• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.4961-4964
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• 2013

Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management.

• 한국지능시스템학회논문지
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• 제1권1호
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• pp.9-25
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• 1991

This tutorial paper has been written for biologists, physicians or beginners in fuzzy sets theory and applications. This field is introduced in the framework of medical diagnosis problems. The paper describes and illustrates with practical examples, a general methodology of special interest in the processing of borderline cases, that allows a graded assignment of diagnoses to patients. A pattern of medical knowledge consists of a tableau with linguistic entries or of fuzzy propositions. Relationships between symptoms and diagnoses are interpreted as labels of fuzzy sets. It is shown how possibility measures (soft matching) can be used and combined to derive diagnoses after measurements on collected data. The concepts and methods are illustrated in a biomedical application on inflammatory protein variations. In the case of poor diagnostic classifications, it is introduced appropriate ponderations, acting on the characterizations of proteins, in order to decrease their relative influence. As a consequence, when pattern matching is achieved, the final ranking of inflammatory syndromes assigned to a given patient might change to better fit the actual classification. Defuzzification of results (i.e. diagnostic groups assigned to patients) is performed as a non fuzzy sets partition issued from a "separating power", and not as the center of gravity method commonly employed in fuzzy control. It is then introduced a model of fuzzy connectionist expert system, in which an artificial neural network is designed to build the knowledge base of an expert system, from training examples (this model can also be used for specifications of rules in fuzzy logic control). Two types of weights are associated with the connections: primary linguistic weights, interpreted as labels of fuzzy sets, and secondary numerical weights. Cell activation is computed through MIN-MAX fuzzy equations of the weights. Learning consists in finding the (numerical) weights and the network topology. This feed forward network is described and illustrated in the same biomedical domain as in the first part.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.55-59
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• 2015

The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권6호
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• pp.548-557
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• 2020

Purpose: To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media. Methods: We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation. Results: Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team. Conclusion: Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.

• Childhood Kidney Diseases
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• 제18권2호
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• pp.132-136
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• 2014

결절성 경화증은 과오종의 발생을 특징으로 하는 유전질환으로, 피부, 뇌, 심장, 눈, 폐, 구강, 신장 등의 다양한 장기들을 침범한다. 신장에서 관찰 가능한 다양한 병변들은 발생 빈도와 사망률이 높기 때문에 주의를 필요로 하며, 신장 증상의 이른 발생 시기를 고려하여 소아 연령에서부터 적절한 진단과 관리가 중요하다. 저자들은 소아 연령에서 발생한 거대 혈관근육지방종, 신세포암, 신경색, 신낭종, 그리고 신결석증 등이 동반된 결절성 경화증 4례를 경험하였기에 보고하는 바이다.

• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.283-291
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• 2016

지난 10년 동안 암 관리법에 의한 국가 정책에 따라 일본에서는 호스피스 및 완화의료가 급속히 발전해왔다. 완화의료 시설 및 입원 환자의 호스피스, 병원의 완화 의료팀, 가정 호스피스 기능을 갖춘 진료소의 수는 꾸준히 증가하고 있으며 국가 협회로부터 완화의료 전문가로 공인된 의사, 간호사, 약사의 수도 증가하고 있다. 학부, 대학원 및 계속적인 의학 교육을 통해서 교육프로그램 및 교육의 기회를 표준화하고 보급하기 위한 공동 노력이 이루어졌다. 일본의 연구 활동은 말기 섬망, 말기 탈수증, 완화적 진정, 임종 환자의 의료, 예후, 의사 소통, 정신 종양학, 지역적인 완화의료 프로그램의 분야에서 현저하게 기여하였다. 이 보고서에서는 일본에서의 주요 완화의료 환경, 특성, 국가 협회, 교육, 완화의료 연구에 초점을 맞추었다.

