• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.660-668
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• 1999

Background: Lung cancer continues to increase and one half of all cases of lung cancer occur in patients age 65 years and older. However, it seems that lung cancer is less treatable in elderly patients because of co-morbid illness or poor tolerance of surgery and chemotherapy. The intention of this study is to seek an adequate treatment approach for lung cancer in the elderly through an understanding of its characteristics. Method: The clinical data of 207 patients who were diagnosed with histologically proven lung cancer at the department of internal medicine in Seoul Municipal Boramae Hospital between September 1994 and August 1998 were retrospectively analyzed according to their age groups; group I$\geq$65 years(n=122) and group II<65 years(n=85). Results: The peak incidence of age was 7th decade(36.2%) and male age 65 years and older were 42% of all patients. Although dyspnea was more common in group I(26%) than in group II(11%)(p=.0l), there were no significant difference in other symptoms, stage, and histologic type between two groups. Group I significantly had more patients with poor performance(ECOG 3&4) than group II(35.2% vs.12.9%, p=.000). The percentage of patients with non-small cell carcinoma received supportive care only was significantly higher in group I than in group I(74% vs. 35%, p=.000). However, survival of patients who had curative intent treatment was similar between two groups(median survival 11.3 mos vs. 23 mos, p>.05). The histologic subtype, stage and performance status were significant prognostic factors affecting survival, but age itself was not. Conclusion : Lung cancer is prevalent in the elderly and aggressive diagnosis and treatment should be considered in elderly patients with good performance status.

• Archives of Pharmacal Research
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• v.26 no.11
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• pp.967-973
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• 2003

Cytochrome P4502C9(CYP2C9) is largely responsible for terminating anticoagulant effect by hydroxylation of S-warfarin to inactive metabolites. Mutations in the CYP2C9 gene result in the expression of allelic variants, CYP2C9*2 and CYP2C9*3 with reduced enzyme activity compared to wild type CYP2C9 *1. The aim of this study was to assess relationship between requirement of warfarin dose and polymorphism in CYP2C9 in Korean population. Patients on warfarin therapy for longer than 1 year were included from July 1999 to December 2000 and categorized as one of four groups; regular dose non-bleeding, regular dose bleeding, low dose non-bleeding and low dose bleeding. Low dose was defined as less than 10 mg/week for 3 consecutive monthly follow-ups. Bleeding complications included minor and major bleedings. Blood samples were processed for DNA extraction, genotyping and sequencing to detect polymorphism in CYP2C9. Demographic data, warfarin dose per week, prothrombin time (INR), indications and co-morbid diseases were assessed for each group. Total 90 patients on warfarin were evaluated; The low dose group has taken warfarin 7.6$\pm$1.7 mg/week, which was significantly lower than 31.4$\pm$0.9 mg/week in the regular dose group (p<0.0001). The measured INR in the low dose group was similar to that of the regular dose group (2.3$\pm$0.7 vs. 2.3$\pm$0.6, p=0.9). Even though there was a higher possibility of CYP2C9 variation in the low dose group, no polymorphism in CYP2C9 was detected. All patients were homozygous C416 in exon 3 for CYP2C9*2 and A1061 in exon 7 for CYP2C9*3. The DNA sequencing data confirmed the homozygous C416 and A 1061 alleles. In conclusion, polymorphism in CYP2C9 is not a critical factor for assessing warfarin dose requirement and risk of bleeding complications in a Korean population.

• Korean Journal of Veterinary Service
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• v.30 no.1
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• pp.133-144
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• 2007

This study was conducted to determine the effective environmental control measures in preventing calf diarrheal disease in farms. It was found that the high numbers of calves in a cow house was directly related with the high incidence rate of diarrheal diseases. When the number of calves was increased in a cow house, it was difficult to reduce the diarrheal diseases of calves. It was revealed that the incidence rates of calf diarrheal disease were dramatically reduced when the delivery house which faced south. The periodical changes of bedding materials seemed beneficial good to control the possible resident infectious agents, including pathogenic viruses and bacteria. The control of the delivery time was important for reduction of calf diarrhea. It was revealed that September and October were the best time as the delivery period. In order to use old cow house as a delivery house, it should be sterilized by the disinfectant and the flame. When the diarrheal feces were removed as soon as possible, the transmission of diarrheal diseases among calves In the same house was reduced. When the diarrheal feces were not disposed, the incidence rate of diarrhea reached up to 50%. When the morbid calves were not quarantined, the incidence rate of diarrhea was 100%. In contrast, when the diseased calves were quarantined from other calves, the incidence rate of diarrhea was reduced, remarkably. The mean recovery time from the diarrhea of the treated calves in the southern cow house was much faster than that in the north cow house. The treatment of calves in a clean and well-ventilated cow house with dry bedding was more effective than that in a cold, wet, and dark house. It could be postulated that the most important environmental factor in the reduction of diarrheal diseases of calves is the blocking of the entry of the infectious agents. The complete sanitation and control of the delivery house in the using farm is more important than building a new cow house, for prevention of calf diarrheal diseases.

