• 한국환경보건학회지
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• 제45권5호
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• pp.511-519
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• 2019

Objectives: The standard method for the enumeration of environmental Legionella is culturing, which has several disadvantages, including long incubation and poor sensitivity. The purpose of this study is to demonstrate the usefulness of real-time PCR and to improve the standard method. Methods: In 200 environmental water samples, a real-time PCR and culture were conducted to detect and quantify Legionella. Using with the results of the survey, we compared the real-time PCR with the culture. Results: Each real-time PCR assay had 100% specificity and excellent sensitivity (5 GU/reaction). In the culture, 36 samples were positive and 164 samples were negative. Based on the results of the culture, real-time PCR showed a high negative predictive value of 99%, 35 samples were true positive, 105 samples were true negative, 59 samples were false positive and one sample was a false negative. Quantitative analysis of the two methods indicated a weak linear correlation ($r^2=0.29$, $r^2=0.61$, respectively). Conclusions: Although it is difficult to directly apply quantitative analysis results of real-time PCR in the enumeration of environmental Legionella, it can be used as a complementary means of culturing to rapidly screen negative samples and to improve the accuracy of diagnosis.

• 의료법학
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• 제9권1호
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• pp.285-317
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• 2008

To accept the doctor's professional negligence in the medical malpractice, the mistakes, by which the doctor did not foresee the production of the results in spite of the possibility of foresight and did not avoid the production of the results in spite of the possibility of avoidance, must be considered, and to decide the presence of the doctor's professional negligence, the standard must be the attention standard of general-common doctor engaged in the same business and the same function, and the medical enviornments, the conditions, the extraordinary nature of medical behavior, and etc should be considered by the general level of medical science at the time of accident. This principlel must be applied to the medical malpractice case occurred being on duty without exception. But, because of the extraordinary nature of duty work, it is difficult for any doctor to do one's best technical practice by making all diagnosis, medical treatment with all the equipment on the same plane as the ordinary times. That cannot be also expected for any doctor to do one's best technical practice in the terms of a social idea. From this point of view looking into The Precedent case related to Medical-service person being on duty sentenced by The Supreme Court, unlike the general medical malpractice case, the presence of the professional negligence in the medical malpractice occurred being on duty seems to be decided with more consideration on the general level of medical science, the medical enviornments and the conditions, particularities of medical practice at the time of accident. Especially, the extraordinary nature of medical behavior of the medical service person being on duty in the emergency room seems to be admitted compared to that of the medical service person being on duty in ward.

• 동의생리병리학회지
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• 제22권6호
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• pp.1347-1353
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• 2008

Pulse condition is the essential division for conducting pulse diagnosis which is one of the most fundamental and important diagnostics in traditional Korean/Chinese medicine. We studied the pulse condition referred to classics of traditional medicine for a full understanding in present time and come to a conclusion like below. The reference to pulse condition was concluded to 'twenty four pulse conditions' which is the fundamental conception generally accepted in present age since it had first mentioned in "Huangdi Neijing" and after it had passed through "Nanjing", "pulse pattern identification-chapter of normal pulse"of Zhang Zhongjing and reached "Maijing"of Wang Shuhe. Although medical partitioners had different views to some extent about pulse condition, there were no significant differences in the main theoretical frame. Even though there had been a diversity of opinions on the classification of pulse-condition between various medical practitioners, the method of Dae-dae and the method of systematic endeavored by Zhou Xueting and Zhou Xuehai who were medical scholars in the Ch'ing dynasty have been a criterion for the classification of pulse-condition up to date. We were able to recognize that the change of pulse condition caused by pathological situation should be compared to physiological pulse condition for detecting the deficiency and excess by researching the analyzing methods of pulse condition mentioned in the "Lingshu", and the book of Hua Shou and Zhou Xuehai). To sum up, first normal pulse which is the physiological pulse condition should be a standard for detecting physiological pulse condition. Secondly, Zhou Xueting insisted that relaxed pulse should be a standard pulse condition for detecting normal pulse.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2793-2796
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• 2014

