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Cancer Registration in Korea: The Present and Furtherance (암 등록사업의 현황과 추진방향)

  • Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.265-272
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    • 2007
  • It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993-1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.

Infection Rate of Chlamydia pneumoniae in Patients with Chronic Cough (만성기침 환자에서 Chlamydia pneumoniae 감염률)

  • Chun, Seung-Yeon;Park, Kwon-Oh;Park, Yong-Bum;Choi, Jeong-Hee;Lee, Jae-Young;Mo, Eun-Kyung;Park, Sung-Hoon;Kim, Cheol-Hong;Lee, Chang-Youl;Hwang, Yong-Il;Jang, Seung-Hun;Shin, Tae-Rim;Park, Sang-Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.426-433
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    • 2010
  • Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.

The Development and Implementation of Problem-Based Learning Package in Physical Therapy (물리치료학에서의 PBL 학습교재 개발 및 적용)

  • Hwang, Hyun-Sook;Chung, Jin-Woo;Lim, Jong-Soo
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.83-94
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    • 2002
  • Within physical therapy education, there has been increased attention to curricula and course that emphasize problem solving, clinical reasoning, and synthesis of information across traditional discipline-specific boundaries. This article describes the development implementation, and outcomes of a problem-based learning course in Physical therapy. The course was designed to help students to integrate the various elements of a physical therapy curriculum and to enhance their abilities to respond to an ever-changing health care environment. An evaluation of the course by the first 50 students who completed it revealed both strengths and weaknesses. Students responded that the course enhanced their professional behavior, including interpersonal communication skills, team work, and follow-through with professional responsibilities. The learning package was developed by the authors and implemented to a college students during three weeks of the first semester of 2001. Most studies which conducted PBL module development were short period or temporary PBL package application and evaluation rather than a whole semester's. While, this study carried on partial integrated PBL curriculum development and application with recomposing content of the two subjects to one subject Physical therapy which includes four PBL packages. This package was developed from a simple concept to complex and partial integrated PBL curriculum application systematically variable learning methods such as discussion, practice, lecture, video. There are 2 classes, each class has 25 students, in the college. Each class has 5 small groups consisting 5 students. Two tutors proceeded discussion charging each class also, they used multiple methods and materials like tutorials, self-directed learning, lecture, and video. The package is 5 grades and 5 hours per week and the rate of discussion, lecture is 4, 1 respectively. One of the most change is the increase of interaction between students and tutors. Whenever students need information and suggestion, they can visit tutors who provide reading materials and guide for the direction of self learning. Therefore, this study describes the PBL package development process and application during one semester recomposing contents of two subjects to Physical therapy concepts. Besides, it will contribute to active application of existing each subject to tutors who intend to convert as PBL methods. The study has significant meaning to show potentiality of partially integrated PBL application, using systematic PBL package development from two subjects contents. However, when students' need of yearning is over the extent of Introduction of Physical therapy and Rehabilitation medicine, tutors should set learning extent. So, there is limitation to attain completely integrated PBL education within one subject, therefore, it is high lighted to proceed development of integrated curriculum to maximize learning effects of PBL. It is exected that partial integrated PBL package development and application will distribute to prosper excellent physiotherapist in practice.

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Effects of Dental Fear on Depression Symptom and Stress in Adults (일부 성인의 치과공포가 우울 증상과 스트레스에 미치는 영향)

