• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• Molecules and Cells
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• 제37권1호
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• pp.66-73
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• 2014

Myeloid-derived suppressor cells (MDSCs) play an important role in impairing the function of T cells. We characterized MDSCs in two chronic hepatitis C (CHC) cohorts: a cross-sectional group that included 61 treatment-naive patients with CHC, 14 rapid virologic response (RVR) cases and 22 early virologic response (EVR) cases; and a longitudinal group of 13 cases of RVR and 10 cases of EVR after pegylated-interferon-${\alpha}$/ribavirin treatment for genotype 1b HCV infection. Liver samples from 32 CHC patients and six healthy controls were subjected to immunohistochemical analysis. MDSCs frequency in treatment-naive CHC was significantly higher than in RVR, EVR, or healthy subjects and was positively correlated with HCV RNA. Patients infected with HCV genotype 2a had a significantly higher frequency of MDSCs than those infected with genotype 1b. Decreased T cell receptor (TCR) ${\zeta}$ expression on $CD8^+$ T cells was significantly associated with an increased frequency of MDSCs in treatment-naive CHC patients and was restored by L-arginine treatment in vitro. Increased numbers of liver arginase-$1^+$ cells were closely associated with the histological activity index in CHC. The TCR ${\zeta}$ chain was significantly downregulated on hepatic $CD8^+$ T cells in CHC. During antiviral follow up, MDSCs frequency in peripheral blood mononuclear cells was directly correlated with the HCV RNA load in the plasma and inversely correlated with TCR ${\zeta}$ chain expression in $CD8^+$ T cells in both RVR and EVR cases. Notably, the RVR group had a higher frequency of MDSCs at baseline than the EVR group. Collectively, this study provides evidence that MDSCs might be associated with HCV persistence and downregulation of CD8 ${\zeta}$ chain expression.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2857-2860
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• 2016

Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

• Journal of Oral Medicine and Pain
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• 제31권1호
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• pp.101-111
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• 2006

측두하악관절장애에 관한 역학연구는 주로 1970년대 초 스칸디나비아국가에서 국민을 대상으로 무작위 추출법에 의한 악관절 및 저작계기능에 관한 역학조사로 시작되었으며 국내에서도 1970년대 이후 측두하악관절장애의 유병률에 대해 많은 역학연구가 보고되었다. 하지만 성, 병력, 주소, 진단에 따른 각각의 증상과 징후들을 평가한 연구는 외국에 비해서 많이 부족한 실정이다. 측두하악관절장애에 대한 증상과 진단에 관한 총괄적 연구조사는 오래전에 이루어진 것이 대부분이기 때문에 본 연구를 통해서 측두하악관절장애를 가진 환자들의 성, 병력, 주소, 진단에 따른 증상들을 총괄적으로 조사하여 향후 점증하는 측두하악관절장애환자의 진단과 치료에 도움이 되는 기초자료를 확보하고자 하였다. 본 연구결과를 보면 우선 연령의 경우 전체 내원 환자 6500명의 평균나이는 34.06세로 남자는 33.15세, 여자는 34.62세였으며 진단그룹별로 연령차이가 있었다. 의뢰 환자는 대체로 치과의사가 의뢰한 환자가 많았으며(80.07%), 의뢰한 환자 진단군은 관절성장애, 근육성장애, 연조직질환 순이었다. 전체 내원 환자 중 63%가 안면통증으로 내원하였으며, 발생부위에 대한 비교에서 좌우 유의한 차이를 볼 수 없었다. 또한 통증 발생은 6개월 미만에서는 주로 남성이, 6개월 이상인 경우는 여성의 비율이 상대적으로 높음을 알 수 있었다. 관절잡음의 경우 병력 환자는 3445명(53.15%)였으며, 발병시기에는 성차가 없었다. 관절잡음의 발생부위는 좌우 양측간에 차이가 없었으며 주로 clicking sound가 많음을 알 수 있었다. 이갈이는 주로 남자에서, 이악물기는 여자에서 나타났었다.

