• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.2
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• pp.16-30
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• 2021

Objectives: The aim of this study was to establish a clear diagnostic definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 21 experts of Korean medicine, particularly in of gynecologic medicine, participated in the Delphi examination that included answering the 4th round survey. The Delphi examination was carried out through evaluating and correcting the questionnaire by e-mail. Results: Through the Delphi survey, we have reached on an agreement regarding the basic concepts, time, cause, essential symptoms, and accessory symptoms of Sanhupung. They are as follows: 1) Sanhupung is a culture bound syndrome reflecting Korea's cultural specificity. 2) Sanhupung can be diagnosed even after the miscarriage. 3) For the diagnosis of Sanhupung, the main cause of symptoms should not be classified as other disease. 4) Sanhupung can be diagnosed based on essential symptoms and accessory symptoms. 5) Essential symptoms include local symptoms such as joint pain at specific areas, partial sensory impairment and general symptoms including pain of all the joints, whole body sensory impairment, increased sweating, feeling of wind coming into the body, worsened symptoms with the cold, intolerance to cold, and pain of all the muscles. Conclusions: The basic concepts and diagnostic definition of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve reliability and validity of diagnostic definition of Sanhupung in clinical trials.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1083-1095
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• 2020

Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1759-1767
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• 2016

Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

• Journal of Preventive Medicine and Public Health
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• v.1 no.1
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• pp.25-36
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• 1968

Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2627-2630
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• 2013

Background: Ovarian cancer continues to pose a major challenge to physicians and radiologists. It is the third most common gynecologic malignancy and estimated to be fifth leading cancer cause of death in women, constituting 23% of all gynecological malignancies. Multi-detector computed tomography (MDCT) appears to offer an excellent modality in diagnosing ovarian cancer based on combination of its availability, meticulous technique, efficacy and familiarity of radiologists and physicians. The aim of this study was to compute sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of 64-slice MDCT in classifying ovarian masses; 95% confidence intervals were reported. Materials and Methods: We prospectively designed a cross-sectional analytical study to collect data from July 2010 to August 2011 from a tertiary care hospital in Karachi, Pakistan. A sample of 105 women aged between 15-80 years referred for 64-MDCT of abdomen and pelvis with clinical suspicion of malignant ovarian cancer, irrespective of stage of disease, were enrolled by non-probability purposive sampling. All patients who were already known cases of histologically proven ovarian carcinoma and having some contraindication to radiation or iodinated contrast media were excluded. Results: Our prospective study reports sensitivity, specificity; positive and negative predictive values with 95%CI and accuracy were computed. Kappa was calculated to report agreement among the two radiologists. For reader A, MDCT was found to have 92% (0.83, 0.97) sensitivity and 86.7% (0.68, 0.96) specificity, while PPV and NPV were 94.5% (0.86, 0.98) and 86.7% (0.63, 0.92), respectively. Accuracy reported by reader A was 90.5%. For reader B, sensitivity, specificity, PPV and NPV were 94.6% (0.86, 0.98) 90% (0.72, 0.97) 96% (0.88, 0.99) and 87.1% (0.69, 0.95) respectively. Accuracy computed by reader B was 93.3%. Excellent agreement was found between the two radiologists with a significant kappa value of 0.887. Conclusion: Based on our study results, we conclude MDCT is a reliable imaging modality in diagnosis of ovarian masses accurately with insignificant interobserver variability.

• The Journal of Pediatrics of Korean Medicine
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• v.23 no.3
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• pp.109-119
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• 2009

Objectives The purpose of this study is to collect the statistics of pediatric problems and to develop more effective oriental medical treatments for pediatric diseases, their clinical applicability, and chief complaints on pediatric inpatients in oriental hospitals. Methods The study was composed of seventy inpatients that were age from 0 to 20, had received hospital treatment at the pediatrics in Dongguk Bun-Dang Oriental Medicine Hospital for seven years from 1 January 2002 to 31 December 2008. The chief complaints were mainly categorized by oral examination on their patients. Results 1. In this study, male children were thirty one and female children were 39. Thus, sex ration of male to female was 0.79:1. 2. In age distribution, one month to one year were three (4.3%), 1 to six years were forty two (60%), six to ten years were fifteen (21.4%), and ten to twenty years were ten (14.3%). 3. In November, the number of inpatients was the highest (15.7%) in a year. However, there were no significant seasonal differences. 4. In the systemic division, the respiratory diseases : 44(62.9%), the digestive diseases : 11(15.7%), the infectious diseases : 5(7.1%), the musculoskeletal diseases : 3(4.3%), the diseases of nervous system : 3(4.3%), the gynecologic diseases : 1(1.4%), the liver and biliary disorders : 1(1.4%), and etc. : 3(4.3%). 5. The chief complaint of the inpatients is pneumonia, a common cold, respiratory complex symptoms, rhinitis, sinusitis, bronchitis, tonsillitis, diarrhea and etc. Conclusions The two main causes of inpatients were respiratory diseases and digestive disease. More data of inpatients are required for further study. Thus, the new diseases and treatment methods should be studied as a field of oriental medical treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3435-3442
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• 2015

Objective : To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods: A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results: Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion: Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.301-308
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• 2009

Purpose: The aim of this study was to evaluate the usefulness of FDG-PET/CT as follow up imaging tool in patients with endometrial cancer after therapy. Material and Methods: One hundred one patients with endometrial cancer who underwent FDG PET/CT after the treatment of this disease were included in this study population (25-79 yr old, Mean age 50.6 yr old) and all these patients also performed various laboratory and imaging studies such as serum tumor marker, CT or MRI. The lesions having increased focal FDG uptake were classified into benign, equivocal, and malignant one according to their pattern and activity. Tumor recurrence was confirmed by histopathological results and other clinical and imaging data. Results: Among the 19 patients with 30 malignant or equivocal hot uptakes, 11 of 14 patients supposed to be malignant finding in PET/CT were proved to be tumor recurrence, while one of 5 patients with equivocal lesions were recurred malignancy, Two false negative cases were turned out to be peritoneal carcinomatosis, Estimated sensitivity, specificity and accuracy of PET/CT for diagnosis of recurrence in endometrial carcinoma after treatment were 86 %, 92 % and 91 %, respectively. Positive and negative predictive values in the same issue were 63% and 98%, respectively. Conclusion: FDG-PET/CT is useful for regular work up of endometrial carcinoma after the treatment because of its high negative predictive value as well as high sensitivity and specificity.

