• 한방안이비인후피부과학회지
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• 제21권3호
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• pp.140-149
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• 2008

Objective : This study was performed to find out the difference of symptoms between rhinitis and sinusitis in young patients who were diagnosed by PNS plain radiograph( PNS series), Methods: We did statistical analysis about 147 new outpatients under 12 year-old who had visited the department of ophthalmology, otolaryngology, dermatology in Kyung Hee Oriental Medicine Center from March 2, 2006 to February 29, 2008. All of the patients were diagnosed by PNS series and we divided the patients with two groups; rhinitis group and sinusitis group. We checked the OPD records and explore the distribution on sex, experience of past western therapy, age and duration. Then we divided symptoms into nine; 'nasal obstruction', 'purulent rhinorrhea', 'cough & sneezing', 'watery rhinorrhea', postnasal drip', 'sputum', 'head problem', 'snoring & throat discomfort' and 'epistaxis'. We also divided age into 2 groups: $0\sim7$ years old and $8{\sim}12$ years old. We carried out chi-square test as a statistical method. Results : The results were as follows. 1. Sinusitis group were 102(69.5%); 62 have only sinusitis. 40 have both sinusitis and adenoidal hypertrophy. Rhinitis group were 45(30.5%); 13 have adenoidal hypertrophy and 32 were negative. 2. Male were 98(sinusitis 65, rhinitis 33), female were 49(sinusitis 37, rhinitis 12). 3. Patients who had experienced past western therapy were 120(sinusitis 81, rhinitis 39), no experienced patients were 27(sinusitis 21, rhinitis 6). 4. Distribution on age of sinusitis was 1(1 yr), 2(2 yrs), 3(3 yrs), 15(4 yrs), 15(5 yrs), 23(6 yrs), 13(7 yrs), 12(8 yrs), 8(9 yrs), 5(10 yrs), 1(11 yrs), 4(12 yrs). Distribution on age of rhinitis was 1(1 yr), 0(2 yrs), 1(3 yrs), 1(4 yrs), 9(5 yrs), 5(6 yrs), 3(7 yrs), 5(8 yrs), 1(9 yrs), 8(10 yrs), 6(11 yrs), 5(12 yrs), 5. Duration of sinusitis was 20(<2 months), 6($2{\sim}3$ months), 11($3\sim6$ months), 34($6\sim12$ months), 31(>12 months) and of Rhinitis was 11(<2 months), 0($2\sim3$ months), 5($3\sim6$ months), 18($6\sim12$ months), 11(>12 months) 6. Distribution on symptoms, sinusitis patients were 86(nasal obstruction), 52(purulent rhinorrhea), 46(cough & sneezing), 38(watery rhinorrhea), 41(postnasal drip), 23(sputum), 18(head problem), 15(snoring & throat discomfort), 6(epistaxis). The each symptom and sinusitis have no relation by chi-square test. 7. The number of patients who were 0 $\sim$ 7 years old was 92: sinusitis 72(49%), non-sinusitis 20(13.6%). The number of patients who were 8 $\sim$ 12 years old was 58: sinusitis 30(20.4%), non-sinusitis 25(l7%). By chi-square test(confidence level 95%), sinusitis and age under 7 have a significant relation(p=0.003). Conclusions : There is no relation between rhinologic symptoms and sinusitis. Patients under 7 years old with rhinologic symptoms tend to have sinusitis.

• 한국의료질향상학회지
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• 제7권1호
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.349-358
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• 2003

Objectives : Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. Methods : All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3,874 cases from 136 general hospitals was peformed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive Predictive value : proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. Results : Among 3,874 cases, CSF examinations were peformed on 1,845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1,568/1,845), 86.0 (1,239/l,440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within ${\pm}7%$. Conclusions : In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be peformed.

• 한국학교보건학회지
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• 제3권2호
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• pp.96-108
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• 1990

도시와 농촌지역 고등학생들의 상병 및 의료이용 양상을 파악하여 보건교육자료로 활용하고, 학교보건 정책을 수립하는데 도움이 되고자 1989년 3월 27일부터 4월 8일까지 부산 학생 1,979명과 경남 학생 1,315명의 남 녀 인문계 고등학생을 대상으로 설문조사한 결과는 다음과 같다. 대상학생 중 37.8%가 1개월 간에 1회이상 상병을 경험하였으며, 월간 상병률은 1,000 명당 453.2였다. 도시학생(550.8)이 농촌학생(306.5) 보다 여학생(561.9)이 남학생(328.3) 보다 높았다(P<0.01).