• 여성건강간호학회지
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• 제6권1호
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• pp.67-81
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• 2000

The purpose of this study was to analyze women's health problems using Green & Kreuter's(1991) PRECEDE model and to develop health education program for women's health. The subjects were recruited women from Wonju city 18 years or older. 1. The results showed that about 50% of the women were satisfied with their lives as women, 23% of the sample felt there was a need for a women's health care center. The mean number of health problems was 3.1 and the prevalence rate, 44.4%. 2. We developed on educational program according to group differences related to health problems, diagnosis of disease, variables influencing health promotion behavior, and programs which each group wanted. Also we stressed self-efficacy and self-help group for the management of individual health to all groups. 3. The diagnoses of diseases that were experienced premarital over the past year were gastritis, bronchitis, spinal disk, and fracture, for the childbearing/rearing group, gastritis, vaginitis and cervicitis, cervical cancer and cystitis and nephritis and arthritis and for the middle-aged/elderly group arthritis, gastritis, vaginitis and cervicitis, and spinal disk. Of the sample 30.5% did not have a health exam in the past year, and only 10% of the premarital group, 12.5% of the childbearing/child-rearing group, and 18.3% of the middle aged-elderly group were concerned about their health and did something for their health. 4. The average score on the HPLP was 2.41. the HPLP was scores according to group were found to have significant differences. self-efficacy, family functions, health attention and were considered important variables in the premarital group, in the childbearing/child-rearing group self-efficacy, family functions, internal locus of control, health attention, and health perception and power others locus of control and then for the middle aged-elderly group self-efficacy, health attention, internal locus of control, family functions and health perception. 5. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. The premarital group requested the educational programs on diet, health exercise, family health and stress management. Also the childbearing/child-rearing group wanted programs on diet, family health, stress management, and health exercise, and the middle-aged/elderly group wanted that of family health, diet, climacteric changes stress management and health exercise. The program suggested that this program should be applied to women in the community to insure adequate management of women's health. Follow-up research with PROCEED is needed to analyze health outcomes, also, a women's health nursing specialist system is required to develop health promotion, and improve the quality of life for women.

• Journal of Yeungnam Medical Science
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• 제18권1호
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• pp.51-58
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• 2001

담즙정체성 간염의 원인과 임상양상, 검사실 소견 및 경과를 알아보고자 1991년에서 2000년까지 영남대학교 의과대학 부속병원에서 혈액검사 및 간생검으로 담즙정체성 간염이 확진된 14명의 환자를 대상으로 후향적 연구를 시행하여 다음과 같은 결과를 얻었다. 담즙정체성 간염에서 비정상 간기능검사의 기간은 1개월에서 30개월까지 다양하게 나타났고, 항결핵제, 항생제에 의한 담즙정체성 간염이외에도 한약제, 건강식품에 의한 경우 검사실 소견과 임상경과가 중하게 나타나는 경우가 있으므로, 이들 약물을 사용한 병력이 있는 경우 정기적인 간기능 검사가 필요하다. 담즙정체성 간염이 만성 간내 담즙정체를 보이는 경우 바이러스에 의한 담즙정체성 간염과 담관소멸 증후군으로의 진행 유무, 원발성 담즙성 간경변증, 자가면역성 간염과의 감별이 필요하며, 지속적인 간기능 검사이상을 보일 경우에는 연속적인 간생검이 필요할 것으로 생각된다.

• Allergy, Asthma & Respiratory Disease
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• 제6권6호
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• pp.310-314
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• 2018

Purpose: Conventional serum IgE assay was costly, required the skills of expert, and relied heavily on expensive equipment. Quantitative measurement of total IgE using Point of Care Test (POCT) device can be the solution for these limitations. This study evaluated and validated the reproducibility of ImmuneCheck IgE. Methods: This study included 120 patients of allergic diseases such as allergic rhinitis, asthma, drug allergy, food allergy, atopic dermatitis, or anaphylaxis. The reliability of POCT ImmuneCheck IgE was evaluated by comparing results from the naked eye and from the Q-Reader. Intratest reproducibility and intertest correlation were analyzed using intraclass correlation coefficient (ICC). Results: Of the 120 enrolled patients, 51 were males and 69 were females. The ages ranged from 19 to 84 years, with an average age of 51.5 years. The concentration of serum total IgE measured by Phadia ImmunoCAP IgE ranged from 5.95 to 5,000 IU/mL. ICC for Intratest reproducibility of ImmuneCheck IgE by naked eye and by Q-Reader were 0.991 (P< 0.001) and 0.989 (P< 0.001), respectively. In addition, intertest correlation between ImmuneCheck IgE and Phadia ImmunoCAP IgE results of naked eye and Q-Reader were 0.968 (P< 0.001) and 0.948 (P< 0.001), respectively. Conclusion: The ImmuneCheck IgE was reproducible and highly correlated with conventional Phadia ImmunoCAP IgE assay. This result suggests that ImmuneCheck IgE can be a useful tool for rapid and precise detection of total IgE.