Background: Glioblastoma multiform (GBM) is a highly aggressive tumor with median survival of approximately 14 months. Management consists of maximal surgical resection followed by post-operative chemoradiation with concurrent then adjuvant temozolamide. The standard radiotherapy dose is 60Gy in 2-Gy fractions recommended by the radiation therapy oncology group (RTOG). With the vast majority of tumor recurrences occurring within the previous irradiation field and the poor outcome associated with standard therapy, regimens designed to deliver higher radiation doses to improve local control and enhance survival are needed. In this study, we report a single institutional experience in treatment of 68 consecutive patients with GBM, treated with resection, and given post-operative radiotherapy followed by concurrent and/or adjuvant chemotherapy. Results: Of the 80 patients who entered this study, 68 completed the treatment course; 45 (66.2%) males and 23 (33.8%) females with a mean age at diagnosis of $49.0{\pm}12.9$ (21-75) years. At a median follow up of 19 months, 39 (57.3%) patients had evidence of tumor progression and 36 (52.9%) had died. The median over all survival for all patients was 16 months and progression free survival for all patients was 6.02 months. All potential prognostic factors were analyzed to evaluate their effects on overall survival. Age ${\leq}50$ year, concurrent and adjuvant chemotherapy and extent of surgery had significant p values. We found lower progression rate among patients who received higher doses of radiotherapy (>60Gy). Higher radiation doses improved progression free survival (p=0.03). Despite increasing overall survival, this elevation was not significant. Conclusions: This study emphasize that higher radiation doses of (>60Gy) can improve local control and potentially survival, so we strongly advise prospective multi centric studies to evaluate the role of higher doses of radiotherapy on GBM patient outcome.

• 대한한의진단학회지
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• 제14권1호
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• pp.1-14
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• 2010

Backgrounds : Bojungikgitang is one of the most common herbal prescriptions in Oriental Medicine, and it is highly recommended prescription for Nogwonsang syndrome. The Author developed Nogwonsang questionnaire for quantitative evaluation. Nogwonsang questionnaire is consisted of causes that induce fatigue, symptoms that directly associated with fatigue, and secondary symptoms that is induced from fatigue. Purposes : This study aims to verify whether the Bojungikgitang Questionnaire has causality and meaningful path structure by path analysis. Methods : 242 patients from 12 OMD clinics participated in this study. The patients executed a question investigation in the object. Factor analysis was conducted for extraction of factor and abridgment of items. Path analysis was conducted to verify path structure. SPSS 15.0 for Windows and AMOS 7.0 were used for statistical analysis. Results : Overwork factor explains fatigue factor. Coefficient is 0.771. Fatigue factor explains digesting and cold factor. Individually coefficient is 0.632 and 0.465. Model fit is $X^2=61.395$(df=51), GFI=0.960, AGFI=0.939, NFI= 0.924, CFI=0.986, RMSEA=0.029. Path structure is proved to be significant. Conclusions : Further research is needed Gold standard of Nogwonsang. Establishment of Gold standard leads and the collection of data and the research which are objective are possible. Connection of the clinical indexes which are objective on the paperweight outside and leads and the development of the diagnosis tool which is fixed quantity is demanded.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.37-54
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• 2007

We discuss why many current physical therapy entry-level programs are not designed to educate the type of physical therapy practitioners needed for the 21st century. We face a situation that we have to promote the profession's role in the prevention, diagnosis, and treatment of movement dysfunctions and the enhancement of the physical health and functional abilities of members of the public. The way how to train professional physical therapists became crucial. The purpose of study was to enhance the educational goals of physical therapy and the physical therapy curricula in Korea. In this study, we compared physical therapy training curricula recommended by WCPT with physical therapy training curricula in universities in other countries by dividing physical therapy curricula in universities and colleges into physical therapy students' electives, major required courses, labs and clinical practices, and counting the proportion of each category in the total credit hours. We discuss differences and similarities between curriculum in a university in Korea and curriculum in a university in the United States. We discussed possibly problematic portions of current physical therapy training curricula in korean universities. Finally, we statistically analyzed the regulations of WCPT and Health and Welfare Ministry in Japan, the Physical therapy curriculum of Creighton Entry-level DPT Program in the U.S. and the Inje University in Korea. The progressing direction of curricula in Korea had been researched. The future direction that korean physical therapy is to use an united curriculum that includes basic requirements of WCPT for all universities and colleges in Korea, rather than using each university's own modified version. The results of study can be helpful for developing a basic level of integrated curricula in universities and colleges in Korea.

• 간호행정학회지
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• 제6권1호
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• pp.83-96
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• 2000