• Journal of Chest Surgery
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• 제35권12호
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• pp.871-875
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• 2002

급성 심근경색 후 발생한 심실중격결손은 조기에 적극적인 치료에도 수술 사망률이 매우 높은 질환이다. 저자들은 10년간 급성 심근경색 후 심실중격결손으로 수술한 환자들의 수술 결과와 장기 결과를 분석하였다. 대상 및 방법: 1991년 1월부터 2001년 5월까지 연세대학교 흉부외과에서 급성 심근경색 후 발생한 심실중격결손으로 수술 받은 17명을 조사하였다. 환자들의 평균 나이는 63.2$\pm$9.1세로 남자가 10명, 여자가 7명이었으며, 16명의 환자는 전방부 중격결손 이었고, 1명은 하부 중격결손 이었다. 12명의 환자는 수술 전 심인성 쇽으로 대동맥내풍선펌프를 삽입하였다. 심근경색 후 심실중격결손 발생까지의 기간은 평균 5.6일이었으며, 급성기에 수술 한 환자는 14례로, 심실중격결손 진단 후 수술까지의 평균 기간은 2.5일 이었다. 11명의 환자들은 관상동맥 우회술을 함께 시행받았다. 결과: 수술 후 4명이 30일 이내에 사망하였으며(30일 사망률＝23.5%), 이는 모두 심인성 쇽이 있던 12명의 환자군에서 발생하였다(사망률＝33.3%). 평균 52개월간의 관찰기간에서 1명의 환자가 원인 불명으로 사망하였으며, 퇴원한 환자들의 10년 생존률은 66.7%였다. 추적이 되지 않은 1명을 제외한 10명의 환자들은 마지막 외래 관찰시 모두 NYHA functional class I이나 II였다. 결론: 급성 심근경색 후 발생한 심실중격결손은 가능한 조기에 수술하는 것이 환자의 생존에 매우 중요하다고 생각하며, 장기 결과도 양호 하다고 생각한다.

• 한국산학기술학회논문지
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• 제12권3호
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• pp.1260-1269
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• 2011

본 연구의 목적은 갑상선 유두암환자의 수술 후 삶의 질, 갑상선 특이적 증상, 자가간호이행도, 불안 및 우울수준을 파악하고 수술 후 삶의 질에 미치는 영향 요인을 분석하는 것이다. 154명의 갑상선 유두암환자가 연구에 참여하였으며 구조화된 질문지를 이용하여 수집된 자료는 SPSS/WIN 18.0을 사용하여 기술통계, t-test, ANOVA, Pearson correlation 및 다중회귀분석법으로 분석하였다. 갑상선 유두암환자의 수술 후 삶의 질 평균점수는 2.72점이었고 사회/가족상태 영역에서 가장 낮았으며 연구대상자들의 대부분은 피로, 추위를 견디지 못함, 변덕스런 기분변화 등의 갑상선 특이적 증상을 호소하였다. 자가간호이행 참여도가 가장 높은 항목은 갑상선호르몬제 복용(100%)이었으며 외래방문을 통한 추후관리는 두 번째로 높았다(99.4%). 불안은 45.3점으로 보통 수준이었으나 대상자의 63%가 우울한 상태로 판정되었다. 갑상선 유두암환자의 수술 후 삶의 질은 갑상선 특이적 증상, 불안, 우울과 부정적 상관관계가 유의하게 나타났으며(r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001) 갑상선 특이적 증상, 불안, 우울이 수술후 삶의 질 정도를 64.9% 설명하였다. 이에 갑상선 유두암환자의 수술 후 삶의 질을 증진시키기 위해서 건강관리전문가들은 장기간의 암치료과정에서 느끼는 부정적 정서를 완화시키고 지지체계를 개발하며 신체적, 심리적 증상관리를 돕는 실무정보를 제공해야 할 것이다.

• 지역사회간호학회지
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• 제10권2호
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• pp.372-386
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• 1999

The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.313-318
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• 1986

본 환자는 전신쇠약감 피로감, 고혈압과 혈청 potassium치가 저하되어 있고 혈청 Renin활성도가 감소되어 있으면서 Aldosterone억제 시험에도 억제가 되지 않았음을 볼 때 원발성 Aldosterone증을 의심할 수 있었다. 또 자세변화 시험에서 혈청 Renin활성도가 떨어져 있었고 자세변화에 따라 혈청 Aldosterone이 증가했으며 컴퓨터 단층촬영에서 별다른 병변이 뚜렷이 보이지 않음을 볼때 부신증식성 Aldosterone증으로 의심된다. 따라서 본 환자에게 spironolactone을 투여했고 이후 외래를 통해 추적검사 중이며 혈압 조절이 양호할 뿐 아니라, 불편을 느끼던 증상들도 호전이 되었음을 안 수 있었다. 끝으로 원발성 Aldosterone증에 대한 관심을 더 기울인다면 더 많은 증례가 발견될 것으로 사료되고, 본 저자들은 보다 많은 증례를 찾아 추후 증례보고및 추적검사할 예정이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8227-8233
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• 2016

