• Korean Journal of Acupuncture
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• v.19 no.2
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• pp.149-165
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• 2002

Objective : We proposed fundmental rules of prospective on legal and institutional position and role of Korean medicine doctors working at public health center. Methods : By the result of this research on the current situation, the grade and allowance given to the Korean medicine doctors working at public health center were different every self-governing body. Results : The reason the Korean Medicine Doctor can't serve as a regular order of 5th grade is that the 'The Enforcement Regulation about Administrative Organization and the Standard of Pixed Number of person of Self-Governing Body(지방자치단체의 행정기구와 정원기준등에 관한 규정 시행규칙)' prescribes the number of regular order of 5th grade is regulated within 7% among the number of regular order officials. But not appointing to office as the regular order of 5th grade infringes on the Constitution, the highest law. The reason the Korean Medicine Doctors can't be appointed to office as the regular order officials by the self-governing body is that 'The Enforcement Order of the Law of Preservation of good health of Local Area(지역보건법시행령)' prescribes the Korean Medicine Doctors are not indispensable to Public Health Center. But in fact, the Korean Medicine Doctors can execute many kinds of work such as medical examination or instructing house nursing. Conclusion : The Korean Medicine Doctors working at Public Health Center serve at low positions as daily use or common use, not receiving a regular order. All laws including the Constitution(헌법), the Medical Services Law(의료법), the Law of Preservation of good health of Local Area(지역보건법), the National Public Service Law(국가공무원법), the Local Public Service Law(지방공무원법) and the Law of Higher Education Law(고등교육법) describe that the Korean Medicine Doctors and the Western Medicine Doctors are equal to their position and right.

• Korean Journal of Radiology
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• v.24 no.8
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• pp.761-771
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• 2023

Objective: To investigate the association among the electrode placement method, electrode type, and local tumor progression (LTP) following percutaneous radiofrequency ablation (RFA) for small hepatocellular carcinomas (HCCs) and to assess the risk factors for LTP. Materials and Methods: In this retrospective study, we enrolled 211 patients, including 150 males and 61 females, who had undergone ultrasound-guided RFA for a single HCC < 3 cm. Patients were divided into four combination groups of the electrode type and placement method: 1) tumor-puncturing with an internally cooled tip (ICT), 2) tumor-puncturing with an internally cooled wet tip (ICWT), 3) no-touch with ICT, and 4) no-touch with ICWT. Univariable and multivariable Cox proportional-hazards regression analyses were performed to evaluate the risk factors for LTP. The major RFA-related complications were assessed. Results: Overall, 83, 34, 80, and 14 patients were included in the ICT, ICWT, no-touch with ICT, and no-touch with ICWT groups, respectively. The cumulative LTP rates differed significantly among the four groups. Compared to tumor puncturing with ICT, tumor puncturing with ICWT was associated with a lower LTP risk (adjusted hazard ratio [aHR] = 0.11, 95% confidence interval [CI] = 0-0.88, P = 0.034). However, the cumulative LTP rate did not differ significantly between tumor-puncturing with ICT and no-touch RFA with ICT (aHR = 0.34, 95% CI = 0.03-1.62, P = 0.188) or ICWT (aHR = 0.28, 95% CI = 0-2.28, P = 0.294). An insufficient ablative margin was a risk factor for LTP (aHR = 6.13, 95% CI = 1.41-22.49, P = 0.019). The major complication rates were 1.2%, 0%, 2.5%, and 21.4% in the ICT, ICWT, no-touch with ICT, and no-touch with ICWT groups, respectively. Conclusion: ICWT was associated with a lower LTP rate compared to ICT when performing tumor-puncturing RFA. An insufficient ablation margin was a risk factor for LTP.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.143-148
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• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.711-714
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• 2011

Purpose: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5 cm. Methods: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2 cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5 cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. Results: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5 cm. Conclusion: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.51-54
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• 2013

Synovial sarcoma is a rare malignancy in the thoracic cavity, especially in the mediastinum. In this paper, a case of primary mediastinal synovial sarcoma is reported. A 34-year-old woman was hospitalized with dyspnea. Her chest X-ray and computed tomography (CT) showed a $16{\times}13{\times}11$ cm mass in her anterior mediastinal space. Surgical resection was performed but was incomplete. The pathological and immunohistochemical analysis confirmed the diagnosis of monophasic spindle cell synovial sarcoma. The patient underwent adjuvant radiotherapy for two months, but local recurrence and metastasis occurred in her pleural cavity. She eventually underwent chemotherapy for one year and died 18 months after her operation.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.199-203
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• 2021

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.172-179
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• 2023

