• Progress in Medical Physics
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• v.18 no.4
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• pp.187-193
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• 2007

In an effort to assess the internal absorbed dose of radionuclides that is suitable to Koreans' physiological characteristics, we asked 28 male Koreans to take $^{131}|$ orally, determined the thyroidal uptake and daily urination ratio, and assessed the absorbed dose by organ. As a result, first, 24 hours after administering, the average thyroidal uptake and the daily urination ratio registered 19.70% and 71.12%, respectively. Second, the whole body effective dose according to the thyroidal uptake calculated herein and the existing ICRP-suggested thyroidal uptake of 30% offered 1.464E-08 Sv and 2.189E-08 Sv, respectively, showing a 1.5 times difference. To evaluate the quantity of the absorbed dose of radioactive iodine, we can better reduce the error in assessing the body exposure dose by conducting measurement according to human races rather than depending on the existing ICRP data.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.40-50
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• 2009

Objectives: The clinical document forms, a format for collecting clinical data, is the most fundamental object of standardization. Doctors must have a mutual understanding of the clinical chart. Methods: Clinical document forms were developed by investigating existing conditions in hospitals and conducting demand surveys, doing literature research, and seeking expert advice for the improvement of version 1.0. In addition, an organization of a network of 19 Oriental medical doctors and nurses, 190 patients, and users of collected and assessed data was formed to come up with version 2.0. Results: The overall format was divided into different portions that the patient, nurse, and doctor must fill out, respectively. The patient's section consists of demographic data, lifestyle details, history, and symptoms. The data to be supplied by the nurse include the patient's vital signs and anthropometric parameters. As for the doctors, they are to supply data regarding the patient's palpitation, the detailed symptoms of the patient's head, ophthalmological and otorhinolaryngological symptoms (mouth), respiration, circulatory organ and chest conditions, digestive-organ conditions (thirst), neuropsychiatric conditions, reproductive system, musculoskeletal system, skin (depilation), etc. Conclusions: Common clinical chart development is the prior question to Traditional Korean Medicine standardization. A web-based clinical document format should be developed to support diagnosis and treatment, and furthermore EMR (electronic medical record system) and EHR (electronic health record) developed. Clinical information could be shared through a network of medical institutions and be useful Traditional Korean Medicine for evidence-based medicine.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.108-111
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• 2018

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

• 한국노년학
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• v.31 no.1
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• pp.171-188
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• 2011

The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.1-4
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• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.1115-1122
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• 2008

Chronic renal failure (CRF) is defined as a permanent reduction in glomerular filtration rate (GFR) sufficient to produce detectable alterations in well-being and organ function. This usually occurs at GFR below 25 ml/min. In this report, is a 75-year-old woman who had back pain and diarrhea as chief complaints. She was diagnosed with CRF on March. 2008. is a 62-year-old man who had whole body weakness, anorexia and dyspepsia as chief complaints. He was diagnosed with CRF on 2008. We used herbal enteroclysis solution. which consists of Radix et Rhizoma Rhei. Concha Ostreae and Radix Glycyrrhizae or Radix Salviae Miltiorrhizae. Herbal enteroclysis was done for 15 min once a day. Enteroclysis solution was controlled at 37-39 $^{\circ}C$ and inserted 15-20cm depth for intubation. We found the patient's BUN, creatinine and GFR were improved through enteroclysis. In both and , the patient's BUN and creatinine decreased, and GFR increased favorably. This result suggests that herbal enteroclysis used for CRF is effective in clinical therapy.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.675-681
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• 2001

Objectives : It was designed for making theoretical base about the relation of the Spleen, Stomach and the liver which could be used in clinic. Methods : Including Huang Di Nei Jing(黃帝內經), the 22 kinds of books written about the relation of the Spleen, Stomach and the Liver, and 2 kinds of papers were referenced. They were divided and studied according to physiology, pathology, meridian system and treatment. This study is focused on internal organ theory. Conclusion 1. In physiology, the Liver has the function of smoothing and regulating the flow of vital energy(Ki), while the Spleen is in charge of digestion and transportation. 2. In pathology, there can be informed disharmony of the Spleen, Stomach and the Liver, blood deficiency in the Liver and Spleen, jaundice, and bleeding etc. 3. In meridian system, the junction points of Spleen Meridian and Liver Meridian are Liv14, SP6, SP12, SP13. 4. In treatment, 1) If there is disharmony of the Liver and Spleen, the Liver must be soothed and the function of Spleen invigorated. 2) If there is disharmony of the Liver and Stomach, the Liver must be soothed and the function of Stomach invigorated.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.225-229
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• 2009

Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

• Journal of Yeungnam Medical Science
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• v.23 no.2
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• pp.252-257
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• 2006

Glycogen storage diseases are a heterogeneous group of metabolic disorder affecting multiple organ system: liver, skeletal muscle, heart and brain. Clinical features include: short status, hepatomegaly, hypoglycemia, dyslipidemia and rare involvement of the myocardium except in the case of type III, glycogen storage diseases with hypertrophic cardiomyopathy in adult, which is extremely rare. We treated a case of hypertrophic cardiomyopathy with hepatomegaly that was unknown etiology. The patient was diagnosed as having glycogen storage disease. This 46-year old women was transferred with dyspnea on exertion and abnormal LFTs. She was diagnosed with hypertrophic cardiomyopathy by echocardiography but there was no specific cause for hypertrophic cardiomyopathy. A liver biopsy was performed. The result showed glycogen storage disease possible type III, IV or IX. In conclusion, patients with hypertrophic cardiomyopathy of unknown etiology and abnormal LFTs should be evaluated for glycogen storage disease.