With the increased use of computers in medical fields, we can consider introducing computer mediated communication into the area of patient care such as medical or health counseling and education. But little was known about what problems can be counseled, what is the main direction of counseling, and what difficulties are met during the computer mediated counseling. So I conducted this study. This is a fundamental study concerning the health counseling by the inter-net. In this study, medical counseling using a method of questioning -answering through a computer mediated communication system was carried out from June 1998 to May 1999. I analyzed the contents of questions and answers by the ICPC classification. The ICPC classification emerged as a standard for information categorization in Primary Health Care within a few years. One of the most prominent features of this classification is the inclusion of the complaints of the patients (symptoms & complaints) and the social problems (Chapter Z). Thus, and for the first time, the demand of patients may be assessed such as it is expressed in the reality. The ICPC list is now an international standard whose validity is not questioned any more. It is translated in more than twenty different languages. The data collected were analyzed by descriptive statistical method, c2 test by cross tabulations. Followings are the results of this study. 1. The 3,054 users composed of 64% of males and 36% of females. The highest number of users was showed in the age group of $25{\sim}29$ (39.4%). 2. During the one-year period, the average number of counseling per user was 2.5 cases and per day was 21.1 cases. 3. In classifying symptoms and complaints by 17 chapter, digestive(17.6%), general and unspecified (12.7%), skin(12.7%) and musculoskeletal system (9.6%) were most common questions. 4. The distribution of diagnosis by 17 chapter, general and unspecified (21.4%), digestive (15.3%), skin (11.9%) and mus- culoskeletal system (8.9%) were most common answers. 5. Many users wanted to know symptoms and complaints(3,609 cases), treatment principles (2,928 cases), prognosis and preventive methods for health problems which were previously diagnosed (284 cases).

• Journal of Acupuncture Research
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• 제20권5호
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• pp.252-260
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• 2003

Objective : The purpose of this report is to examine the effects of Scalp Acupuncture therapy in the H.I.V.D patients. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Cheonan O. M. hospital from Aug. 1, 2001 to Jan. 31. 2002. 30 patients had a diagnosis of herniated lumbar intervertebral disc by Lumbar-C.T or Lumbar-M.R.I. we treated 30 patients by Scalp Acupuncture therapy. Results : 1. We operated Scalp Acupuncture on the foot-motion sensory area(족운동감각구), the sensory area(감각구) 2. In the result of treatment due to clinical symptoms, leg radiating pain was more effective than any other clinical symptoms. 3. The efficacy of Scalp Acupuncture therapy was 83.3%(when we set a standard things more than fair) and 63.3%(when we set a standard things more than good). Conclusions: The Scalp Acupuncture therapy is effective of H.I.V.D patients, but we thought that it needed to prove effects of Scalp Acupuncture therapy for efficient application by more clinical reports.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6081-6086
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• 2014

Background: To evaluate the effectiveness of Microlux/DL with and without toluidine blue in screening of potentially malignant and malignant oral lesions. Materials and Methods: In this diagnostic clinical trial clinical examination was carried out by two teams: 1) two oral medicine consultants, and 2) two general dentists. Participants were randomly and blindly allocated for each examining team. A total of 599 tobacco users were assessed through conventional oral examination (COE); the examination was then repeated using Microlux/DL device and toluidine blue. Biopsy of suspicious lesions was performed. Also clinicians opinions regarding the two tools were obtained. Results: The sensitivity and, specificity and positive predictive value (PVP) of Microlux/DL for visualization of suspicious premalignant lesions considering COE as a gold standard (i.e screening device) were 94.3%, 99.6% and 96.2% respectively, while they were 100%, 32.4% and 17.9% when considering biopsy as a gold standard. Moreover, Microlux/DL enhanced detection of the lesion and uncovered new lesions compared to COE, whereas it did not alter the provisional clinical diagnosis, or alter the biopsy site. On the other hand, adding toluidine blue dye did not improve the effectiveness of the Microlux/DL system. Conclusions: The Microlux/DL seems to be a promising adjunctive screening device.

• 대한핵의학회지
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• 제22권1호
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• pp.39-45
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• 1988

To evaluate diagnostic accuracy of liver scintigraphy we analysed liver scans of 143 normal and 258 patients with various liver diseases. Three ROC curves for SOL, liver cirrhosis and diffuse liver disease were fitted using rating methods and areas under the ROC curves and their standard errors were calculated by the trapezoidal rule and the variance of the Wilcoxon statistic suggested by McNeil. We compared these results with that of National Institute of Radiological Science in Japan. 1) The sensitivity of liver scintigraphy was 74.2% in SOL, 71.8% in liver cirrhosis and 34.0% in diffuse liver disease. The specificity was 96.0% in SOL, 94.2% in liver cirrhosis and 87.6% in diffuse liver diasease. 2) ROC curves of SOL and liver cirrhosis approached the upper left-hand corner closer than that of diffuse liver disease. Area (${\pm}$ standard error). under the ROC curve was $0.868{\pm}0.024$ in SOL and $0.867{\pm}0.028$ in liver cirrhosis. These were significantly higher than $0.658{\pm}0.043$ in diffuse liver disease. 3) There was no interobserver difference in terms of ROC curves. But low sensitivty and high specificity of authors' SOL diagnosis suggested we used more strict decision threshold.