%). Two patients had undergone a previous nidus resection, and three patients had undergone a previous embolization. Twenty-four patients underwent only GKRS. With respect to the nidus type and blood flow, the ratio of compact type to diffuse type and high flow to low flow were 17 : 12 and 16 : 13, respectively. In this series, 24 patients (82.8%) had a prior hemorrhage. The mean target volume was 1.7 $cm^3$ (range 0.1-11.3 $cm^3$). The mean maximal and marginal radiation doses were 38.5 Gy (range 28.6-43.6 Gy) and 23.4 Gy (range 18-27 Gy), and the mean isodose profile was 61.3% (range 50-70%). Results : Twenty-four patients had brainstem AVMs and were followed for more than 3 years. Obliteration of the AVMs was eventually documented in 17 patients (70.8%) over a mean follow-up period of 77.5 months (range 36-216 months). With respect to nidus type and blood flow, the obliteration rate of compact types (75%) was higher than that of diffuse types (66.7%), and the obliteration rate of low flow AVMs (76.9%) was higher than that of high flow AVMs (63.6%) (p<0.05). Two patients (6.9%) with three hemorrhagic events suffered a hemorrhage during the follow-up period. The annual bleeding rate of AVM after GKRS was 1.95% per year. No adverse radiation effects or delayed cystic formations were found. Conclusion : GKRS has an important clinical role in treatment of brainstem AVMs, which carry excessive surgical risks. Angiographic features and radiosurgical techniques using a lower maximal dose with higher isodose profiles are important for lesion obliteration and the avoidance of complications.