• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.582-589
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• 2005

Background : The incidence of lung adenocarcinoma, which is more prevalent in women and nonsmokers, is increasing. The aim of this study was to determine the prognostic factors of an adenocarcinoma of the lung. Material and method : The clinical information of patients diagnosed with an adenocarcinoma of the lung at the Kosin University Gospel Hospital from January 1994 to July 2004 was reviewed retrospectively. The survival time of these patients was analyzed by the patient's age, gender, performance status, weight loss, smoking history, location of the primary tumor, clinical stage, serologic tumor markers, and treatment modality. Results : For all 422 patients with an adenocarcinoma of the lung, 247 (58.5%) were male, and their mean age was 59.8 years the. The majority of patients were smokers (58.3%), and the tumors were located in the periphery (59.7%). In the smokers, the tumor was located more in the central airway compared to the non-smokers (42.8% vs. 31.9%, p=0.12). The overall median survival time was 390 days (95% CI;304-436 days). Univariate survival analysis revealed that an older age (${\geq}65$ years old), male, weight loss, smoker, central type, advanced clinical stage, elevated serum carcinoembryonic antigen (CEA, >5 ng/ml) and neuron specific enolase (NSE, >15 ng/ml), and the supportive care only were significantly poor prognostic factors. The median survival time was shorter in the smokers than nonsmokers (289 days vs. 533 days, p<0.001). In addition, it was also shorter in the elevated NSE group than in the normal range group (207 days vs. 469 days, p<0.001). Multivariate analysis showed that age, clinical stage, serum NSE, smoking status, and treatment modality were independent predictors of survival (hazard ratios: 1.68, 1.94, 1.92, 2.39 and 1.57, respectively). Conclusions : Smoking is an important prognostic factor in an adenocarcinoma of the lung, but not gender. This suggests that the better prognosis of women is more related with the lower rate of smoking. In addition, the elevated serum NSE is also an important prognostic in an adenocarcinoma of the lung.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.173-189
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• 2000

The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.193-200
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• 2019

The study was conducted surveying ultrasound room workers on hospital infection awareness in Daejeon and Choong-chunng region. The contamination of ultrasonic probes used in clinical trials was measured using ATP, and the results were verified after using 70% alcohol sterilization. It was measured on the group's general characteristics and the specific categories such as academic background, job type, having professional certificate and infection education. After the examination, the gel removal and method, disinfection status of the probe and variable correlation analysis were performed to analyze the recognition of the ultrasonic probe disinfection. After examination in ultrasound room, it was found that towels were used the most for cleaning, and the gel container was not replaced for more than three months. After 70% alcohol disinfection, ATP contamination was reduced from $1055.4{\pm}944.2$ to $133.5{\pm}93.2$ and the result was analyzed to be statistically significant.(${\rho}<0.01$) The found bacteria were CNS, Gram positive bacillus, and Micrococcus specs. In order to solve this problem, 70% alcohol sterilization was applied and the bacteria were not detected after the treatment. The research shows that regular training on infection control and efforts to prevent infection are necessary, and that 70% alcohol is effective in disinfect the bacteria. Therefore, the medical institution should provide active hospital infection control education to improve the awareness of hospital infection among workers and contribute to the prevention of patient infection. It is also understood that proper use of the results of this study will help prevent infection by means of ultrasonic probes.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.79-83
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• 2018

