• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제21권1호
• /
• pp.1-11
• /
• 2018

The emergence of mucosal healing as a treatment goal that could modify the natural course of Crohn's disease and the accumulating evidence showing that biologics are most effective in achieving mucosal healing, along with the success of early treatment regimens for rheumatoid arthritis, have led to the identification of early Crohn's disease and development of the concept of catching the therapeutic window during the early disease course. Thus, an increasing number of pediatric gastroenterologists are adopting an early biologic treatment strategy with or without an immunomodulator. Although early biologic treatment is effective, cost and overtreatment are issues that limit its early use. Currently, there are insufficient data on who will benefit most from early biologics, as well as on who will not need early or even any biologics. For now, top-down biologics should be considered for patients with currently known high-risk factors of poor outcomes. For other patients, close, objective monitoring and accelerating the step-up process by means of a treat-to-target approach seems the best way to catch the therapeutic window in early pediatric Crohn's disease. The individual benefits of immunomodulator addition during early biologic treatment should be weighed against its risks and decision on early combination treatment should be made after comprehensive discussion with each patient and guardian.

• 대한한방소아과학회지
• /
• 제30권4호
• /
• pp.66-76
• /
• 2016

Objectives This study aims to investigate current status of the Korean medicine treatment on the cerebral palsy (CP) via interviewing the doctors who have expertise in CP children. Methods From June 2015 to May 2016, the surveys and in-depth interviews were conducted on the fifteen Korean medicine doctors. Results Based on the surveys and interviews, widely-used treatments were body acupuncture and herbal decoction. Scalp acupuncture, intradermal acupuncture and manipulation were also used frequently. Experts stated Korean medicine could be more effective in younger patients, patients with cognitive or language problem. They also stated that Korean medicine has its advantage on strengthening the body to help grow and develop in CP children. However, the absence of guideline related to Korean medicine treatment in CP children as well as high cost are the problems. Finally, the issues regarding Korean medicine treatment in CP children, based on the in-depth interviews, emerged when western medicine is used simultaneously, when having seizure during treatment. Further research is needed for better understanding. Conclusions This study provided current status of the evidence-based Korean medicine treatment in CP children. However, further studies about the addressed issues are needed.

• The Korean Journal of Pain
• /
• 제28권3호
• /
• pp.169-176
• /
• 2015

This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.

• 한국치위생학회지
• /
• 제9권3호
• /
• pp.380-391
• /
• 2009

Objectives : The purpose of this study was to compare results of dental satisfaction at different type of character and provide basic materials for making the valuable strategies of dental service. Methods : Data was obtained from 256 patients using questionnaire from September 5 to October 13, 2007. Self-administered questionnaires was utilized to assess their types of personal psychological variable and find out its influential factors upon dental consumers and their intent of revisit. The data was analyzed with t-test, one-way ANOVA and logistic regression using the SPSS 14.0 Windows. Results : There is no meaningful difference in dental satisfaction as for character types and factors. Considering the difference of dental satisfaction according to general characteristics, there was a meaningful difference between groups of gender. Also interpersonal relationship as well as level of skill is significantly high in periodical dental visit. Conclusion : The results of this study indicated that environment and facility, cost is the most important influencing factor in determining whether or not the patient will visit a dental clinic repeatedly. In the future, more precise and in-depth questionnaires should be developed to analyze dental consumers.

• 지역사회간호학회지
• /
• 제13권3호
• /
• pp.444-455
• /
• 2002

Purpose: This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization. Method: The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation. Result: Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed. Conclusion: In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.

• 한국정보통신학회:학술대회논문집
• /
• 한국해양정보통신학회 2005년도 춘계종합학술대회
• /
• pp.1153-1156
• /
• 2005

PACS 시스템은 다양한 의료영상 진단장치를 통해 병원의 업무 효율 및 환자들을 위한 진료 및 진단의 효율성을 향상시키기 위해 개발 되었다. PACS시스템은 필름없는 병원을 위해 연구되어 왔지만, 아직도 촬영된 영상들에 대한 높은 정확성을 제공해 줄수 있는 이미지 필터링 기술들은 부족하다. 따라서 본 연구에서는 Xray영상 처리 시스템 개발중 이미지 처리부분을 중점적으로 다루었으며 영상처리의 최적화를 위해 단순하면서도 필수적으로 필요한 필터를 주로 사용하였다. 앞으로 환자들의 진단을 보다 정확히 결정하고 외국산 모델에 비해 저렴한 진단용 XRay장비의 보급에 많은 영향을 미칠 것으로 기대한다.

• 한국의료질향상학회지
• /
• 제5권1호
• /
• pp.92-104
• /
• 1998

Background : Hospitals in Korea are in trouble at ecomomic matters because of low cost of medical insurance, and consumers' demand for high quality. The management of inpatient clothing is very difficult. Especially the management of patient's clothing size is very difficult because the case mix of patients in wards is very different from the stocked clothing size. Because of the economic matters, the ward does not prepare enough size of clothing. The nurses in ward are in trouble with managing the clothing. So the nurses want free size patient clothing for ease management of clothing size. Method : The experimental inpatinets clothing is designed for in 170cm height refer to Korean standard. The fit of 8 subjects from 150 cm to 185 cm wearing experimental were evaluated by clothing specialists, nurses and patients. Result : 75.8% of evaluators like free size clothing. This results show that the fit of subjects from 160cm to 180cm was good in general but subjects with 150cm, 155cm, 185cm height showed poor fit.

• 보건행정학회지
• /
• 제31권1호
• /
• pp.17-23
• /
• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• Archives of Plastic Surgery
• /
• 제43권1호
• /
• pp.53-58
• /
• 2016

Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%-10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy. Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy. Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%). Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권12호
• /
• pp.4891-4894
• /
• 2015

Background: To evaluate the value of combined detection of serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrateantigen 125 (CA125) for the clinical diagnosis of nonsmall cell lung cancer (NSCLC). Materials and Methods: Serum CEA, CYFRA21-1 and CA125 were assessed in 140 patients with NSCLC, 90 patients with benign lung disease and 90 normal control subjects, and differences of expression were compared in each group, and joint effects of these tumor markers in the diagnosis of NSCLC were analyzed. Results: Serum CEA, CYFRA21-1 and CA125 in patients with NSCLC were significantly higher than those with benign lung disease and normal controls (P<0.05). The sensitivity of CEA, CYFRA21-1 and CA125 were 49.45%, 59.67%, and 44.87% respectively. As expected, combinations of these tumor markers improved their sensitivity for NSCLC. The combined detection of CEA + CYFRA21-1 was the most cost-effective combination which had higher sensitivity and specificity in NSCLC. Elevation of serum CEA and CYFRA21-1 was significantly associated with pathological types (P<0.05) and elevation of serum CEA, CYFRA21-1 and CA125 was significantly associated with TNM staging (P<0.05). Conclusions: Single measurement of CEA, CYFRA21-1 and CA125 is of diagnostic value in the diagnosis of lung cancer, and a joint detection of these three tumor markers, could greatly improve the sensitivity of diagnosis on NSCLC. Combined detection of CEA + CYFRA21-1 proved to be the most economic and practical strategy in diagnosis of NSCLC, which can be used to screen the high-risk group.