• Title/Summary/Keyword: 15,000임상도

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A Clinical Study on Macrosomia (거대아에 대한 임상적 연구)

  • Lee, Kang-Won;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Youn
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.293-299
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    • 1986
  • Obstetric problems concerning macrosomia were evaluated by retrospective review of 91 pregancies that resulted in the delivery of an infant weighing 4,000gm or more at the Yeungnam University Hospital during 3 1/2 years from Jun. 1983 to Oct. 1986. The results obtained were as follows. 1. Macrosomic infants weighing 4.000gm or more occured in 2.8% of the deliveries. 2. 65.9% of macrosomic infants and 53.5% of total infants were male. The ratio of male was statistically higher in the macrosomic infants than in the total infants(P<0.05). 3. The incidence of macrosomia was higher with increasing qestational age, and deliveries at 42 weeks or more gestation were more common in the macrosomic infants than in the total infants(P<0.01). 4. The incidence of macrosomia was highter with increasing parity, and stastically higher in the multipara than in the primipara(P<0.01). 5. There was no difference in the incidence of macrosomia between the mothers aged 24 or less and that of 30 or more. 6. The cesarean section rate of macrosomia(30.8%) was stastically higher than that of the total infants(15.7%)(P<0.01) 7. With the pregnacy and delivery of macrosomic infants, 22 antepartum anemia(24.2%), 10 postpartum hemorrhage(11.0%), 9 birth canal injury(10.0%), 7 prolonged second stage of labor (7.7%), 4 breech presentation, and 3 pregancy induced hypertension occured in the mothers, and 10 asphyxia(or Apgar score 6 or less), 2 shoulder dystocia, 1 intrauterine fetal death, and 1 sacrococcygeal teratoma occured in the infants.

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Geographic Distribution of Physician Manpower by Gini Index (GINI계수에 의한 의사의 지역간 분포양상)

  • Moon, Byung-Wook;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.301-311
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    • 1987
  • The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of disparity in physician distribution and in identifying changes in the distributional pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physicians located counties to whole physicaians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1955, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of genral surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1955, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 to 0.5868 for counties indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.

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Safety and Significance of Surgical Lung Biopsy for Interstitial Lung Disease (간질성 폐질환에 대한 수술적 폐생검의 의의 및 안전성)

  • Lee, Yu Jin;Joung, Mi Kyong;Chung, Chae Uk;Park, Ji Won;Shin, Ji Young;Jung, Sun Young;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.59-66
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    • 2007
  • Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

An Epidemiological Study on the Industrial Injuries among Metal Products Manufacturing Workers in Young-Dung-Po, Seoul (일부 금속 및 기계제품 제조업체 근로자들의 산업재해($1980{\sim}1981$)에 관한 조사)

  • Lee, Jung-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.187-196
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    • 1982
  • The followings are the results of the study on industrial accidents occurred at 12 factories manufacturing metal products during the period of 2 years from January 1980 to December 1981 in the area of Yong-Dung-Po in Seoul. The results of the study are as follows: 1. The incidence rate of industrial injuries was 45.7 per 1,000 workers of the sample group and the rate of male (54.0) was three times higher than that of female (17.5). 2. In age groups, the highest rate was observed in the group of under 19 years old with 83.5, while the lowest in the group of 40s. 3. It was found that those who had short term of work experience produced a higher rate of injuries, particularly, the group of workers with less than 1 year of experience showed the highest rate of it as 48.1%. 4. In working time, the highest incidence rate occurred 3 and 7 hours after the beginning of their working showing the rate of 6.0 and 6.1 per 1,000 workers, respectively. 5. The highest incidence rate was observed on Monday as 8.4 per 1,000 workers, and it was 18.3% in aspect of the days of a week. 6. In aspect of the months of a year, the highest incidence was observed on July 1,000 workers and the next was on March as 4.8. These figures account for 11.8% of total occurrence in respective month. as 5. 4 per and 10.5% 7. In causes of injuries, the accident caused by power driven machinery showed the highest rate with 37.5%, the second was due to handling without machinery with 17.2%, and the third was due to falling objects with 14.2%, and striking against objects with 10.2%, and so on. 8. By parts of the body affected, the most injuries 84.3% of them occurred on both upper and lower extremities with the rate of 58.8% for the former and 25.5% for the latter. Fingers were most frequently injured with a rate of 40.3%. Comparing the sites of extremities affected, rate of injuries on the right side was 55.0% and 45.0% on the left side. 9. In the nature of injury, laceration and open wound were the highest with 34. 0%, the next was fracture and dislocation with 31. 9%, and sprain was the third with 8.1%. 10. On the duration of treatment, it lasted less than one month in 68.9% of the injured cases, of which 14.5% of the cases were recovered within 2 weeks, and 54.4% of them were treated more than 2 weeks. And the duration of the treatment tended to be prolonged in larger industries. 11. The ratio of insured accidents to uninsured accidents was 1 to 4.7.

