• Clinical and Experimental Reproductive Medicine
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• 제37권1호
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• pp.49-56
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• 2010

Objective: To investigate assisted reproductive technology (ART) outcomes in women with WHO class I anovulation compared with control group. Design: Retrospective case-control study. Methods: Twenty-three infertile women with hypogonadotropic hypogonadism (H-H) who undertook ART procedure from August 2003 to January 2009 were enrolled in this study. A total of 59 cycles (H-H group) were included; Intra-uterine insemination with super-ovulation (SO-IUI, 32 cycles), in vitro fertilization with fresh embryo transfer (IVF-ET, 18 cycles) and subsequent frozenthawed embryo transfer (FET, 9 cycles). Age and BMI matched 146 cycles of infertile women were collected as control group; 64 cycles of unexplained infertile women for SO-IUI and 54 cycles of IVF-ET and 28 cycles of FET with tubal factor. We compared ART and pregnancy outcomes such as clinical pregnancy rate (CPR), clinical abortion rate (CAR), and live birth rate (LBR) between the two groups. Results: There was no difference in the mean age ($32.7{\pm}3.3$ vs. $32.6{\pm}2.7$ yrs) and BMI ($21.0{\pm}3.1$ vs. $20.8{\pm}3.1kg/m^2$) between two groups. Mean levels of basal LH, FSH, and $E_2$ in H-H group were $0.62{\pm}0.35$ mIU/ml, $2.60{\pm}2.30$ mIU/ml and $10.1{\pm}8.2$ pg/ml, respectively. For ovarian stimulation, H-H group needed higher total amount of gonadotropin injected and longer duration for ovarian stimulation (p<0.001). In SO-IUI cycles, there was no significant difference of CPR, CAR, and LBR between the two groups. In IVF-ET treatment, H-H group presented higher mean $E_2$ level on hCG day ($3104.8{\pm}1020.2$ pg/ml vs. $1878.3{\pm}1197.7$ pg/ml, p<0.001) with lower CPR (16.7 vs. 37.0%, p=0.11) and LBR (5.6 vs. 33.3%, p=0.02) and higher CAR (66.7 vs. 10.0%, p=0.02) compared with the control group. However, subsequent FET cycles showed no significant difference of CPR, CAR, and LBR between the two groups. Conclusion: H-H patients need higher dosage of gonadotropin and longer duration for ovarian stimulation compared with the control groups. Significantly poor pregnancy outcomes in IVF-ET cycles of H-H group may be due to detrimental endometrial factors caused by higher $E_2$ level and the absence of previous hormonal exposure on endometrium.

• Clinical and Experimental Reproductive Medicine
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• 제27권1호
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• pp.59-65
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• 2000

Objective: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. Methods: we performed retrospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant. Results: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility was significantly higher than the tubal (27.2%) and other female factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. Conclusion: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.

• Clinical and Experimental Reproductive Medicine
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• 제34권4호
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• pp.305-312
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• 2007

Objective: To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. Method: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002$\sim$2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2$\sim$5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. Results: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5$\pm$22.3% vs 52.9$\pm$28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. Conclusion: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.

• Journal of The Korea Institute of Healthcare Architecture
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• 제15권3호
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• pp.61-69
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• 2009

This study has been started in order to provide basic information for the planning of Korean elderly care facilities by analysing For-profit elderly homes of Japan. Japan is famous for her high elderly proportion and also her fast aging speed. Therefore, Japanese experiences of trials and errors related to the supply of elderly homes will be a good guideline for Korea which is undergoing the sharp increase in elderly population. Data have been mainly collected from the official statistics of Japan and Korea. The outcomes of this study are as follows. At first, the definition of For-profit elderly homes of Japan has been proposed clearly. Secondly, the trends of them related to supply and operational characteristics have been analysed. Thirdly, the size and utilization rate of them have been analysed. And finally, the physical characteristics of elderly residences in For-profit elderly homes of Japan have been discussed.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3521-3526
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• 2016

Digital breast tomosynthesis (DBT) as a breast cancer screening modality, through generation of three-dimensional images during standard mammographic compression, can reduce interference from breast tissue overlap, increasing conspicuity of invasive cancers while concomitantly reducing false-positive results. We here conducted a systematic review on previous studies to synthesize the evidence of DBT efficacy, eventually 18 articles being included in the analysis. The most commonly emerging topics were advantages of DBT screening tool in terms of recall rates, cancer detection rates and cost-effectiveness, preventing unnecessary burdens on women and the healthcare system. Further research is needed to evaluate the potential impact of DBT on longer-term outcomes, such as interval cancer rates and mortality, to better understand the broader clinical and economic implications of its adoption.

