• Clinical and Experimental Reproductive Medicine
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• 제24권3호
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• pp.393-398
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• 1997

Cytogenetic analysis was performed in 1321 couples and 141 women with history of abnormal reproductive outcome during 1988-1996. The use of high resolution banding technique and fluorescence in situ hybridization (FISH) in the chromosome analysis has made the precise evaluation of chromosome aberrations. The prevalence of balanced chromosomal translocation carriers were 3.74% (104/2783 patients). 70 cases (2.52%) were reciprocal translocation carriers and 34 (1.22%) had Robertsonian translocations. Chromosome aberrations were more frequent in women (73 cases) than in men (31 cases). No phenotypical abnormalities were found in all carriers, but they experienced abnormal reproductive outcomes such as recurrent spontaneous abortions, anomalous offsprings or infertility problem. Prenatal diagnosis was carried out on 36 subsequent pregnancies in balanced translocation carriers. The fetal karyotypes showed that 12 cases (33%) were normal, 22 (61%) were balanced translocations, and two (6%) were unbalanced translocations. It is concluded that the prevalence of balanced chromosomal translocations in patients with abnormal reproductive outcome is higher than that of the normal population. Most of the fetal samples showed normal karyotypes or balanced translocations. Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal diagnosis, individuals with balanced translocations are predisposed to abnormal offspring with partial trisomy or monosomy. Therefore we recommend that genetic counselling and cytogenetic prenatal diagnosis for translocation carriers have to be offered to prevent recurrent chromosomal abnormal babies.

• 한국멀티미디어학회논문지
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• 제17권8호
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• pp.995-1011
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• 2014

In consideration of the rapid changes in the so-called information society of the $21^{st}$ century, about 80% of a total population in Korea has used the Internet. However, the social effect of the Internet and related devices has not been yet systematically studied in the literature. In healthcare as well, consumers' efficient use of the Internet for their positive health outcomes is becoming an issue. The purpose of this study was to analyze the medical subject headings keywords of the selected studies on consumers' use of Internet and mobile health information. For the analysis, social network analysis was used to provide basic information to present directions for future research on the field of interest.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.536-543
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• 2018

Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functional gastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptom presentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functional dyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.

• 보건행정학회지
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• 제30권3호
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• Journal of Preventive Medicine and Public Health
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• 제53권3호
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• pp.171-174
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• 2020

The coronavirus disease 2019 (COVID-19) pandemic has not only caused significant challenges for health systems all over the globe but also fueled the surge of numerous rumors, hoaxes, and misinformation, regarding the etiology, outcomes, prevention, and cure of the disease. Such spread of misinformation is masking healthy behaviors and promoting erroneous practices that increase the spread of the virus and ultimately result in poor physical and mental health outcomes among individuals. Myriad incidents of mishaps caused by these rumors have been reported globally. To address this issue, the frontline healthcare providers should be equipped with the most recent research findings and accurate information. The mass media, healthcare organization, community-based organizations, and other important stakeholders should build strategic partnerships and launch common platforms for disseminating authentic public health messages. Also, advanced technologies like natural language processing or data mining approaches should be applied in the detection and removal of online content with no scientific basis from all social media platforms. Furthermore, these practices should be controlled with regulatory and law enforcement measures alongside ensuring telemedicine-based services providing accurate information on COVID-19.

• Clinical and Experimental Reproductive Medicine
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• 제35권4호
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• pp.293-301
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• 2008

목 적: 비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따라 고환조직내 정자채취술 (Testicular sperm extraction, TESE) 후 난자세포질내 정자주입술 (Intracytoplsmic sperm injection, ICSI)의 체외수정시술 결과를 알아보고자 하였다. 연구방법: 비폐쇄성 무정자증으로 고환조직내 정자채취술 후 난자세포질내 정자주입술을 이용하여 배아 이식을 시행한 122주기를 분석하였다. 고환의 조직병리학적 진단에 따라 Germ-cell aplasia (GA, 40주기), Maturation arrest (MA, 32주기) and severe hypospermatogenesis (S-HS, 50주기)로 구분하여 체외수정시술 결과를 비교하였으며, 이들 결과를 난자세포질내 정자주입술을 이용한 폐쇄성 무정자증 환자의 체외수정시술 결과와 비교하였다. 결 과: 고환조직내 정자채취술 후 난자세포질내 정자주입술시 수정율은 각각 58.1% in GA, 42.2% in MA and 48.0% in S-HS로 조직병리학적 진단에 따른 차이는 없었으며, 폐쇄성 무정자증 환자의 72.9%에 비해 유의하게 낮은 수정율을 보였다 (p<0.001). 고환조직내 정자채취술시 채취된 정자 (spermatozoa, 94주기)로 난자세포질내 정자주입술을 시행한 주기의 배아 이식 후 임신율은 각각 22.6% in GA, 29.4% in MA와 26.1% in S-HS이었으며, 출생률은 각각 16.1%, 29.4%와 19.6%로 조직병리학적 진단에 따른 차이는 없었다. 정자세포 (spermatid, 16주기)를 사용하여 난자세포질내 정자주입술을 시행한 주기의 임신율은 각각 0.0% (0/3 주기), 9.1% (1/11주기)와 0.0% (0/2주기)이었으며, 출생률은 각각 0.0%이었다. 정모세포 (spermatocyte, 12주기)를 사용한 주기의 임신율은 각각 0.0% (0/6주기), 0.0% (0/4주기)와 0.0% (0/2주기)이었으며, 출생률도 각각 0.0%이었다. 결 론: 비폐쇄성 무정자증환자의 배아이식을 시행한 주기에서 고환의 조직병리학적 진단에 따른 난자세포질내 정자주입술시 수정율은 차이가 없었으며, 폐쇄성 무정자증 환자에 비해 유의하게 낮은 수정율을 보였다. 비폐쇄성 무정자증환자에서 고환조직내 정자채취술시 정자를 채취하여 난자세포질내 정자주입술을 시행한 주기의 체외수정시술 결과는 고환의 조직병리학적 진단에 따라 차이를 보이지 않는다.