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A Clinical Study of Aseptic Meningitis in the Northern Area of Seoul in 2002 (2002년 서울 북부지역에서 유행한 무균성 수막염의 임상적 고찰)

  • Song, Myoung Hak;Chung, Ju Young;Kwon, Ji Won;Kim, Sang Woo
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.176-182
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    • 2004
  • Purpose : The etiologic agents of aseptic meningitis remain mostly unknown due to difficulty of viral culture and identification. There was an outbreak of aseptic meningitis in northern area of Seoul from June to August, 2002. We report the clinical features, laboratory data and causative viruses on 196 children with aseptic meningitis during this period. Methods : We retrospectively studied about clinical manifestations and laboratory findings 196 patients diagnosed as aseptic meningitis at Sanggye-Paik hospital. Virus isolation and serotype identification were performed by cell culture and reverse transcription polymerase chain reaction(RT-PCR) of the cerebrospinal fluid. Results : The male to female ratio was 1.39 : 1 and the mean age was 5.8+3 years. The clinical manifestations were fever, headache and vomiting. It occurred mostly in June, July and August. The numbers of peripheral blood leukocytes were $4,800{\sim}24,360/mm^3$. On cerebrospinal fluid examinations, leukocytes were in range of 10~2,000(mean 105)/$mm^3$, protein level in range of 15~171(mean 41.4) mg/dL and glucose level from 16~97(mean 57.9) mg/dL. Viral culture of cerebrospinal fluid showed 3 cases of Echovirus 9, 1 case of 25 and 30. In stool culture, 2 cases of Echovirus 6, 2 cases of Echovirus 13 and 1 case of Echovirus 30 were isolated. Conclusion : The etiologic viruses of the aseptic meningitis in northern area of Seoul in 2002 are presumed to be Echovirus 6, 9, 13, 25, 30.

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Bee-Venom theraphy -Method of Clinical Approach- (봉독요법 -임상활용방법을 중심으로-)

  • 이재동
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.3-8
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    • 2000
  • 1. Definition : Bee-venom therapy does not involve actual bee-stings: it is a treatment method with acquired bee-venom extract through the electric stimulus on the bee, It is injected subcutaneusly on the acupuncture point after refining, according to the diagnosis of constitution and disease. 2. History : Around 2000 B.C., records that Bee-venom was used for therapy were written in the medical book of Babylonia and Papirus of ancient Egypt. Hippocrates, who is called the father of Medicine, said that Bee-venom is Arcanum, which means mysteric medicine. In Oriental medicine, B.C. 200, there was a clinical record that the meat suspended in front of the bee house on the tree in order to get bee-venom, was attached on the lesion. 3. Mechanism of Action : There are two aspects: 1) The effect of stimulating acupunture point It is similar to the chemical moxa. I think that there are several methods of stimulating the acupuncture point: For example, a simple needle is a mechanical stimulus, Moxa is a heating stimulus and electric and Raser acupunture etc. And another stimulus: in the ancient orient, a chemical stimulus called Chungu(Tianjiu), is attached to the lesions by using grinded insects (ex. Mylaris phalerate PALL.) which have toxin. So Bee venom therapy is similar to this. 2) The effect of biochemical ingredients Bee venom consists of 40 kinds of ingredients. For example, me Iii tin, Apamin, Pospholipase A2, MCD peptide, Adolapin and so on. They have effects which have been proven through experimentation l) tonifying mechanism of the body through increasing hormon secretion 2) tonifying immune system through proliferation of WBC, lymphocytes, macrophage 3) anti-inflammatory reaction Therefore Bee venom therapy is the representative 3rd Medicine, which combined East & West medicine. 4. Application of disease : L.B.P and HIVD, O.A, R.A, degenerative arthritis, shoulder pain and other pain diseases. 5. Therapic methods : According to constitution and disease, proper concentration of bee venom is injected on acupunture point, 2 times a week. Generally one term is consisted of 15times. 6. Contraindication : Heart disease, TBc, DM, kidney disease(nephritis), pregnancy, woman in menstruation 3-4 persons per 100,000 persons may have severe allergic reaction.

