• Title/Summary/Keyword: korean medical clinic

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The Usefulness of Stereotactic Radiosurgery for Radioresistant Brain Metastases

  • Kim, Hyool;Jung, Tae-Young;Kim, In-Young;Jung, Shin;Moon, Kyung-Sub;Park, Seung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.107-111
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    • 2013
  • Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.

Psychological effects and risk perception after genetic counseling

  • Shin, Sunghwan;Ryu, Mi Ra;Kwon, Won Kyung;Kim, Suhee;Jang, Ja-Hyun;Kim, Jong-Won
    • Journal of Genetic Medicine
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    • v.18 no.1
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    • pp.38-43
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    • 2021
  • Purpose: Demand for genetic counseling on cancer predisposition syndrome is increasing. We evaluated the psychological effect on counselees after genetic counseling at a clinic in a single center. Materials and Methods: We surveyed a total of 72 enrolled participants who visited a genetic counseling clinic at the Samsung Medical Center (SMC). The initial survey was conducted before the first genetic counseling session, and the second survey was conducted after the second genetic counseling session. A total of 43 participants completed both the initial and second surveys. Results: The initial survey of 72 participants indicated higher feelings of guilt in the group with religion, higher depression and anxiety in the group with a diagnosis of self, and higher anxiety in the group on self-referral to the genetic counseling clinic. In the completed survey of 43 participants, overall decreased depression was observed after the second genetic counseling session (P=0.013). Risk perception and anxiety decreased in the group diagnosed with benign variant/variant of uncertain significance (BV/VUS, 25/3) and increased in the group diagnosed with pathogenic variant (PV, 15). Risk perception and anxiety differed between the BV/VUS and PV groups (P<0.001 and P=0.03, respectively). Conclusion: The genetic counseling clinic at the SMC was effective in ameliorating the depression score. Assessment of survey results revealed different depression scores, feelings of guilt and anxiety, and different effects of the genetic counseling clinic, depending on the subgroups. Understanding the needs and psychological characteristics of different groups is necessary for improving genetic counseling services.

Population-related factors affecting the regional distribution of medical institutions in Korea (지역별 요양기관의 분포에 영향을 미치는 인구관련 요인)

  • Lee, Sunkyoung;Cho, Eunseong;Yoon, Seok-Jun
    • Korea Journal of Hospital Management
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    • v.18 no.2
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    • pp.15-32
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    • 2013
  • Few public health researchers have paid research attention to the location of medical institutions in Korea. Previous studies were published in geography journals, and relied on limited data in terms of geographic regions and the type of medical institutions. This study utilized nationwide data covering 8 types of medical institutions. We obtained data from Health Insurance Review and Assessment Service and National Population and Housing Census. The correlation coefficients of resident, daytime, university-graduate population, and the population of different age groups (fewer than 15, 15~64, 65 or more) were compared to understand their relative association with the location of medical institutions. Medical clinic, dental clinic, oriental medical clinic, and pharmacy, all of which are almost completely operated by private sector, showed strong positive correlation with population. Hospital-level medical institutions, which are operated by both public and private sector, had moderate positive correlation. Daytime population and university-graduate population, rather than resident population, were more correlated with the location of medical clinics. The correlation coefficients of the population of 15~64 age group and the location of medical institutions were greater than that of other age groups. The results showed that daytime and university-graduate population are more important than resident population to explain the location of medicalrelated facilities. The results also suggests that the population of age groups (especially, 15~64) might be one of important influence factors in the location of medical institutions.

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Two Cases Report of Oriental Medical Therapy for Sinusitis in the Overweight Children (과체중 소아의 부비동염에 대한 한방 치료 2례)

  • Jang, Jung-Hee;Park, Jun-Hong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.2
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    • pp.149-160
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    • 2016
  • Objectives : The purpose of this clinical study is to investigate effectiveness of oriental medical treatment for sinusitis in the two overweight children. Methods : This study was performed for two 5-years old of age and overweight (BMI>90th percentile) children with sinusitis who visited the clinic. The symptoms of sinusitis are rhinorrhea, poor sleep due to nasal congestion, cough, sputum. Oriental herb medicines(Kami-Hyunggyeyungyotang and Kami-Cheonggeumganghwatang), moxibustion, nebulizer and aroma nasal spray were treated to two children. The progress of treatment for sinusitis was evaluated through the subjective symptoms and endoscope inspection. Results & Conclusions : After oriental medical treatment, the subjective symptoms and endoscope inspection were improved in all two children. Our results suggested that oriental medical treatment have effective to alleviate the symptoms of sinusitis in overweight children.