Background: To investigate polymorphisms in heat shock proteins A1B and A1L (HOM) and associated risk of oesophageal carcinoma in Northeast India. Materials and Methods: The study includes oesophageal cancer (ECA) patients attending general outpatient department (OPD) and endoscopic unit of Gauhati Medical College. Patients were diagnosed based on endoscopic and histopathological findings. Genomic DNA was typed for HSPA1B1267 and HSPA1L2437 SNPs using the polymerase chain reaction with restriction fragment length polymorphisms. Results: A total of 78 cases and 100 age-sex matched healthy controls were included in the study with a male: female ratio of 5:3 and a mean age of $61.4{\pm}8.5years$. Clinico-pathological evaluation showed 84% had squamous cell carcinoma and 16% were adenocarcinoma. Dysphagia grades 4 (43.5%) and 5 (37.1%) were observed by endoscopic and hispathological evaluation. The frequency of genomic variation of A1B from wild type A/A to heterozygous A/G and mutant G/G showed a positive association [chi sq=19.9, p=<0.05] and the allelic frequency also showed a significant correlation [chi sq=10.3, with cases vs. controls, OR=0.32, $p{\leq}0.05$]. The genomic variation of A1L from wild T/T to heterozygous T/C and mutant C/C were found positively associated [chi sq=7.02, p<0.05] with development of ECA. While analyzing the allelic frequency, there was no significant association [chi sq=3.19, OR=0.49, p=0.07]. Among all the risk factors, betel quid [OR=9.79, Chi square=35.0, p<0.05], tobacco [OR=2.95, chi square=10.6, p<0.05], smoking [OR=3.23, chi square=10.1, p<0.05] demonstrated significant differences between consumers vs. non consumers regarding EC development. Alcohol did not show any significant association [OR=1.34, chi square=0.69, p=0.4] independently. Conclusions: It can be concluded that the present study provides marked evidence that polymorphisms of HSP70 A1B and HSP70 A1L genes are associated with the development of ECA in a population in Northeast India, A1B having a stronger influence. Betel quid consumption was found to be a highly significant risk factor, followed by smoking and tobacco chewing. Although alcohol was not a potent risk factor independently, alcohol consumption along with tobacco, smoking and betel nut was found to contribute to development of ECA.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6429-6438
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• 2015

Glutathione S-transferases (GSTs) play an important role in detoxification of carcinogenic electrophiles. The null genotypes in GSTM1 and GSTT1 have been implicated in carcinogenesis. Present study was planned to evaluate the influence of genetic polymorphisms of GSTM1 and GSTT1 gene loci in cervical carcinogenesis. The study was conducted in Lok Nayak hospital, New Delhi. DNA from clinical scrapes of 482 women with minor gynaecologic complaints attending Gynaecology OPD and tumor biopsies of 135 cervical cancer cases attending the cancer clinic was extracted. HPV DNA was detected by standard polymerase chain reaction (PCR) using L1 consensus primer pair. Polymorphisms of GSTM1 and GSTT1 were analysed by multiplex PCR procedures. Differences in proportions were tested using Pearson's Chi-square test with Odds ratio (OR) and 95% confidence interval (CI). The risk of cervical cancer was almost three times in women with GSTM1 homozygous null genotype (OR-2.62, 95%CI, 1.77-3.88; p<0.0001). No association of GSTM1 or GSTT1 homozygous null genotypes was observed in women with normal, precancerous and cervical cancerous lesions among ${\leq}35$ or >35 years of age groups. Smokers with null GSTT1 genotype had a higher risk of cervical cancer as compared to non-smokers (OR-3.01, 95% CI, 1.10-8.23; p=0.03). The results further showed that a significant increased risk of cervical cancer was observed in HPV positive smoker women with GSTT1 (OR-4.36, 95% CI, 1.27-15.03; p=0.02) and GSTM1T1 (OR-3.87, 95% CI, 1.05-14.23; p=0.04) homozygous null genotypes as compared to HPV positive non smokers. The results demonstrate that the GST null genotypes were alone not associated with the development of cervical cancer, but interacted with smoking and HPV to exert effects in our Delhi population.