• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.313-316
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• 1994

Usually the persistence of ventricular activity in Tc-99m DTPA cisternography is deter mined using 24 hour images in our country. However, the 24 hour image is regarded as an in-sufficient data by many investigators. They prefer 48 hour image. The aim of the present study was to evaluate the feasibility and usefulness of 48 hour delayed imaging in Tc-99m DTPA cisternography. We performed 48 hour cisternography using Tc-99m DTPA in 38 patients with known hydrocephalus. 37-111 MBq (1-3mCi) of Tc-99m DTPA were injected by lumbar puncture. Anterior and both lateral Images were obtained at 2, 6, 24 and 48 hours. The classification of hydrocephalus was done at 24 and 48 hours by two independent nuclear medicine physicians. The 48 hour images were interpretable in all cases. In seven patients, the clearance of ventricular activity was noted only on 48 hours images. Therefore, their classification was changed from type W to type III. Sixteen of 38 patients were underwent shunt operations. Clinical improvement was noted in 13 patients(1/1 of type II, 3/6 of type III 8/9 of type IV). One case who showed a changing pattern from IV to IIIa showed no clinical improvement after shunt operation. In conclusion, the 48 hour delayed imaging was feasible and useful technique in Tc-99m DTPA cisternography.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.27-35
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• 1999

Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of "psychogenic rheumatism". Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls ($mean{\pm}SD$: $178.3{\pm}75.5$ ng/ml versus $166.3{\pm}76.6$ ng/ml; p=0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.28-38
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• 2000

Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.21-27
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• 2018

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

• Health Policy and Management
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• v.16 no.1
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• pp.1-16
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• 2006

Recently, there has been prevailing of the combined utilization (CU) with herbs and prescribed drugs in medical therapies in the world. But the information about frequency, efficacy and safety of this CU has not well known in Korea, yet. This study aimed to identify the status of CU by Koreans, and to inquire which side effects of CU represent to those people. A self-completed questionnaire survey was performed through each health examination center in twenty general hospitals and one oriental hospital. Of the initial 2,100 health examinees, 1,851 were participated in this survey, resulting in a response rate of 88.1%. The proportion of CD was 26.3%. The most commonly mentioned reason of CD was 'to promote general health and well-being' (17l persons, 35.5%). The main route of taking CD was self-purchase at drugstore or at herbs market, followed by the prescription of (oriental)physicians. 33.0% (151 persons) of those who took the CD rated it as effective. 93 respondents (19.8%) were experienced several adverse effects including nausea, fatigue, and dizziness. The growing simultaneous use of herbal products and pharmaceutical drugs by Korean consumers may be continuously increased the risk of herb-drug interactions. The medical professionals should be provided with comprehensive and up-to-date information about potential benefits and risks of herbs and prescribed drugs. In the future studies it may be recommended to deal common cold, health promotion, indigestion, headache, and hypertension for the effect and safety of the CD by well-organized prospective study design.

• The Journal of the Korea Contents Association
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• v.12 no.2
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• pp.349-357
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• 2012

Although u-healthcare service is emerged as an alternative method for effective chronic disease management services, the service has not yet been applied for real healthcare setting. The objective of this study is to explore the doctors' perception and influential factors on intention to use u-healthcare service. We conducted survey for physicians about u-healthcare service provision to compare characteristics by different groups. In addition, logistic regression analysis is conducted to find out factors affecting the usage intention. As a result, doctors responded only 16.0% of total respondents had experience of u-healthcare services, but also showed that as high as 70.1% had intention to use service. Also, respondents answered that u-healthcare services is appropriate to apply for chronic disease prevention and diabetes and hypertension are suggested as the most appropriate diseases in order. The intention to use the u-healthcare service by non-university hospital doctors was 3.7 times higher than university hospital doctor. This study shows that identifying the differences of doctors' awareness and also the intention to use about the u-healthcare services will contribute to develop more effective business model.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.61-67
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• 1997

