• 대한본초학회지
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• 제22권4호
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• pp.1-8
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• 2007

Objectives : There are many causes that may affect efficacy of a drug but the time of administration for the Herbal Medicine is among the most important factors. Traditionally, administration of medicine was prohibited during the meal time along with food and the time of administration has been highly regarded in medical practitioners. The rules of administration time are stated in a book titled, "Materia Medica" but it lacked the details and index. Thus, the systemized administration rules for Herbal Medicine were prepared. Methods : The rules were drawn from both ancient teachings and the experiences from modern clinics. Ancient teachings about the administration are focused on treatment of a disease by utilizing biorhythm of the body in accordance of changes in Yin and Yang and Day and Night. Results : It means the medicine should be prepared and administered at the appropriate time of the day and this type of administration method is thought to be superior to the western method such as "once a day" or "twice a day in the morning and evening" that does not take consideration of cold, hot, warm and cool properties of the medicine. If the prescription is assigning appropriate medicine, administration time is an important method of maximizing drug efficacy. Conclusion : With the ancient teaching in mind, it was concluded that, the drug administration time must be determined with regard to properties of the drug and the condition of the patient.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.46.1-46.7
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• 2016

Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

• Biomolecules & Therapeutics
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• 제13권2호
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• pp.65-77
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• 2005

Present article reviews about clinical pharmacology of mycophenolic acid (MPA), the active form of mycophenolate mofetil (MMF), as widely used component of immunosuppressive regimens in the organ transplantation field. MMF, used alone or concomitantly with cyclosporine or tacrolimus, has approved in reducing the incidence of acute rejection and has gained widespread use in solid organ such as kidney, heart and liver transplantation. The application of MPA and development of MMF has shown a considerable impact on immunosuppressive therapy for organ transplantation as a new immunosuppressive agent with different mechanism of action from other drugs after early 1990s. In particular aspect, use of MMF, a morpholinoethyl ester of MPA, represented a significant advance in the prevention of organ allograft rejection as well as allograft and patient survival. In considering MMF clinical data, it is important to note that there is a strong correlation between high MPA area under curve(AUC) values and a low probability of acute allograft rejection. Individual trials have shown that MMF is generally well tolerated and revealed that MMF decreased the relative risk of developing chronic allograft rejection compared with azathioprine. Recent clinical investigations suggested that improved effectiveness and tolerability will results from the incorporation of MPA therapeutic drug monitoring into routine clinical practice, providing effective MMF dose individualization in renal and heart transplant patients. Therefore, MMF has a selective immunosuppressive effect with minimal toxicity and has shown to be more effective that other agents as next step of immunosuppressive agents and regimens that deliver effective graft protection and immunosuppression along with a more favorable side effect.

• 대한후두음성언어의학회지
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• 제12권2호
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• pp.152-157
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• 2001

Background : Electrolarynx, Esophageal voice, and Silicone voice prosthesis with tracheoesophageal(T-E) fistula have been used as vocal rehabilitating methods for the post-laryngectomized patients. Prosthetic rehabilitation of voice after total laryngectomy has gained wide acceptance and has become a common practice in many clinics since the pioneering works of Singer and Blom In 1979. Since the introduction of tracheo-esophageal puncture and application of Blom Singer$\circledR$ voice prosthesis in 1980, several reliable voice prostheses have been developed and are successfully being used. Objectives : Even though quality of voice produced by Silicone voice prosthesis with T-E fistula is superior to other modalities, it still has some disadvantages. We devised a new cannulatyped silicone voice prosthesis. Methods : 1) Devising a new prototype of cannula-typed silicone voice prosthesis. 2) Application of the prototype using canine animal model(laryngectormized dog) and fitting trial on human patient whose previously inserted Silicone voice prosthesis is not functioning due to presumed fungal infection. Discussion : Final form of prototype was made after several times of major and minor modifications. Insertion of the newly developed Cannula-typed Silicone voice prosthesis on canine animal model and human trial were done without any difficulty. There were no serious leakage of saliva or food during swallowing. Conclusion : The newly developed Cannula-typed Silicone voice prosthesis(So-Mang$\circledR$) and the modified replacement method will further improve the results of post-laryngectomized prosthetic voice rehabilitation. Long-term animal study and human trial are planned in the near future.

