• 대한두경부종양학회지
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• 제34권2호
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• pp.17-21
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• 2018

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

• 한국물환경학회지
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• 제27권3호
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• pp.349-356
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• 2011

This study, which evaluated the contribution of the real economic value and system in the Nakdong River Basin, estimated the emergy analysis for environmental accounting of the TMDL program. And an environmental accounting for TMDL is evaluated before and after adopting TMDL program respectively. The value of emergy after adopting the TMDL was 7.90 E+20 sej/yr. Although the real yield of the river after governmental investment was high (before: 9.7118 E+20 sej/yr and after: 9.7224 E+20 sej/yr), the effects of improvement was not great, in terms of an investment cost. The benefit/cost ratio resulted from environmental accounting has decreased from 1.493 to 1.230 due to the cost of managing treatment facilities. The method of improving water quality in the Nakdong River Basin by the TMDL program should be changed into an ecological treatment facilities using resources efficiently from a control of water quality depending on expansion of the wastewater treatment facilities and advanced treatment plant using high cost and non-renewable energies.

• 치위생과학회지
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• 제6권2호
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• pp.133-138
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• 2006

이 연구는 상수도수불화사업의 경제적 편익에 미치는 영향을 파악하기 위하여 2003년 1월 1일부터 6월말까지 상수도수불화지역인 청주시 상당구, 상수도수비불화지역인 안양시 만안구를 대상지역으로하여, 조사대상지역내의 치과의원에서 진료를 받은 진료지표를 비교 분석한 결과는 다음과 같다. 1. 상수도수비불화사업지역인 안양에서 상수도수불화사업을 실시할 경우 2003년 상반기의 6세에서 18세까지 연령에서 기대되는 치아우식증과 치수 및 치근단 주위조직 질환으로 인한 감소기대진료건수는 1,272건, 저추정시 636건, 고추정시 1,908건이 감소될 것으로 기대된다. 그리고 감소기대진료비는 40,888천원, 저추정시 20,444천원, 고추정시 61,333천원이 감소될 것으로 기대된다. 2. 상수도수불화사업의 전국 확대를 가정한 연간 기대건수는 2,492,018건, 저추정시 1,246,009건, 고추정시 3,738,027건이 감소가 기대되며, 감소기대진료비는 80,105,075천원, 저추정시 40,052,537천원, 고추정시 120,157,612천원이 각각 감소가 기대된다. 3. 급수인원이 48,925명인 영운정수장의 경우 편익/비용 비율이 2.9배이며, 급수인원이 239,751명인 지북정수장의 경우 편익/비용 비율이 9.0배이다. 상수도수불화사업은 급수인원이 증가함에 따라 비용의 증가는 미미하고 규모에 따른 경제 효과가 매우 크게 나타났다. 국민구강건강증진은 아울러 구강건강보험재정의 비용절감과 연관이 있다고 사료되며, 이를 위하여 전국 모든 지역에 상수도수사용을 확대 실시하여, 상수도수와 불소화에 대한 적극적인 홍보와 교육을 통한 신뢰 구축이 추가적으로 필요하다고 생각된다.

• International Journal of Internet, Broadcasting and Communication
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• 제7권2호
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• pp.84-89
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• 2015

About 30% of Mongolian population is populated in the capital of the nation. Too many hospitals are concentrated in size as compared to the capital. This creates a difficult environment to provide equal distribution of medical benefit. In order to resolve this issue of medical benefit inequality, a portable/travelling medical treatment system using 'M-LIMS' is proposed for real-life application. The system with M-LIMS to be designed will include functions such as composing, sharing charts among doctors, standardizing charts. M-LIMS will be designed considering Mongol's regional characteristics, and application plans will be proposed accordingly.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3937-3940
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• 2015

Background: Pancreatic cancer risk is increased in patients with type 2 diabetes, while being reduced by metformin treatment. However, it is unclear whether metformin could be associated with clinical outcomes of patients with pancreatic cancer and concurrent type 2 diabetes. Materials and Methods: A pooled analysis of 4 publications including 1,429 patients was performed to investigate the association of metformin and overall survival(OS) in patients with pancreatic cancer and concurrent type 2 diabetes. Results: A borderline significant relative survival benefit was found in metformin treated patients compared with non-metformin treated patients (hazard ratio 0.80; 95% CI: 0.62-1.03). Conclusions: These results suggest that further investigation is warranted of whether metformin may benefit the survival of patients with pancreatic cancer and concurrent type 2 diabetes.

• 보건행정학회지
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• 제24권3호
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

• Journal of Chest Surgery
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• 제47권2호
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• pp.77-93
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• 2014

Lung cancer is one of the most common malignant tumors, and it has the highest death rate. Oncothermia is a feasible and successful treatment for lung cancer. Results show a remarkable survival benefit for patients, with a good quality of life. The treatment has no, or in some cases mild, side-effects and could decrease the adverse effects of the complementary treatment. Applying oncothermia together with other treatment methods could increase the effects and result in better performance. A comparison of studies demonstrates a good correspondence in the data, which strengthens the reliability of the studies, and clearly shows the feasibility of the application of oncothermia to treating all kinds of pulmonary malignancies including non-small-cell and small-cell primary tumors, and all of the metastatic diseases of the pulmonary system.

• Clinical and Experimental Pediatrics
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• 제53권11호
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• pp.936-941
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• 2010

The systematic approach to pharmacologic treatment is typically to begin with the safest, simplest, and most conservative measures. It has been realized that the more rapidly inflammation is under control, the less likely it is that there will be permanent sequelae. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial treatment for inflammation. In addition, the slow-acting antirheumatic drugs (SAARDs) and disease-modifying antirheumatic drugs (DMARDs) have efficacy of anti-inflammatory action in children with chronic arthritis. New therapeutic modalities for inflammation, such as etanercept and infliximab, promise even further improvements in the risk/benefit ratio of treatment. It is not typically possible at the onset of the disease to predict which children will recover and which will go on to have unremitting disease with lingering disability or enter adulthood with serious functional impairment. Therefore, the initial therapeutic approach must be vigorous in all children.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5589-5594
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• 2015

Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

• 대한치과마취과학회지
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• 제13권3호
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• pp.81-87
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• 2013

This article discusses the issues of benefit and possibility of application of patient-controlled sedation (PCS) for the dental treatment. The purpose of administering PCS for patients is to diminish anxiety and to provide cooperative and effective dental treatment. But there are a lot of barriers to application of PCS such as knowledge about pharmacokinetics of sedatives, expensive high speed and patient-controllable syringe pump, and well educated sedationist. And there could be risk of deep sedation, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, appropriate drug selection, selection of right bolus dose, lock-out time is much important.