• IE interfaces
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• 제20권4호
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• pp.488-497
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• 2007

In order to provide appropriate decision supports in medical domain, it is required that clinical knowledge should be implemented in a computable form and integrated with hospital information systems. Healthcare organizations are increasingly adopting tools that provide decision support functions to improve patient outcomes and reduce medical errors. This paper proposes a process centric clinical decision support system based on medical knowledge. The proposed system consists of three major parts - CPG (Clinical Practice Guideline) repository, service pool, and decision support module. The decision support module interprets knowledge base generated by the CPG and service part and then generates a personalized and patient centered clinical process satisfying specific requirements of an individual patient during the entire treatment in hospitals. The proposed system helps health professionals to select appropriate clinical procedures according to the circumstances of each patient resulting in improving the quality of care and reducing medical errors.

• Journal of Hospice and Palliative Care
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• 제26권3호
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• pp.140-144
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• 2023

Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.

• Journal of Physiology & Pathology in Korean Medicine
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• 제28권4호
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• pp.440-445
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• 2014

Korean medical system is unique system that has two medical system, Western medical institution and Korean medical institution. In this environment, patients who use each medical institution have different selection factors. The study explores the selection factors' difference of korean/western medical institutions. The empirical analysis of the surveyed data produced the following outcomes. The result of factor analysis, four factors were extracted. That was Human services, Costs and Physical Environment, Prestige and reputation, Public relations and reliability. Overall, the four selection factor importance scores of Korean medical institution were higher than western medical institution's. These findings show that there is a difference between korean and western medical institutions in terms of selection factors. After this study, More study about medical management and healthcare policy including korean medical characteristics is needed.

• The Korean Journal of Rehabilitation Nursing
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• 제20권1호
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• pp.42-51
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• 2017

Purpose: In people who have chronic diseases, disabilities, and rehabilitation needs, self-management education can improve health and health-related behavior, and it can reduce the utilization of healthcare services. The purpose of this research was to assess the long-term effects of chronic-disease self-management education in Japan. Methods: This study included 184 adults living with various chronic medical conditions who participated in the Chronic Disease Self-Management Program (CDSMP) in Japan. Data were collected before the program began, and then collected 3 more times over 1 year. Results: Healthcare-service utilization was low at baseline, and it did not change. Self-evaluated health status, health-related distress, coping with symptoms, communication with doctors, and self-efficacy to manage symptoms all improved after the program. However, there was backsliding in all of the outcomes that had improved. Conclusion: Some benefits of this program can last for at least 1 year, but interventions to prevent attenuation may be needed. For economic evaluations, research should focus on populations with higher baseline levels healthcare-service utilization, including use of rehabilitation services. Also, more attention should be focused on the longer-term decay or persistence of the program's benefits, particularly regarding on preventing and reducing disabilities and with regard to rehabilitation needs.

• Korean Medical Education Review
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• 제19권1호
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• pp.1-9
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• 2017

For the last half-century, interprofessional education (IPE) has been identified and discussed as a critical educational process to facilitate collaboration in order to improve healthcare outcomes for healthcare participants. While the concept is not new, outcome-based research has provided few valid and reliable explanations of whether and how IPE can be effective in healthcare quality improvement. This challenge stems from the struggle to understand the epistemological meaning of IPE. The purpose of this literature review paper is to provide a synthesized understanding of IPE, its meaning, and to provide practical guidance for medical educators. The paper reviewed several key aspects of IPE. Professionalility was discussed to understand the historical background of IPE, followed by an explanation of the international trend of embracing the complexity of health care practice and the need for interprofessional collaboration. Additionally, several theoretical perspectives, such as general systems theory, social identity theory, and community of practice were reviewed to pinpoint what constitutes IPE. Several existing definitions were discussed with similar concepts (i.e., disciplinary vs. professional, and multi-, inter-, vs. trans-) to clarify the nature of knowledge and collaboration in IPE. Three concepts, including practice, authenticity of context, and socialization were proposed as key constructs of IPE, followed by appropriate timing of IPE, outcome research, directions for future research, and guidance for implementation. Community-based medical education practice, professional socialization within a community, and longitudinal system-based outcome research are recommended as future directions for research and practice.