• 동의생리병리학회지
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• 제18권6호
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• pp.1575-1579
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• 2004

According to 2004 health statistics yearbook, cancer ocupies second death reason next to disease of blood circulation system and 1/4 was died because of cancer. There are very many factors to onset cancer, for example the exposure to varius kinds of pollution materials by development of industry, excess intake of harmful food to one's health, spritual stress, as become old age society, increase of attack-rate of geriatric diseases etc, attack-rate of cancer comes to be high gradually. The author had study about to treatment cancer by TCM(traditional chinese medicine) and combining TCM & western medicine, in Guang An Men hospital in Beijing of China from February 2003 to January 2004. TCM papers are 105 and combining TCM & western medicine papers are 280 of total 385 papers. Clinical reserch papers are 166, review articles are 194, animal experimental papers are 25. The papers used development herbal medicine are 42(10.9%), the papers used undevelopment herbal medicineare are 228(59.2%), the papers used senior TCM doctor's therapeutic experience and theory are 17(4.4%), the papers used theory of TCM or theory of combining TCM & western medicine are 71 (18.4%), the papers used acupuncture, qigong, thermotherapy, etc, other methods are 5, the papers used TCM patient's care or dietary treatment are 12 and ststistical papers are 10. Cancer is complicated hard case disease in pathological process. Combining TCM & western medicine treatment system is more efficient than one of TCM or western medicine in diagnosis, treatment, reserch of cancer.

• Journal of Microbiology and Biotechnology
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• 제26권9호
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• pp.1605-1612
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• 2016

Quinolone-resistant Salmonella strains were isolated from patient samples, and several quinolone-sensitive strains were used to analyze mutations in the quinolone resistance-determining region (QRDR) of gyrA, gyrB, parC, and parE and to screen for plasmid-mediated quinolone resistance. Among the 21 strains that showed resistance to nalidixic acid and ciprofloxacin (MIC 0.125-2.0 μg/ml), 17 strains had a mutation in QRDR codon 87 of gyrA, and 3 strains had a single mutation (Ser83 → Phe). Another cause of resistance, efflux pump regulation, was studied by examining the expression of acrB, ramA, marA, and soxS. Five strains, including Sal-KH1 and Sal-KH2, showed no increase in relative expression in an analysis using the qRT-PCR method (p < 0.05). In order to determine the genes involved in the resistance, the Sal-9 isolate that showed decreased susceptibility and did not contain a mutation in the gyrA QRDR was used to make the STM (MIC 8 μg/ml) and STH (MIC 16 μg/ml) ciprofloxacin-resistant mutants. The gyrA QRDR Asp87 → Gly mutation was identified in both the STM and STH mutants by mutation analysis. qRT-PCR analysis of the efflux transporter acrB of the AcrAB-TolC efflux system showed increased expression levels in both the STM (1.79-fold) and STH (2.0-fold) mutants. In addition, the expression of the transcriptional regulator marA was increased in both the STM (6.35-fold) and STH (21.73-fold) mutants. Moreover, the expression of soxS was increased in the STM (3.41-fold) and STH (10.05-fold) mutants (p < 0.05). Therefore, these results indicate that AcrAB-TolC efflux pump activity and the target site mutation in gyrA are involved in quinolone resistance.

• Journal of Nutrition and Health
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• 제36권8호
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• pp.834-840
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• 2003

지방간 소견을 나타낸 12인의 피검자를 대상으로 하여 3개월간 1일 2회, 아침과 저녁 식사를 생식으로 대용시킨 후 3개월후 혈액 및 신체계측 조사를 통하여 생식의 지방간 개선 효과를 관찰하였다. 그 결과 생식 섭취 3개월후 체지방 양 및 체중의 감소가 나타났으며, 간손상의 지표로 사용되는 AST, ALT, r-GTP 및 ALP의 활성이 모두 유의적으로 저하되는 모습이 관찰되어 생식의 섭취가 지방간을 개선시키는데 유용한 도구가 될 수 있는 것으로 판명되었다. 생식의 지방간 개선 기작을 탐구하기 위하여 고지방 사료를 통하여 흰 쥐에게 고지혈증을 유도한 이후 생식을 6주간 섭취시킨 결과에서도 실험 동물의 혈중 콜레스테롤, 중성지방의 농도가 모두 낮아지는 것으로 나타나 생식 섭취가 체내지질 대사의 정상화에 기여하는 능력이 있는 것으로 판단되었다. 지방간은 다양한 원인에 의해서 발생되나 그 중 가장 중요한 인자는 체내 높은 지방 함량이라 할 수 있으며, 생식의 섭취는 체내 지질 대사를 정상화함으로서 지방간의 개선에 높은 효과를 발휘 할 수 있을 것으로 추측된다.