• Clinical and Experimental Reproductive Medicine
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• 제41권3호
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• pp.132-136
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• 2014

Objective: The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partner's age affects these vacuoles. Methods: Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope ($400{\times)$) in 980 men. The normal morphology was divided into three categories (group A, <4% of normal morphology; group B, 4%-14% of normal morphology; and group C, >14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. Results: The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. Conclusion: A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.221-227
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• 2016

Objective: The aim of this study was to evaluate the influence of maternal age on fertilization, embryo quality, and clinical pregnancy in patients undergoing intracytoplasmic sperm injection (ICSI) using testicular sperm from partners with azoospermia. Methods: A total of 416 ICSI cycles using testicular spermatozoa from partners with obstructive azoospermia (OA, n = 301) and non-obstructive azoospermia (NOA, n = 115) were analyzed. Female patients were divided into the following age groups: 27 to 31 years, 32 to 36 years, and 37 to 41 years. The rates of fertilization, high-quality embryos, clinical pregnancy, and delivery were compared across maternal age groups between the OA and NOA groups. Results: The rates of fertilization and high-quality embryos were not significantly different among the maternal age groups. Similarly, the clinical pregnancy and delivery rates were not significantly different. The fertilization rate was significantly higher in the OA group than in the NOA group (p< 0.05). Age-group analysis revealed that the fertilization and high-quality embryo rates were significantly different between the OA and NOA groups in patients aged 27 to 31 years old, but not for the other age groups. Although the clinical pregnancy and delivery rates differed between the OA and NOA groups across all age groups, significant differences were not observed. Conclusion: In couples using testicular sperm from male partners with azoospermia, pregnancy and delivery outcomes were not affected by maternal age. However, women older than 37 years using testicular sperm from partners with azoospermia should be advised of the increased incidence of pregnancy failure.

• 품질경영학회지
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• 제43권1호
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• pp.11-30
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• 2015

Purpose: The purpose of this study is to lay groundwork for future research on the outcomes of national quality awards for secondary-care healthcare organizations. Methods: For this study, a secondary-care hospital was selected through a convenience sampling method and all of its organizational members participated in complete enumeration survey using 109 survey questions derived from the MBNQA criteria for healthcare through structural equation modeling (SEM) Results: As a result, Leadership was shown to drive Foundation and Direction, which affect System that creates Results with 12 hypotheses supported out of 18 hypotheses established. Conclusion: The findings of this study will provide valuable implications to the top management of secondary-care hospitals for self-examining quality management and promoting sustainable competitiveness.

• 한국보건간호학회지
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• 제27권1호
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• pp.16-26
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• 2013

Purpose: The aim of this study was to identify a conceptual link between role conflict, job satisfaction, and organizational commitment, with a specific examination on how job satisfaction mediated the relationship between role conflict and organizational commitment, among community healthcare workers. Methods: Participants were 119 community healthcare workers of the Seoul Preventive Project for Metabolic Syndrome at 15 community health centers. Descriptive analysis, correlations analysis, and multiple regression analysis were used for statistical analysis of our data. Additionally, Sobel's test was used to verify the significance of the mediating effect. Results: An inverse association between role conflict and organizational commitment was found (beta=-0.53, p<.001). This relationship was fully mediated by job satisfaction (z=-6.43, p<.001). Conclusion: Job satisfaction mediates the effects of role conflict on the organizational commitment of healthcare workers in community health centers. Strategies for improving the components of job satisfaction are needed to achieve better outcomes in organizational commitment in the Seoul Preventive Project for Metabolic Syndrome and possibly other work settings.