To understand the current status of pediatric surgical practice of the members of the Korean Association of Pediatric Surgeons, a survey of the practice of the 31 members in both 1994 and 1995. Twenty five members(80%) representing 20 hospitals responded. An average of four hundred and seventy four cases pediatric surgical operations were performed at individual institution in 1995 with 40 newborn cases. Eighteen members(72%) are currently working at university hospital. Fourteen institutions(70%) are currently classified as tertiary by the health insurance agency. The majority(15 to 60%) of members are working in the metropolitan Seoul area, while five in Taegu area. Sixteen members reported having the title of department head/director. Four members reported occasional non-pediatric surgical practice. Nine members out of 20 reported having independent pediatric surgical out-patient clinic before the establishment of the association(1985). Eight out of 15 members reported being appointed chief of pediatric surgery before 1985. In 20 institutions, 34 full time physicians(27 members, reportedly) are working in pediatric surgery. In regarding to pediatric surgical training, 16 members(64%) received an average of 16 months of training abroad, 5 members trained at home and abroad, and 4 from only at home. There are no differences in length of training periods in these groups. Twenty one members received their basic pediatric surgical training before 1985, the year of inauguration of the association. Twelve members received post-pediatric surgery refresher courses averaging 11 months' duration, after 2-11 years. Thirteen participants of this study belongs to the founding members of the association.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.25-32
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• 2015

Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.25-32
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• 2018

Purpose: Methamphetamine is an ongoing illegal drug problem worldwide, and its use in South Korea has spread over the last few years. In this study, a clinical review of patients who visited emergency medical centers with positive methamphetamine tests was conducted. Methods: Patients underwent methamphetamine screening based on physician suspicion over a period of 13 years. Their patient characteristics, clinical features, and drug administration properties were described. Results: A total of 297 patients were included, with 19 positive methamphetamine results. Patient age ranged from 21 to 84, with a mean of 37.52. Additionally, 13 were male and 6 were female. The mean BP, PR, RR were 131/82 mmHg, 94/min, 20/min. Saturation levels were all over 95%. Five patients had a psychiatric history. Patient showed varied symptoms ranging from mental changes to chest discomfort. In addition, seven showed abnormal electrocardiography findings and one showed elevated cardiac enzyme levels. Other laboratory results revealed no significantly abnormal results. Six patients also suffered from related trauma. The majority of patients consumed the methamphetamine orally, with unknown motivation at unknown locations. Most were transported by 119 and six patients co-ingested other drugs. Conclusion: Patients who showed positive results to a methamphetamine screening test in Korea visited the emergency medical center mostly by 119 and were unaware of or reluctant to reveal the fact that they had ingested methamphetamine. Emergency physicians should be more aware of the possibility that a patient may have consumed methamphetamine.

• Journal of Korean Medical classics
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• v.23 no.2
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• pp.33-62
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• 2010

"The Golden Mirror of Medicine(醫宗金鑑)" was compiled by the medical officers of the Cheong(淸) government headed by Ogyeom(吳謙: 1736-1795) in 1742, and was adopted as a textbook by the Institute of Imperial Physicians(太醫院) in 1749. This book provides a good summary of academic contents and clinical experiences from before the Cheong(淸) dynasty, and serves as a convenient and practical guide book. "The Notes of Treatise on Cold-Induced Diseases(傷寒論注)" is one part of "The Golden Mirror of Medicine(醫宗金鑑)", and this is placed at the beginning of the book, indicating its importance. The chapter on taeeum-disease[太陰病篇], which is the third part of "The Notes of the Treatise on Cold-Induced Diseases(傷寒論注)", has not yet been translated into Korean. Therefore, in this study, the characteristics of Ogyeom's(吳謙) notes are inspected through a comparative study of the chapter of taeeum-disease[太陰病篇] based on translation and the notes of famous scholars. The texts first provide an outline of taeeum-disease[太陰病], which is followed by diarrhea, vomiting and therapeutic methods of syndrome involving both the exterior and interior[表裏兼證], as well as abdominal distension and pain. The prognoses are then explained in succession. The eight texts that have been shown in the chapter of taeeum-disease[太陰病篇] of original text were relocated and the seven texts that existed in the chapters of taeyang(太陽), yangmyeong(陽明) and gwol-eum(厥陰) were moved to this chapter. Furthermore, Ogyeom(吳謙) moved the cold-dysphagia[寒格] text from a chapter of gwol-eum-disease[厥陰病] to a chapter of taeeum-disease[太陰病] and explained vomiting due to pathogenic cold. The origins of taeeum-disease[太陰病] are purported to occur through the yang-channel[陽經] to the eum-channel[陰經], and taeeum-disease[太陰病] was reported to include both interior-deficiency-cold-syndrome[裏虛寒證] and interior-excess-heat-syndrome[裏實熱證]. In the case of diarrhea-more-severe-symptoms[自利益甚], he thought it induced by faultpurgation[誤下], and in indication for decoction of cinnamon with peony[桂枝加芍藥湯] and decoction of cinnamon with rhubarb[桂枝加大黃湯], he thought it included the exterior syndrome of taeyang-disease[太陽表證], and rhubarb was used in purgation of taeeum-excess[太陰實].