• The Korean Journal of Pain
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• 제28권1호
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• pp.11-21
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• 2015

Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

• 종양간호연구
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• 제7권2호
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• pp.119-130
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• 2007

Purpose: The purpose of this study was to analyze the data regarding questions raised by women with breast cancer through Internet counseling in Korea. Methods: The data were collected from one internet web-site, providing counseling by physicians. A total of 617 questions were analyzed by content analysis method. Results: About 90 percent of the counselees were patients themselves. But most of the general and health-related characteristics of them were not known from the data. As a result of content analysis, 617 questions were grouped into 9 major categories. The most common major category was identified as "life after treatment" (212 questions, 34.2%), followed by "chemotherapy" (139 questions, 22.3%) and "hormone therapy" (115 questions, 18.9%). Questions regarding "physical symptoms" were the most frequent one in the major categories of "life after treatment", "chemotherapy", and "radiotherapy", while questions regarding "psychological problems" were the least. Conclusion: The findings of this study indicate that it is important for health professionals to provide continuous on-line informational support to women with breast cancer, even after all the treatment is over, especially focusing on physical symptoms. In addition, off-line program needs to be reinforced to provide emotional support that is not well delivered by on-line program.

• 대한한방소아과학회지
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• 제13권1호
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• pp.63-138
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• 1999

From all possible chinese medical literatures, I studied the history of chinese pediatrics by dividing into Chunqiu Zhanguo, QinHan dynasties, LiangJin, SuiTang five dynasties, Song Dynasty, Jin and Yuan dynasties, Ming Qing dynasties. The conclusions are summarized as followings 1. The mentions related with pediatrics existed already in Yan ruins turtle shell letters, and 〈Yellow Emperor's classic of internal medicine> in Chunqiu Zhanguo time formed the system of medicine, established the theoretical foundation. 2. Chang Ji established the system of diagnosis and treatment based on overall analysis of symptoms and signs in , and later pediatricians commonly applied his prescriptions to the febrile diseases. 3. The period from LiangJin to SuiTang, Pediatrics was established as special department then in , Chao Yuanfang stated the etiology, pathogenesis, symptomatology of pediatric diseases. 4. In Song dynasty. pediatric 4 major, symptoms that had been mentioned from SuiTang dynasties, were clearly established, pediatrical special books were published, and written by Qian Yi who is considered as the founder of chinese pediatrics, established the foundation of pediatrical division formation in distinction from adult fields. 5. In Jin and Yuan dynasties, four eminent physicians established the actual relationship between the theories and practical applications and insisted various and creative theories based on the classical medicine, for example, the theory that fire and heat in the body was the main cause of diseases of Liu Wansu purgation theory of Zhang Congzheng, qi regulating theory of Liu Gao, ministerial fire theory and the theory that yang is ever in excess while Yin is ever deficient of Zhu Zhenheng, etc, and they applied those theories to pediatrical various sides. 6, In Ming Qing dynasties, pediatrical specialists and pediatrical publications had increased, eg, father and son Xue Kai Xue Ji, Wan Quan, Lu Bai-si, etc in Ming dynasty, Ye Gui, Chen Fuzheng, Xia Ding, etc in Qing dynasty were famous as pediatricians. Specially, the doctrine of epidemic febrile diseases at that time showed prominent effects to children's epidemic febrile diseases.

• 대한약리학회지
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• 제11권2호
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• pp.47-53
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• 1975

Pan-Korean multi-center trial of doxycycline in the treatment of upper and lower respiratory infection was carried out in the summer(from May to October) of 1975. A total of 204 patients between the ages of 3 and 75 was treated by 37 physicians including the internal medicine, pediatrics and ENT specialist in 17 general hospitals and 2 private clinics all-over the country. The dosage recommended was 200 mg on the first day of therapy followed by 100 mg daily thereafter. The pediatric dosage was 4 mg/kg on the first day and then 2mg/kg on each successive day. The subjective and objective signs of respiratory infection such as temperature, cough, sputum, pain and associated inflammatory symptoms were assessed using the carefully designed protocols and it showed rapid improvement by the fifth day (80%) of therapy. Only minor side-effects were reported and these were mild and mainly limited to gastrointestinal tract. The overall evaluation of the trial showed that 170 patients(83.3%) had a very good or good result, 13 patients (6.4%) a moderate and another 13 patients (6.4%) a negative result.