• 한국전통의학지
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• 제15권1호
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• pp.128-144
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• 2006

This Study aims at looking into the use of oriental medical services in treating hypertension. The first objective to be explored through this study is the morbidity caused by the disease, classifying them by age, gender, and occupation. The second is to determine the regular use of anti-hypertensive medicine and their efficacy in controlling blood-pressure. The third is to investigate the use-rate and satisfaction of oriental medical service. 838 households across the country, were asked to answer questionnaires for the period of time from Apr. to Jun. 2005. The conclusion from the survey can be summarized as following. The age of which the first medical diagnosis of hypertension were made showed lower in males, those with higher education and income. The study showed females were more active in blood-pressure control, with their frequent monitoring of blood-pressure for the past year. With age, people in under 50 age group proved to be less active. The management of high blood pressure was more effective in group with regular dosage compared to group with irregular use of anti-hypertensive medication, but their difference was minimal. Also, group with no medication showed signs of blood-pressure control. The use of oriental medical service for the past year, were more frequent in groups with lower education, either low or high income, old age, females and occupations in agriculture, forestry and fishing industry. Results were similar in both general population and high blood-pressure patient group. Females, people over 51 years old and with lower education showed more intentions in utilizing oriental medical services in the future. Results were similar in both general population and high blood-pressure patient group. It is necessary to offer a more accurate information on oriental medical treatments. Also, a systematic reform to reduce the patient's share of the treatment cost, as well as, heightening public awareness on the infirmity of present blood-pressure management system is crucial.

• 한방비만학회지
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• 제13권1호
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• pp.1-9
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• 2013

Objectives: This study was performed to analyze the recent trend of the studies about obesity in medicine and to provide background for futher studies. Methods: All of the article were selected in "The Korean Journal of Obesity". Search were conducted through "http://kosso.or.kr" with the search word "obesity". Collected articles were classified into clinical study, experimental study, literary study, case report. Results: One hundred eighty four studies were included and analyzed in terms of study design, subject, intervention, period, obesity index and so on. The numbers of clinical studies, literary studies, experimental studies, case reports were respectively 143 (77.7%), 26 (14.1%), 2 (1.1%) and 7 (3.8%). In clinical studies, observational studies were 112 (78.3%) and intervention studies were 31 (21.7%). And most of sample sizes were more than 100 and less than 499. Body mass index, waist circumstance, body fat percent were major criteria of clinical study. Most of the subjects on obesity were about relation with another disease or experimental results and diagnosis. According to classification by the kinds of intervention, diet, exercise, drug, behavior were respectively 22, 18, 8, and 8. More than fourty percent of intervention studies were studied for 12 weeks. Conclusions: To improve the quality of Korean Medicine study for obesity, we need to recruiting big sample size and activate randomized clinical trial.

• 정신신체의학
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• 제29권2호
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• pp.77-85
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• 2021

유방암은 여성에서 가장 높은 유병율을 보이는 암으로, 진단과 치료과정 및 치료 후에도 다양한 정신사회적 디스트레스가 자주 나타난다. 유방암 환자의 치료에는 의학적 치료뿐만 아니라 정신신체의학적 통합치료가 필요하다. 유방암 환자는 스트레스, 불안장애, 우울장애, 적응 장애 등에 대한 취약성이 증가하고, 이러한 정신장애는 유방암의 악화 또는 재발과 연관이 있다. 유방암 환자의 불안과 우울에 대한 정신사회적 치료는 환자의 삶의 질을 증진시키고, 유방암의 재발과 악화를 감소시킨다. 본 연구에서는 5편의 유방암 치료 가이드라인에서 정신사회적 디스트레스에 대한 정신사회적 치료와 대체의학적 치료가 포함된 정신신체의학적 통합치료 부분에 초점을 맞추어 논의하였다. 5편의 가이드 라인에서 사용한 서로 다른 근거 기준은 US Preventive Service Task Force (USPSTF) 기준에 맞춰 연구자들이 평가하여 근거를 기술하였다. 또한 유방암 환자의 불안, 우울, 기분, 삶의 질에 대한 정신사회적 치료의 효과 크기를 요약하였고, 정신신체의학적 통합치료 서비스 제공에 대한 장벽과 이에 대한 대안을 제시하였다. 다학제 팀을 구성하고, 환자 요구도를 조사하며, 정신사회적 치료의 정보를 환자에게 제공하여 환자와 가족이 참여하는 것이 중요하다. 또한 준비된 계획에 따라 정기적으로 정신사회적 디스트레스를 평가하고, 정신신체의학 전문가 또는 자문조정 정신건강의학과 의사에 의한 정신신체의학적 통합치료가 환자에게 제공되는 것이 가장 중요하다.