Inhibition of Cyclooxygenase and Prostaglandin E2 Synthesis by Crude Methanolic Extract from Euonymus Alatus (Thunb.) Sieb in SKBR3 Human Breast Cancer Cell Line

  • Kim Joong-Oh;Jang Tae-Hyun;Kim Min-Sung;Kim Dong-Il;Lee Tae-Kyun
    • The Journal of Korean Medicine
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    • v.26 no.1 s.61
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    • pp.37-45
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    • 2005
  • In the present study, we examined the effect of crude methanolic extract (CME) from Euonymus alatus (Thunb.) Sieb on arachidonic acid (AA) cascade in SKBR3 human breast cancer cell line. CME had a potent inhibitory activity of prostaglandin E2 (PGE2) release induced by A23187, a $Ca^{2+}$ ionophore. The inhibition was concentration-dependent, with the 50 value of about 5 M. CME had no inhibitory effect on A23187-induced phosphorylation of p42/p44 extracellular signal regulated kinase/mitogen-activated protein kinase or on the liberation of [14C]-AA from the cells labeled with [14C]-AA. However, CME concentration-dependently inhibited the conversion of AA to $PGE_2$ in microsomal preparations, showing its possible inhibition of cyclooxygenase (COX). In enzyme assay in vitro, CME inhibited the activities of both constitutive COX (COX­I) and inducible COX (COX-2) in a concentration-dependent manner, with the 50 values of about 0.8 and 2M, respectively. Lineweaver-Burk plot analysis indicated that CME competitively inhibited the activities of both COX-l and -2. This study is a first demonstration that CME directly inhibits COX activity.

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Clinical study on the correlation between five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) and Autistic disorder (자폐장애와 오지(五遲).오연(五軟)과의 상관성에 관한 임상적 연구)

  • Park, Jae-Hyung;Park, Jae-Hyun;Paeck, Eun-Kyung;Yun, Young- Ju;Jeong, Seul-Ki;Lim, Ja-Seong;Lyu, Yeoung- Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.25-34
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    • 2005
  • Background and Objectives There was no clinical data except literary study on mutual correlation with autistic disorder in Western medical diagnosis and five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) in Oriental medical diagnosis. This study was performed to investigate the correlation of five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) to the children with autistic disorder and to set the time table for clinical diagnosis of developmental retardation by making a comparative study of normal developmental children so we can treat the children with autistic disorder in good time. Method We made the comparative study of interview sheets recorded by parents of total 163 children who were diagnosed as autistic disorder who visited HaeMa Oriental Medical Clinic with interview sheets recorded by parents of generally accepted normal developmental children(263) and then we took statistics. Results : 1. There was significant correlation with speech and walking among five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) in autistic disorder statistically and clinically in comparison with normal children. 2. There wasn't significant correlation with growth time of tooth among five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) on diagnosis of autistic disorder in comparison with normal children. 3. There was significant correlation with retardation of times going to toilet by oneself (it does not consist in five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲).) in both of autistic disorder. Conclusion Autistic disorder was significantly correlated with the faculty of speech(語遲), retardation in walking out(行遲) of five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲). We need to concrete the index of diagnosis, because it is so difficult to measure times and register retardation in tooth eruption(齒遲), retardation in hair-growing(髮遲), debility of neck and nape(頭項軟), flaccidity of extremities(手軟) and flaccidity of muscle(肌肉軟). And we can also use times going to toilet by oneself as one of diagnostic criteria because of its significant correlation. It is required to make early diagnosis of five kinds of flaccidity in infants(五軟), five kinds of retardation(五遲) using these criteria, and to treat them early by oriental medicine.

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