Objectives: Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran. Methods: This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables. Results: The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination. Conclusions: Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.129-138
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• 2018

Purpose: This study was conducted to compare clinical outcomes and treatment-related toxicities after stereotactic body radiation therapy (SBRT) with two different dose regimens for small hepatocellular carcinomas (HCC) ${\leq}3cm$ in size. Materials and Methods: We retrospectively reviewed 44 patients with liver-confined HCC treated between 2009 and 2014 with SBRT. Total doses of 45 Gy (n = 10) or 60 Gy (n = 34) in 3 fractions were prescribed to the 95% isodose line covering 95% of the planning target volume. Rates of local control (LC), intrahepatic failure-free survival (IHFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Results: Median follow-up was 29 months (range, 8 to 64 months). Rates at 1 and 3 years were 97.7% and 95.0% for LC, 97.7% and 80.7% for OS, 76% and 40.5% for IHFFS, and 87.3% and 79.5% for DMFS. Five patients (11.4%) experienced degradation of albumin-bilirubin grade, 2 (4.5%) degradation of Child-Pugh score, and 4 (9.1%) grade 3 or greater laboratory abnormalities within 3 months after SBRT. No significant difference was seen in any oncological outcomes or treatment-related toxicities between the two dose regimens. Conclusions: SBRT was highly effective for local control without severe toxicities in patients with HCC smaller than 3 cm. The regimen of a total dose of 45 Gy in 3 fractions was comparable to 60 Gy in efficacy and safety of SBRT for small HCC.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.49-58
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• 1978

To try to determine the type of medical service wanted by the rural population, in Chungnam Province, a survey amongst the populations of 6 counties was conducted; Within the 6 counties, 2 local communities, which had no access to local medical services, were surveyed. The 12 communities were actively involved in Sae-maul activities, and total number of households surveyed, was 822. The survey was conducted over a 1 month period, from July 16th, 1976, thru August 20th, and the followings are the results, summarised. 1. The largest number of respondents desired a combination of Public Health Center and Country Hospital, followed in order by Private Clinic and Modern Medical Facility. 2. The respondents, aged under 40 years, desired the Private Clinic type medical service, whilst those over 40 years of age, wanted the County Hospital, and as the numbers in this age bracket, were larger, so the ratio was much higher. 3. Sex, educational background, and occupation did not play any particular emphasis in the decisions. 4. Monthly income affected the responses to the survey. These in the lower-income bracket, wanted the County Hospital, and the ratio was high. These in the high income bracket desired the Modern Medical Service, accordingly. Those with an income of 50,000 won or less, amongst the low-income bracket, favored the Public Health Sub-center type of service. The ratio for this service was very high.

• Journal of agricultural medicine and community health
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• v.30 no.3
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• pp.293-303
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• 2005

Objectives: Yearly, annual report of cancer patients in Korea is released by National Cancer Center. But, this report is focused in all of the patients in nation. So, there is needed to modify and analyze this report to be used properly for local resident. In Ulleung island, local county and Ulleung medical center don't have cancer occurrence data of local resident until now. The aim of this analysis is to know characteristics and data of cancer patients occurrence in Ulleung island for 10 years. Methods: We are offered data of cancer patients occurrence in Ulleung island for 10 years from National Cancer Center. This data was composed of sex, address (only town level), diagnosed date, diagnosis. So, we analyze this data and compare to Korea data for same duration. Results: There were 268 patients for 10 years (1993-2002). Man were 175 about 65% and women were 93 about 35%. There were 163 in Ulleungeup about 60%, 39 in Seomyun about 14.5% and 48 in Bukmyun about 18%. There were 19 patients in unknown residence. After 1998, above 30 patients were occurred, but before 1998, below 27 patients were occurred. Diagnosed date was concentrated in June, 33 patients were occurred about 12%, but least occurred month was December. Most occurred age were from 60 to 69, there were 80 patients about 30%. Most occurred cancer was gastric cancer, there were 54 patients about 20%. Hepatic cancer was second and third was lung cancer. In man, most occurred cancers were gastric cancer and hepatic cancer, both was 38 patients. In woman, gastric cancer and uterine cervix cancer were occurred mostly. After 2001, in Korea most occurred female cancer was breast, but in Ulleung island, most occurred cancer was stomach. Conclusions: Researcher should demand and analyze cancer data from National Cancer Center that cancer management project in local county and public health education of cancer could focus on local resident because annually released cancer data from National Cancer Center focus on a nation. In Ulleung island, cancer incidence was more than incidence in Korea and breast cancer was occurred less than in Korea. So, more study should be needed to confirm why more cancer were occurred than Korea and breast cancer was less occurred.