• 대한한의학원전학회지
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• 제18권3호통권30호
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• pp.172-182
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• 2005

The study is on Yoshimasu Todo's thoughts of diseases and medical treatments. Conclusions are as below. 1. Yoshimasu Todo‘s thoughts of diseases. Diseases are existence of the poison in the human body. The poison oppresses and blocks the stream of vital energy. 'When evil-Qi is excessive. we call it Existence[邪氣盛則實]' means 'The existence of the poison in human body'. In this case, we must use herbal medicine as treatments. However, 'When body energy is exhausted, we call it Deficiency[精氣奪則虛]’ means 'The deficiency of body energy'. In this case, we don't have to use herbal medicine, because it is not a disease. For the recovery of the health. we shall intake nutritional food. 2. Yoshimasu Todo‘s thoughts of medical treatment. Medical treatment is to expel the poison from the body by using herbal medicine. When a medicine strikes the poison right, a reaction called 'Myunghyun[暝眩]' occurs. Myunghyun is the reaction of a living body when the poison is being expelled. To strike the poison right with herbal medicine, we must treat the patient according to the symptoms, not to the cause, nor the name[病名] of a disease.

• 대한영양사협회학술지
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• 제13권2호
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• pp.138-156
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• 2007

The purposes of this study were to a) measure the service quality attributes of foodservice type such as school foodservice, hospital foodservice and business & industry(B&I) foodservice, managed by contract management company(CMC), b) compare with service quality attributes by CMC scale, c) analyze overall customer satisfaction(CS) by the foodservice type and the CMC scale, and d) identify the effect of service quality attributes on an overall CS by the foodservice type and the CMC scale. The questionnaires were handed out to 6,620 customers of 207 school, 38 hospital, and 86 B&I foodservices in 108 CMCs. The statistical data analysis was completed using SPSS Win(ver 12.0) for descriptive analysis, t-test, reliability analysis, and multiple linear regression analysis. From an analysis on service quality attributes, 'proper arrangement of table and chair at hall distribution(3.53)', 'operation of nutrition education(3.50)' were highly perceived to student, 'correctable serving(4.08)', 'serve at fixed distribution time(4.08)', 'kindness of serving employee(4.04)' were highly perceived to patient, 'employee's kindness(3.84)' were highly perceived to customer of B&I. In comparison of service quality attributes by CMC scale, most scores of large enterprise(LE) were significantly higher than small and medium sized enterprise(SME) in school foodservice, hospital foodservice and B&I foodservice. Overall CS levels were 3.53 out of a maximum 5 on B&I, 3.46 on school, and 3.44 on hospital and were evaluated differently CS score by CMC scale. Finally, regression results for the effects of service quality attributes on overall CS by each of foodservice type were identified significantly different service quality attributes by foodservice type such as school, hospital, B&I(p<.001) and by CMC scale. For considering the goal of enterprise on profit-making through CS and the needs of customer on CS at moment of truth(MOT), the findings should be applied to the CMC and the foodservice industry.

• 한국병원경영학회지
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• 제18권1호
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• pp.59-69
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• 2013

Purpose Patients should have a regular medical check-up, the cost direct and indirect medical expenses to check the results, and revisit the hospital. Some of patients often want to use the telephone for a medical consultation, Method The subjects participating in this study were a selection 485 patients who received outpatient service in Asan Medical Center and Gangbuk Samsung Hospital. The patients's favorite method for medical check-up, time, cost, fatigue, and inconvenience, in regard with the revisit to check the examination results, were researched and analyzed on identical questionnaires about them. Results The average transportation, food expenses and opportunity costs the subjects spent was 90,400 for those from the Seoul and Gyunggi area, and 269,800 from other area. And the average required time per visit was 4.13 hours for those from the Seoul and Gyunggi area, 11.84 hours from other areas, and averagely 7.72 hours for all the subjects. More than 75% of the subjects answered that they felt tired and their work was interrupted. The subjects from both areas preferred the check by phone. Conclusion If the scope of telephone medical consultation is defined and the doctor-patient certification is possible, it can be thought as an efficient alternative of the medical check-up by revisit. It is necessary to discuss an appropriate amount of the medical check-up by phone which the same cost and effort can be allocated in.