• Journal of mucopolysaccharidosis and rare diseases
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• v.2 no.2
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• pp.35-37
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• 2016

Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3209-3212
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• 2012

Introduction: Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the older population, but it is also quite frequent among young adults in developing countries. The aim of this study was to update the trends of clinicopathological features of CRC in young Nepalese. Methods: A retrospective comparative study on the data retrieved from the surgical records of all patients between 20 to 39 years of age with CRC was carried out for periods of 5 years each from 1999 to 2003 (early) and 2004 to 2008 (recent), treated at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were $34{\pm}4.7$ and $31.8{\pm}5.1$ years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

• Quality Improvement in Health Care
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• v.29 no.2
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• pp.47-63
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• 2023

Purpose:This study aims to suggest the future direction for applying service design to improve the quality of healthcare as part of hospital service innovation and present implementation plans in Korea, based on a review of quality improvement activities and the current status of service design applications. Methods: Through a literature review, we examined the status of service design introduction and application in the healthcare field, focusing on cases in the US and Europe. The possibility and limitations of service design in the healthcare field were examined through a comparison of oversea and domestic cases. Results: Recently, service design has begun to be applied to the healthcare field worldwide. Service design shows the possibility of an alternative that alleviates and complements the limitations of existing quality improvement activities. It also offers the possibility of creating new organizational improvement and innovation approaches through integration and convergence with existing quality improvement activities and management innovation. Conclusion: To effectively apply service design to hospitals, it is necessary to integrate internal organizations related to service improvement, combine methods, and objectively measure and evaluate performance. To this end, we propose the operation of a nationwide education and training center for quality improvement and service design led by academic society. Service design will provide an opportunity to change the management innovation and organizational culture of hospitals beyond the scope of the current quality improvement, which deals only with micro-subjects of individual hospitals.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.195-207
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• 1997

High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors on hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to find out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows: Number of CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for CT. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.91-101
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• 1989

The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula, preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1)pulsating exophthalmos, (2)orbital and cephalic bruit and murmur, (3) headache, (4) chemosis. (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesions. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases. the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in :3 cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.

• The Journal of Pediatrics of Korean Medicine
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• v.12 no.1
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• pp.257-276
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• 1998

Introduction The effects of Samchulkunbitang on the immunosuppression induced by methotrexate in rats were investigated in this experument. The multiple parameters of immunity assessed in each rats includes the rate of body weight loss, weight changes in thymus, spleen and axillary lymphnode. The number of lymphocytes and CD4+ T cell count in the blood, thymus, spleen and axillary lymphnode were also measured. Methodology Male Sprague-Dawley rats were chosen as an experiment object and were divided into 4 groups by a random selection. Each group consisted of 6 rats. The normal group didn't receive any treatment. The control group was administered with methotrexate for 5 days. The sample Ⅰ group was administered with Samchulkunbitang for 5 days. The sample Ⅱ group was administered with both Samchulkunbitang and methotrexate for 5 days. The dosage of medication was 2cc/day, 1cc given at 10 AM and another 1cc given at 5 PM. Results The rate of body weight loss was significantly increased in the Sample Ⅰ and Sample Ⅱ group. The weight of thymus and spleen were significantly increased in Sample Ⅰ and Sample Ⅱ groups While the weight of axillary lymphnode did not show much increase. No significant differences were measured among the experimental groups. Blood lymphocyte count, blood CD4+ T cell count, spleen lymphocyte count, axillary lymphnode lymphocyte and CD4+ T cell count were significantly increased in Sample Ⅰ and Sample Ⅱ groups while spleen CD4+ T cell count did not show much increase. No significant differences were measured among the experimental groups. Conclusion As one can witness from the above results, administration of Samchulkunbitang played potent role in increasing immune system among the rats treated with methotrexate which induces immunosuppression. Overall increase of lymphocyte count and CD4+ T cell count in the sample groups with Samchulkunbitang effectively proves its ability to boost the immune system.

• Journal of Korean Medical classics
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• v.31 no.1
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• pp.29-43
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• 2018

Objectives : This paper studies how the people of the past deal with constipation before the introduction of modern medical knowledge. Then, the paper selected some of the methods that use food ingredients with little to no side effects, and studied them to find a basic set of data that can be applied to today's medical practices. Methods : This paper reviewed six literatures: China's Eumsunjungyo, Nonohangeon, and Shiggamboncho, and Chosun's Singnyochanyo, Donguibogam, and Jejungsinpyeon. The food cures related to constipation were studied to discover what ingredients and preparation forms were used, how they were taken, what types of prescriptions existed, and how they were applied. Results : The food cure for constipation included ingredients such as mazi, suzi, sesame, honey, yiyiren, yuliren, xingren, taoren, and rice. These ingredients are known for replenishing the body's fluid and humor and allowing the better flow of qi. Mazi porridge, suma porridge, raw sesame oil, suzhu porridge, and suxing porridge were effective in dealing with the conspitation caused by heat, and jingshen wan, yiyiren porridge, yuliren porridge, yulirenyiyiren porridge, xingren porridge, and taoren porridge were effective in taking care of conspitation caused by qi deficiency. Conclusions : With a constipation caused by heat, it is good to take mazi and spinach regularly which is helpful in cooling down the heat. For senior citizens, constipations occur due to the qi deficiency that leads to the lack of fluid and humor. In this case, suzhu porridge should be taken regularly together with milk and sesame oil in order to replenish the qi. This will tonify the amount of qi and moisten the large intestines, which will be also helpful in tonifying the body itself.