• Herbal Formula Science
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• v.9 no.1
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• pp.35-82
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• 2001

In the Encyclopedia Medica Koreana(Dongeuibogam), I have researched 245 prescriptions in which Panax Ginseng plays an important role. And I have got the following results. The healing scope and frequency of ginseng-mainly-included prescriptions are Child Part 29(11.83%), Violent Cough Part 23(9.38%), Sick-by-Cold Part 21(8.57%), Oncosis Part 16(6.53%), Overwork Part 14(5.71%), Gynecologic Part 14(5.71%), Internal Part 13(5.3%), Apoplexy Part 11(4.48%), Mind Part 10(4.08%) and Fecal Part 10(4.08%) prescriptions. And also each of Nausea Part, Anger Part, and Spirit parts has the same 5 (2.04%) prescriptions. And each of Qi Part, Diabetes Meatus Part, Malaria Part, and Humoral Part has 4(1.63%) prescriptions. And each of Foot Part, Choleraic Part, Genital Part, Blood Part, and Voice Part has 3 (1.2%). All of these prescriptions cover 88.88%. And besides listed parts above, Panax Ginseng is all used in 48 Parts: Body-Mind Part. Mouth-Tongue Part, Breast Part, Muscle Part, Swelling Part, Urine Part, Epidermis Part, Heat Part, Anus Part, Stomach Part, Eye Part, Laryngopharynx Part. Uterus Part" Heavy Stomach Part, Head Part, Pulse Part, Hair Part, Navel Part, Emetic Part, Costal Part, Edema Part, Vomiting Part, Superstitious Part, and Cardiac Part, etc. Of the prescriptions in which Panax Ginseng plays an important role, the most representative diseases, which more than 86.8% prescriptions cure, are shock, numbness from cold, Taeeum disease, oncosis, overwork, sick from eating, numbness of extremities, diarrhea, tachycardia, forgetfulness, nausea, heat from kidney, nocturnal emission, short breath, diabetes meatus, malaria, sweating, sweating overnight, beriberi, cholera, insomnia from enervation, sialitis, navel pain, hemorrhage, and loss of voice. The pathology of the prescriptions in which Panax Ginseng plays an important role is divided into the organ problems, six natural factors, seven extreme feelings, unbalanced humoral status, overwork, and, unbalance of qi and blood. Spleen, heart, and uterus is the main cause of organ problems; wind and cold are the main cause of six natural factors; heavy humors are the main cause of unbalanced humoral status; the stasis of seven feelings are the main cause of seven extreme feelings; the lack of stamina and overwork are the main cause of the overwork; the lack of qi, the lack of blood, and, the lack of qi and blood are the main cause of the unbalance of qi and blood. After I have researched the contents of the prescriptions in which Panax Ginseng plays an important role, I could understand the addition of the different prescriptions, combination of medicines, and the role of medicine groups associated with Panax Ginseng. So from now on, the results I have got could be used as the data which show the theoretical basis on the prescriptions.

• Women's Health Nursing
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• v.9 no.2
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• pp.189-200
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• 2003

The purpose of this comparative study is to find out women and their spouses' sexual life and the factors affecting on their sexual life after women's hysterectomy. The data were the 110 questionaires which were collected from the participants, the 55 women who had undergone a hysterectomy due to gynecologic disease or benign tumor of genital organs and their spouses from January 1, 1999 to January 30, 2002 in one general hospital located in Seoul, Korea. Questionnaires were mailed to couples, who agreed to participate on the study and self reported questionnaires returned in the pre-stamped envelopes. And personal visits were made for those couples who did not respond. Tools for Sexual life and characteristics of sexual activities were reconstituted by the author based on Kim(1996) and Chang(1988)'s tools and were reviewed by a nurse specialist. Data analysis was done by SPSS 10.0 program using frequency, percentage, mean, S.D. Pearson correlation coefficient, t-test, oneway ANOVA and multiple regression. The results of this study are as follows; 1. Of all female subjects, 80% had experienced hysterectomy below the age of 50. 2. 72.8% of female subjects and 67.3% of male subjects did not receive any sexual education & counseling before and after the surgery. More than 60% of both female and male subjects answered that it was necessary to have a sexual counseling. And 40% wanted to receive sexual counseling from a professional sexual counselor. 3. More than half of couples started their first coitus within 4 weeks after the surgery. And 88.9% of females and 85.2% of males answered that they were experiencing orgasms with their sexual relationship. 4. Influencing factors on the satisfaction level of sexual life were couple's intimacy and sexual discomfort in women and couple's intimacy and sexual knowledge in spouses. These factors explained the 33% and 24% of total variance respectively. In conclusion, the result suggests that it is necessary for couples to receive a professional sexual education and counseling to improve couples' quality of life. It is also necessary for institutions to use prepared nurses by receiving sexual counseling and education program as a professional sexual counselors or educators so as to provide individualized sexual education and counseling for their clients.