  • Park, Eun-Seon
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.203-211
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    • 2017
  • The purpose of this study was to determine the association of some adult dental fear and depression, and stress. Among the patients who came to the dental clinic for periodontal treatment, 68 patients who agreed to participate in the study and who met the selection criteria were included. Dental fear, depression symptom questionnaire, salivary cortisol, which can objectively evaluate blood pressure, pulse, and stress. The results of the analysis showed that depressive symptom was related to 'delayed treatment promise', 'cancellation of treatment appointment', 'increased muscle tension', 'rapid breathing when entering dentistry', 'fear when waiting in the waiting room', 'fear when you smell the hospital', 'fear when looking at the dental clinic', 'fear when seeing the anesthetic needle', 'fear when tooth whistle was heard', 'fear when teeth were removed', and 'total fear of dentistry'(p<0.05). Stress symptoms were higher in 'having sweated in the dentist', 'faster pulse', 'fear of entering the dentist' and 'total fear of the dentist'(p<0.05). Based on these results, it is necessary to study the effective methods to control the depressive symptoms and stress of patients who visit dental clinics, and it seems that continuous management is needed to prepare methods such as relaxation therapy for dental fear patients.

The Use Criteria and Appropriateness of Korean Classification of Diseases(KCD) Focused on Emmeniopathy (월경병을 중심으로 본 한국표준질병사인분류(KCD)의 사용 기준과 적합성)

  • Kang, You-Jeong;Lee, In-Seon;Cho, Hye-Sook;Lee, Seung-Hwan;Bae, Geung-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.4
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    • pp.126-149
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    • 2011
  • Purpose: KCDO-3(Korean Classification of Diseases(Oriental Medicine)-third edition) being used in January, 2010 accepted the KCD(Korean Classification of Diseases) and added disease pattern and syndrome of oriental medicine. But, the diagnoses of oriental medicine are too uncertain to express in A00-Z99(KCD). In this case, you should choose in U codes under the KCD use guidelines, but U codes are not capable of representing the symptoms too. So, we suggest the use criteria and consider the weakness of the U codes with medical records of patients who visited with amenorrhea or oligomenorrhea. Methods: We referred medical records of patients who visited oriental obstetrics and gynecology from January 1st to December 31st, 2010. From among them, we set up 122 patients who related with emmeniopathy as target group and searched codes distribution based on medical records. And we described that the process of choosing appropriate codes based on the medical records of 49 amenorrhea or oligomenorrhea patients. Results and Conclusions: The emmeniopathy is divided into menstrual disorder, amenorrhea and systemic disorders at the period of menstruation. And emmeniopathy is expressed in some codes such as N91, N92, N93, N94, U321, U77. When a patient visit hospital, a doctor should choose causal codes when there is confirmed diagnosis. Otherwise, a doctor chooses symptom codes. And if there are more than two diagnosis consistent with definition of chief condition, a doctor should code the first listed diagnosis as a chief condition. Because KCD-5 is classified according to western medical diagnosis, it is difficult to choose in KCD-5 when we diagnosed with disease pattern and syndrome of oriental medicine. But U codes are also deficient to express various condition of emmeniopathy. So we should add 'deficiency and detriment of the thoroughfare and conception vessels', 'prolonged menstruation' and various systemic disorders at the period of menstruation.

Clinical Investigation of Fatigue Among Outpatients (피로를 호소하는 외래환자에 대한 임상적 관찰)

  • Park, Shin-Myong;Seung, Hyun-Suk;Kim, Young-Chul;Lee, Jang-Hoon;Woo, Hong-Jung;Lee, Ji-Hyeon
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.299-307
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    • 2001
  • Objectives: Fatigue is a common symptom experienced by many people who visit Oriental medical clinics or hospital. However, there has been little study about the fatigue in the Oriental medical academic world. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with Health Practice Index(HPI). Methods: The subjects were 63 outpatients who visited the Tonification Clinic in Kyunghee Oriental Medical Center between January 1, 2001 and July 31, 2001. Their chief complaint was fatigue and they did not have any physical or mental problem. They were given a questionnaire which included questions reflecting general characteristics, fatigue degree and health habits. We measured degree of fatigue by Chalder scale et al. Health habits were investigated about 5 articles out of 'Breslow 7 Health habits'. Results: Among the subjects, 48 people(76.2%) were considered as 'fatigue patients' by the Chalder scale. Of this 48 fatigue patients, 27 people(56.3%) had manifested fatigue for more than 6 months. The average of scale II for all the patients was 14.05, which indicates moderate degree of fatigue. They complained fatigue, drowsiness and general weakness, dryness and discomfort of the eyes, headache, shoulder pain and neck stiffness, dizziness, heat in the upper part of the body, and poor concentration. There were no differences in degree of fatigue according to Health habits including exercise or not, smoking or not, the frequency of drinking, hours of sleeping, and body mass index. Conclusions: Many people complain fatigue symptom. Therefore doctors should have more interest in fatigue and care. This study can provide standards of prognosis of fatigue patients. Also prospective studies are needed to find relationship between health habits and fatigue degree.