• Journal of Technologic Dentistry
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• v.30 no.2
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• pp.105-119
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• 2008

This study explored the status of free time activities among the dental technicians who are working at Seoul, Gyonggido, and Gangwondo. On the basis of this research, we aim to present needs and applicable solutions to improve the working conditions and enhance the quality of life through more effective time management in free time activities that lead to their self development and far more enriched life. 500 subjects were randomly chosen and the questionary sheets were provided. Among them, 305 sheets were returned to be analysed through SPSS Win 10.0 software and the results are as follows; First, mean in the satisfaction of leisure activities was 3.44(SD=.73). Mean in sub categories was as follows; psychological factor(M=3.65, SD=.71), social factor(M=3.54, SD=.75), rest factors(M=3.52, SD=.63), physical factor(M=3.43, SD=.88), other factors(M=3.40, SD=.66), circumstantial factor(M=3.33, SD=.63), educational factor(M=3.24, SD=.73). Second, the most relevant sub categories in the satisfaction of leisure activities were social, educational, physical, and other circumstantial factors by sequence. Factors that affect leisure activities satisfaction were career and status of health, which shows statistical significance(p<.001). That is to say, contention of this study is that the general characteristics are closely related with and affect the types and the level of satisfaction in leisure activities of the subjects. Considering these results, the dental businesses and the associations of dental technicians should recognize the needs to improve the time management through more efficient cooperations between dentists and back office dental team, systemized working time, and introduction of incentive system among others. On the basis of this appreciation, the dental business should provide more time and various opportunities with the dental technicians. Dental technicians also need to reconsider their appreciations of leisure activities, that is, leisure activities are not just spending time doing something but they refresh them and enable them to be more active and faithful to home and work.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.15 no.2
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• pp.244-251
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• 2002

Introduction: SLE is autoimmune disease to appear systemic pathology in the connective tissue. Perniotic LE is sub-type of chronic dermal LE which causes purple macules on the terminal part of body-nose, ends of fingers, heals, calfs of the legs, elbows and knees. Objective: The purpose of this study was to estimate the efficiency of oriental medical treatment and management on the SLE and perniotic LE. Subject: We studied 2 patients who visited and hospitalized in Daejon University Oriental Hospital Dept. of Dermatology, with SLE and pemiotic LE from April 2002 till May 2002 Method: We treated them with herb medication, acupuncture and in addition to we consulted western medication if they were needed Results: In case of SLE patient, we considered it to be Yeol-Dok-Chi-Seong, so we priscriped Ga-Mi-So-Dok-Eum1, 2 , Yang-Dok-Baek-ho-Tang first. and till 22 days of hospitalization, we considered to be Gi-Eum-Yang-Heo and priscriped Ji-Hwang-Tang-Hab-Cheong-Sim-Yeon- Ja -Eum-Ga-Mi. but it wasn't adjust and high fever was reaccurred. And till 24 days of hospitalization we priscriped Gal-Geon-Hae-Gi-Tang, and becomed to 25 days, high fever was disappeared and the patient discharged and she has remained generally good condition. In case of Perniotic LE, at first we misdiagnosed her disease as a acral lentiginous melanoma, and we considered it to be Gan-Soo-Yeol-Li-Yeol- Jeung and priscriped Cheong-Pae-Sa-Gan-Tang and transferred her to another hospital, but she was diagnosed Perniotic LE Conclusion: Considering the above results, in case of SLE, in acute phase, we could treat her with oriental-western treatment, and in relief phase, we could treat her with only oriental treatment very efficiently. but in case of perniotic LE, we misdiagnosed it as a acral lentiginous melanoma, but we could experienced very rare perniotic LE case. And also further study is needed on the SLE, and perniotic LE, and we have to systematize of dyagnosis and treatment system.

• The Journal of the Korea Contents Association
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• v.19 no.8
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• pp.303-315
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• 2019

In 2018, 14.3 percent of South Korea's elderly population aged 65 or older entered an aged society and is expected to enter a super-aged society with more than 20 percent of the elderly population around 2025. Older adults often visit different medical institutions to take medicine, which requires medication management, such as interaction between each drug. In this study, we wanted to analyze the U.S. system, which specializes in drug management for the elderly, and Korea's system, which is about to enter a super-aged society, to find a systematic way to manage drugs for the elderly. The method of study was a systematic literature study on elderly drug management in Korea and the United States. Studies have shown that the United States has enacted the Medication Therapy Management (MTM) for the elderly and has been running the Senior Drug Enforcement Program. In Korea, a community care business is underway to manage drugs for senior citizens, but it is analyzed that the elderly need to have a special medicine system for senior citizens to use them more safely.