Purpose $^{18}F-FDG$, which is commonly used in PET-CT examinations, is low in capacity and it is difficult to keep the amount of radioactivity busy when the specific activity is high, increasing the amount of space dose and radioactive contamination in the distribution room. Therefore, while evaluating the actual dose administered to patients during the manual dispense process, the medical institution intends to assess the usefulness of the auto dispenser by comparing the differences from the actual dose administered to the patient using the new automatic dispense. Materials and Methods From July 2016 to December 2016, 846 patients were manually administered by workers using $^{18}F-FDG$ and $^{18}F-FDG$ 906 patients were using auto dispenser from July 2017 to December 2017. Results Capacity administered to patients during the manual dispense averaged $35.41{\pm}27.79%$ compared to the recommended dose, and the auto dispenser process showed a small difference of $-2.15{\pm}3.99%$ compared to the recommended dose(p<0.05). Conclusion Working people did not have to touch radioactive medicines directly while they were busy in the auto dispenser, and because of the availability of other tasks far away, the time and distance to receive the exposure were also advantageous. It is believed that future use by many medical institutions will not only reduce the dose to patients but also help reduce the exposure dose to workers.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.84-87
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• 2018

Purpose The radiopharmaceutical used in the nuclear medicine department is used only for the specific patient according to the prescription or instruction of the doctor without selling, so it is dispensed and it is distributed and used for the examination. Radiopharmaceuticals administered to patients should be managed appropriately as well as radiation safety management during dispensation. The purpose of this study is to investigate microbial contamination during dispensation of radiopharmaceuticals Materials and Methods This study distinguished between general workbench and clean workbench and performed three tests. First, microbial cultivation test of radiopharmaceutical prepared and dispensed in general workbenches and sterile workbenches were carried out five times, respectively. The second test was performed settle plate method three times before and after the use of the exhaust filter. Finally, Adenosine Triphosphate (ATP) measurement was performed in each workbench to measure bacterial counts. In addition, ATP measurement were carried out by designating locations and items that may be contaminated during dispensation. Results In the microbial culture test, no microorganisms were detected in both samples. In the settle plate method, it was detected without using of the exhaust filter in a general workbench once. In the ATP measurement test, it was measured at the level of 400 RLU or less, which is the standard value of contamination, in both workbenches surface. In additional ATP measurement test, the refrigerator handle in the distribution room was measured above the reference value of 1217 RLU, the vacuum vial shield of the Tech Generator at 435 RLU, and the syringe holder at 1357 RLU. After environmental disinfection, the results were reduced to 311 RLU, 136 RLU, and 291 RLU. Conclusion No contamination by bacteria was found in both workbenches. However, microbial contamination may occur if the use of an exhaust filter or proper hand hygiene is not achieved. Regular inspections and management for aseptic processing themselves will be necessary.

• The Korean Society of Law and Medicine
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• v.23 no.3
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• pp.3-44
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• 2022

As a result of a close review focusing on the case of obstruction of epidemiological investigation by a religious group A in Daegu, which was a problem when the pandemic of Covid-19 infection began in Korea around February 2, 2020, when an epidemiological investigator requested a specific group to submit a list, While there have been cases where an act of not responding or submitting an edited omission list was sentenced to the effect that the act did not fall under an epidemiological investigation, in the case of non-submission of the visitor list for the B Center, even though a 'list of visitors' was requested. Regarding the fact of refusal without a justifiable reason, 'providing a list of persons entering the building is a key factual act that forms a link between epidemiological investigations accompanying an epidemiological investigation, and refusing to do so is also an act of refusal and obstruction of an epidemiological investigation. There are cases where it is possible to demand criminal punishment. Regardless of whether the request for submission of the membership list falls under the epidemiological investigation, there are cases in which the someones' actions correspond to the refusal or obstruction of the epidemiological investigation. A lower court ruling that if an epidemiological investigation is rejected or obstructed as a result of interfering with factual acts accompanying an epidemiological investigation, comprehensively considering whether or not the list has been diverted for purposes other than epidemiological investigation, the logic is persuasive. Epidemiological investigations such as surveys and human specimen collection and testing are conducted for each infectious disease patient or contact confirmed as a result of the epidemiological investigation, but epidemiological investigations conducted on individual individuals cannot exist independently of each other, and the This is because the process of identification and tracking is essential to an epidemiological investigation, and if someone intentionally interferes with or rejects the process of confirming this link, it will result in direct, realistic, and widespread interference with the epidemiological investigation. In this article, ① there are differences between an epidemiological investigation and a request for information provision under the Infectious Disease Control and Prevention Act, but there are areas that fall under the epidemiological investigation even in the case of a request for information, ② Considering the medical characteristics of COVID-19 and the continuity of the epidemiological investigation, the epidemiological investigator the fact that the act of requesting a list may fall under the epidemiological investigation, ③ that the offense of obstructing the epidemiological investigation in certain cases may constitute 'obstruction of Performance of Official Duties by Fraudulent Means', and ④ rejecting the request for information provision under the Infectious Disease Control and Prevention Act from September 29, 2020 In this case, it is intended to be helpful in the application of the Infectious Disease control and Prevention Act and the practical operation of epidemiological investigations in the future by pointing out the fact that a new punishment regulation of imprisonment or fine is being implemented.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.477-490
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• 2022