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Relationship of Orofacial Pain and Sleep Quality (수면의 질과 구강 안면 통증의 관계)

  • Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.91-99
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    • 2006
  • This study was performed to investigate about sleep quality and orofacial pain pattern between experimental and control group. 101 subjects with temporomandibular disorders without any psychologic and neurologic problem were selected from the patients presented to Wonkwang University dental hospital. Routine clinical examination for TMD was carried out, especially for the frequency of headache and the craniocervical muscles were also done by the author in the first visit. All the subjects filled out the questionnaires, that was, for the evaluation of sleep quality using Pittsburgh sleep quality index(PSQI), and for the analysis of behavioral pain scale questionnaires. Data obtained were statistically processed by the SPSS Windows program and the results of this study were as follows: 1. Subjective sleep index, sleep latency, sleep disturbance, global score in control group were significantly lower than 2. Subjective sleep index, sleep disturbance, global score in subject with headache were significantly lower than subject without headache(P<0.05). 3. Medicine taker have sleeping drug. Caffeine drinkers was significantly higher in daytime dysfunction, global score than no drinker. 4. It have more frequent head and neck pain, pain spreading, daily life difficult in poor sleeper than good sleeper.

Efficacy and Safety of Sublingual Immunotherapy in Elderly Rhinitis Patients Sensitized to House Dust Mites

  • Kim, Ji Hye;Lee, Ji Ho;Ye, Young-Min;Lee, Jae-Hyun;Park, Jung Won;Hur, Gyu-Young;Kim, Joo-Hee;Lee, Hyn-Young;Shin, Yoo Seob;Yang, Eun-Mi;Park, Hae-Sim
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.675-685
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    • 2018
  • Purpose: This study aims to determine the efficacy and safety of house dust mite (HDM)-sublingual immunotherapy (SLIT) in elderly patients with AR. Methods: A total of 45 patients aged ${\geq}60years$ with HDM-induced AR who had ${\geq}3$ A/H ratio on skin prick test and/or ${\geq}0.35IU/L$ to both Dermatophagoides farinae and Dermatophagoides pteronyssinus by ImmunoCAP were enrolled in 4 university hospitals. To evaluate additional effects of HDM-SLIT, they were randomized to the SLIT-treated group (n = 30) or control group (n = 15). Rhinoconjunctivitis total symptom score (RTSS), rhinoscopy score, Korean rhinoconjunctivitis quality of life questionnaire, rhinitis control assessment test, asthma control test scores, and adverse reactions, were assessed at the first visit (V1) and after 1 year of treatment (V5); for immunological evaluation, serum levels of HDM-specific immunoglobulin A/IgE/IgG1/IgG4 antibodies and basophil response to HDMs were compared between V1 and V5 in both groups. Results: There were no significant differences in demographics, RTSS, skin reactivity to HDMs, or serum total/specific IgE levels to HDMs (P > 0.05, respectively) between the 2 groups. Nasal symptom score and RTSS decreased significantly at year 1 in the 2 groups (P < 0.05). There were no significant differences in percent decrease in nasal symptom score and RTSS at year 1 between the 2 groups (P > 0.05); however, rhinoscopic nasal symptom score decreased significantly in the SLIT-treated group (P < 0.05). Immunological studies showed that serum specific IgA levels (not specific IgE/IgG) and CD203c expression on basophils decreased significantly at V5 in the SLIT-treated group (P = 0.011 and P = 0.001, respectively), not in the control group. The control group required more medications compared to the treatment group, but there were no differences in adverse reactions. Conclusions: It is suggested that HDM-SLIT for 1 year could induce symptom improvement and may induce immunomodulation in elderly rhinitis patients.

Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

  • Castillo, Carmen;Lustig, Nicole;Margozzini, Paula;Gomez, Andrea;Rojas, MarIa Paulina;Muzzo, Santiago;Mosso, Lorena
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.466-472
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    • 2018
  • Background: Thyroid dysfunction is associated with negative neonatal and obstetric outcomes. Large differences in thyroid function reference intervals exist across different populations. These differences can be explained by population-specific factors, such as iodine status. Many countries in Latin America report iodine sufficiency, but relatively few countries have published up-to-date data on iodine levels and thyroid function in the overall population, and especially in pregnant women. We evaluated the iodine status of pregnant women in Chile and determined thyroid hormone reference ranges in this population. Methods: This was a prospective observational study of healthy Chilean women at their first prenatal visit before week 14. Thyroid-stimulating hormone (TSH), total thyroxine ($T_4$), free $T_4$, antithyroid peroxidase antibody (TPOAb), and iodine levels from spot urine samples were measured. Iodine status and the reference ranges for TSH were calculated. Results: A total of 1,022 pregnant women in the first trimester were selected. Urinary iodine levels were measured in 302 randomly-selected women. The median urinary iodine concentration was $173.45{\mu}g/L$ (interquartile range, 108.11 to 249.35).The reference ranges of TSH were calculated in 670 patients selected according to the National Academy of Clinical Biochemistry guidelines. The median TSH level was $1.88{\mu}IU/mL$ (2.5th percentile: 0.13 to 97.5th percentile: 5.37). Using the reference range in the 1,022 women, the prevalence of clinical hypothyroidism was 1.76%, and that of subclinical hypothyroidism was 3.92%. TPOAb positivity was more common in women with TSH levels above $3.5{\mu}IU/mL$. Conclusion: We found adequate iodine intake and a right-shifted distribution of serum TSH levels in pregnant women in Chile. The prevalence of hypothyroidism in our sample of pregnant women was higher than has been described in the literature.

Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning (클로르페나피르 음독 후 발생한 독성 시신경병증 1예)

  • Park, Su Jin;Jung, Jae Uk;Kang, Yong Koo;Chun, Bo Young;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1097-1102
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    • 2018
  • Purpose: To report a case of toxic optic neuropathy caused by chlorfenapyr ingestion accompanied by central nervous system involvement. Case summary: A 44-year-old female visited our clinic complaining of reduced visual acuity in both eyes for 7 days. She had ingested a mouthful of chlorfenapyr for a suicide attempt 2 weeks prior to the visit. Gastric lavage was performed immediately after ingestion at the other hospital. Her best-corrected visual acuity was finger count 30 cm in the right eye and hand motion in the left eye. Both pupils were dilated by 5.0 mm and the response to light was sluggish in both eyes. A relative afferent pupillary defect was detected in her left eye. Funduscopy revealed optic disc swelling in both eyes. Magnetic resonance imaging of the brain showed a symmetric hyper-intense signal in the white matter tract including the internal capsule, corpus callosum, middle cerebellar peduncle, and brainstem. The patient was diagnosed with toxic optic neuropathy induced by chlorfenapyr ingestion, and underwent high-dose intravenous corticosteroid pulse therapy. Three days later, the best-corrected visual acuity was no light perception in both eyes. Three months later, optic atrophy was observed in both eyes. Optical coherence tomography revealed a reduction in the thicknesses of the retinal nerve fiber layer and ganglion cell and inner plexiform layer in the macular area. Conclusions: Ingestion of even a small amount of chlorfenapyr can cause severe optic nerve damage through the latent period, despite prompt lavage and high-dose steroid treatment.