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A Clinical Study of Urticaria and an Assessment Guideline (두드러기에 대한 임상 연구 및 평가 지침)

  • Lee Gil-Young;Kim Hae-Jung
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.25-31
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    • 2005
  • Objectives: This study was designed to assess traditional Korean medical therapy for urticaria and establish a clinical assessment guideline. Methods: Duration of symptoms, personal and family history of allergic diseases, serum IgE level, suspected causes and Provocation factors were investigated in 56 patients. Frequency of wheals, duration of wheals, number of wheals, itch severity and antihistamine counts on a 6-point (0-5) scale were assessed in 34 patients. The change of total scores and each criterion between baseline and follow up were analyzed using paired t-test (p<0.05). Results: 1. Acute urticaria within 6 weeks was $26.8\%$ and chronic urticaria over 6 weeks was $73.2\%$. The mean duration of symptoms was $19.2\pm38.8$ months. 2. $57.1\%$ of patients had a personal history of allergic diseases and $50\%$had a family history. $29.1\%$ had over 200 IU/mL serum IgE level. 3. The suspected causes were none $(39.3\%)$, foods $(32.1\%)$, drugs $(12.5\%)$, contact $(5.4\%)$ and maternity$(5.4\%)$. 4. The suspected provocation factors were foods $(41.1\%)$, none $(26.8\%)$, fatigue $(12.5\%)$, heat and sweating $(12.5\%)$, pressure $(10,7\%)$ and stress $(7.1\%)$. 5. The total scores between baseline and follow up of 34 patients were lowered from $15.38^{\circ}\;{\ae}3.75\;to\;8.82^{\circ}\;{\ae}5.21$, which was significant statistically (p=0.000). 6. Itch severity, frequency of wheals and number of wheals were the most significantly lowered of all criteria. Conclusions: Traditional Korean medical therapy was proven to be effective for urticaria, while itch severity, frequency of wheals and number of wheals should be assessed clinically with greater priority.

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Effect of Tailored Music Intervention on Intra-operative Anxiety among Those Undergoing Regional Anesthesia (환자의 선호도를 고려한 음악중재가 부분마취 환자의 수술 중 불안에 미치는 효과)

  • Kim, Joo Hee;Baek, Seol Hyang
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.187-198
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    • 2008
  • Purpose: Music intervention has long been used in research of patients undergoing surgical operation in reducing anxiety level and improve surgical outcome. However, there are few studies that have considered a patient's music preference. We investigated the effect of the tailored music intervention which chose music according to the patient's preference on anxiety level and vital signs. Method: The subjects were 50 patients who received regional anesthesia for surgical operation at D hospital in Pohang city from April, 2006 to November, 2006. All of the subjects were randomly assigned either music group (30 subjects) or non-music group (20 subjects). As the patients arrived in the operating room, vital signs were monitored until the subjects were transferred to the recovery room, while Spielberger's STAI-KYZ questionnaires were applied twice to measure preoperative and intra-operative anxiety. The data were analyzed by 2-test, t-test, one-way ANCOVA and repeated measures ANOVA using SPSS 12.0/PC+. Results: There were no significant differences between the two groups on vital signs. All of the vital signs increased when the subjects arrived in the operating room, but decreased quickly once the operation began, regardless of the groups. However, the music group reported significantly less intra-operative anxiety, compared to the non-music group (F=15.208, p<.000), when preoperative anxiety was treated as a covariance. Conclusion: The findings support that the use of music which was chosen by patients during the surgery significantly reduced patient's intra-operative anxiety during regional anesthesia.

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Low-Molecular Collagen Peptide Supplementation and Body Fat Mass in Adults Aged ≥ 50 Years: A Randomized, Double-Blind, Placebo-Controlled Trial

  • Jeongbin Park;Minji Kim;Hyeri Shin;Hyejin Ahn;Yoo Kyoung Park
    • Clinical Nutrition Research
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    • v.12 no.4
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    • pp.245-256
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    • 2023
  • A randomized, double-blind, placebo-controlled trial was conducted to confirm whether collagen peptide supplementation for 12 week has a beneficial effect on body fat control in older adults at a daily physical activity level. Participants were assigned to either the collagen group (15 g/day of collagen peptide) or the placebo group (placebo drink). Body composition was measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA). In total, 74 participants (collagen group, n = 37; placebo group, n = 37) were included in the final analysis. The collagen group showed a significant reduction in total body fat mass compared with the placebo group, as evidenced by both BIA (p = 0.021) and DEXA (p = 0.041) measurements. Body fat mass and percent body fat of the whole body and trunk reduced at 12 weeks compared with baseline only in the collagen group (whole body: body fat mass, p = 0.002; percent body fat, p = 0.002; trunk: body fat mass, p = 0.001; percent body fat, p = 0.000). Total fat mass change (%) (collagen group, -0.49 ± 3.39; placebo group, 2.23 ± 4.20) showed a significant difference between the two groups (p = 0.041). Physical activity, dietary intake, and biochemical parameters showed no significant difference between the groups. The results confirmed that collagen peptide supplementation had a beneficial effect on body fat reduction in older adults aged ≥ 50 years with daily physical activity level. Thus, collagen peptide supplementation has a positive effect on age-related changes.

Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증후군의 진단에 있어 턱 압박술의 유용성)

  • Kim, Moo-Jin
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.22-29
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.

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