Serious Accident Punishment Act(SAPA) went into effect as of Jan. 27, 2022. The subject of study was the worker of the nuclear medicine department and the investigation was aimed at identifying the present situation of their understanding on the issue in the here and now, which can be utilized as basic research for further study. The survey was conducted on 51 people of the worker in the nuclear medicine department. The general factors were classified by their gender, the scale of the hospitals, the period of career, and the detailed occupational categories. The conclusion was drawn, including 1 missing data in gender and 2 in the type of occupation. The targeted hospitals were tertiary hospital, university hospital, and general hospital which have nuclear medicine department in. The period of subjects' career was categorized by less than 3 years, 3 to 5 years, 5 to 10 years, and more than 10 years. The specific occupation was classified by in-vivo radiological technologist, radiation safety manager and others. The amount of pressure that the job entails was highest in the category of general hospital, the period of 3 to 5 years of job experience, and radiation safety manager each. The system of the code was well constructed in the category of general hospital, the period of less than 3-year career, and radiation safety manager, as they responded. The blood transmissible disease had the largest number of outbreak of accidents related to the serious industrial accident. In addition, the radiopharmaceutical dosing error had the highest number of outbreak of accidents related to the serious civil accident. Therefore, we need to improve SAPA, facility inspection, security of budget, security of professional manpower. It will help the stable use of radiation and ensure patient safety.

• (The) Research of the performance art and culture
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• no.42
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• pp.147-181
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• 2021

Dalgubal drum dance is inherited in a recreated form by incorporating regional symbolism and the dance philosophy and artisticity of Young Hwangbo, the creator, based on the traditional drum dance of the Yeongnam region. This dance having popularity with the transformation of traditional Korean culture has been invited not only to Yeongnam region including Daegu but also to international various venues. This study explores what the movement characteristics of this Dalgubal drum dance are and the unique charm and symbolic meaning of this dance. Specific analysis was conducted through analyzing Dalgubal drum dance video film of the 89th Korean Myeongmujeon's by using Laban Movement Analysis as a research method. The special features of this dance resulted from the LMA analysis in terms of the four categories-Body, Effort, Shape, and Space-reveal simple yet cheerful personalities and strong yet patient characteristics of the people in Daegu. The harmony of drum sounds(music) and movements(dance) creates various characteristics of dances and reveals the beauty and excitement of unique Korean dance. In particular, drum play and its related dance movements create curved linear spatial pattern of arm movements, Spiral Shape in body posture, and diverse floor patterns occupying whole stage space. These movements show the three-dimensional spatial beauty and the artistic ideas for recreation of traditional drum dance, which considered with the spatial structure of the proscenium stage. In addition, the well-organized structure and harmonious movements of this dance show the traditional Korean philosophy, implying heaven, earth, and human being and the wholeness, and the harmony of yin and yang. The dance aims at communication between the audiences and dancers through sharing excitement and the aesthetic beauty of dance. This can be interpreted as a meaningful expression of traditional Korean philosophy developed with the unique value and characteristics of Korean dance.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.108-117
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• 2023

Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.