• Journal of Oral Medicine and Pain
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• v.42 no.4
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• pp.102-108
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• 2017

Purpose: Many metal ions released from dental casting alloys have been reported to influence the intraoral symptoms of oral lichen planus (OLP) and burning mouth syndrome (BMS). The aim of this study was to investigate the relationship between salivary metal ion levels and the prosthetic duration as well as to evaluate the time-dependent morbid effects of metal ions in OLP and BMS patients. Methods: Three study groups consist of the following subjects respectively: 17 OLP patients, 12 BMS patients, and 12 patients without oral symptoms. The salivary concentrations of 13 metal ions (copper, cobalt, zinc, chromium, nickel, aluminum, silver, iron, titanium [Ti], platinum, tin, palladium, and gold) were measured by Laser Ablation Microprobe Inductively coupled Plasma Mass Spectrometry. Results: The Ti ions had statistically significant differences among the groups with a prosthetic duration of less than 5 years. There were no significant differences between all ion levels among the groups wearing dental cast alloys for over 5 years. In the BMS group, the level of Ti ions in patients with prosthetic restorations less than 5 years old were significantly high (p<0.05). Conclusions: In the BMS group, 3-60 months during which salivary Ti levels were higher were matched with the duration of burning symptoms ($15.6{\pm}17.1months$). Furthermore, Ti ions were statistically high in the oral cavity of BMS patients fitted with dental casting alloys for 5 years. These results suggest that Ti ions released from dental implants and oral prostheses could attribute to burning sensation of BMS.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.65-74
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• 2016

Objectives : This study was designed to assess the general distribution, clinical effectiveness of Korean medical treatment on knee pain and the correlation between Korean medical therapy on knee pain and BMI. Methods : This is an observational study. 65 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with musculoskeletal disorders were observed from July, 2014 to July, 2015. They were analyzed according to sex, age, pain lesion, body mass index(BMI) and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, pharmacopuncture, herbal medicines and physical therapy. A zero to ten numerating rating scale (NRS) assessing pain, Western Ontario and McMaster Universities Arthritis Index(WOMAC) index and Range of Motion(ROM) was used before and after treatments. Statistical correlations among assessment measurements were evaluated by examining the paired t-test and the Pearson's correlation coefficients. Results : The average BMI of all patients was $24.03{\pm}2.95kg/m^2$. According to clinical definition of obesity by Korean Society for the Study of Obesity, 33.8% of all patients was within normal weight, 1.5% was underweight, 33.8% was overweight, 24.6% was obesity and 6.2% was morbid obesity. For knee pain patients, NRS (Numeric Rating Scale) decreased from $6.28{\pm}1.63$ to $3.94{\pm}2.03$(p<0.001). WOMAC index decreased from $48.14{\pm}17.63$ to $40.37{\pm}18.28$(p<0.001). But, there were no significant correlations in statistics among BMI, knee pain index and knee pain index improvement. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving functional disorders for patients with knee pain. This study further confirmed the efficacy of Korean medical treatment on knee pain. But, more studies on correlation between knee pain and obesity and development of assessment measurement are needed.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.19 no.3
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• pp.249-256
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• 1986

The carp (Cyprinus carpio) used in the experiment were hatched in the spring this year and reared to 5.96g($4.84{\sim}6.55g$) in mean weight in a nursery pond at Daeyon fish farm, Pusan, Korea. The sample fish were exposed to different conditions of total ammonia (TA-N) concentrations 10, 20 and 30ppm and pH 6.5, 7.0, 7.5 and 8.0 at water temperatures 20, 25 and $30^{\circ}C$ for 24, 48 and 72 hours. After the procedure, the gill, liver and kidney of the fish were examined histopathologically. In this experiment, with the rise of water temperature, increase of pH and ammonia concentration, and the extension of exposure time the three organs showed the tendency of apparent abnormal changes such as hypertrophy and necrosis in their tissues. At $20^{\circ}C$ of water temperature gill tissue did not show any abnormality regardless of the change of pH at 10 ppm of ammonia concentration for 24 hours of exposure, but beyond the conditions given above, there occurred hypertrophy and the epithelium of gill lamellae was detached. The detach of gill lamellae epithelium initiated from the proximal part of the gill lamellae then gradually spread toward the uppermost tip. The heavier vacuolation of the liver was observed with the rise of water temperature and pH, and such morbid state in the liver was considered to be the result of edema in the liver tissue. The kidney showed no damage to the renal tubule epithelium at pH 6.5, but it was damaged at pH 8.0 when exposed to 30 ppm ammonia at $20^{\circ}C$ for 24 hours.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.1
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• pp.13-24
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• 2008

This Chapter mentioned Terror and Palpitation due to Fright(驚悸) and Hemorrhagic disease(血證). Terror and Palpitation due to FrightAcctually Terror(驚) is different from Palpitation(悸). Terror(驚) is one of the seven emotions. But in this case, It refer to the Palpitation and the uneasiness of mind due to one's hearing a strange sound of seeing a strange. Tremulous Pulse can be appear. So Terror(驚) is caused by Exopathic Factors(外因) and belongs to Excess syndrome(實證). Palpitaion(悸) is the sensation of plamus, palpitation and unrest not because of being frightened. It is usurally caused by the deficiency of Ki(氣) and blood(血). So Deep, Thready and weak pulse can be appear. So Palpitaion(悸) is caused by Endopathic Factors and belongs to Deficiency Syndrome. In this Chapter, Terror and Palpitation due to Fright(驚悸) treat with the Kyeji-ke-jakyak-ka-chokchil-moryu-yongkol-kuyuk-tang(桂枝去芍藥加蜀漆牡蠣龍骨救逆湯) and Banha-mahwang-hwan(半夏麻黃丸). There are two type in Hemorrhagic disease(血證). One is bleeding(出血) and another is blood stasis(瘀血). The contents which relate with the Hemorrhagic disease(血證) are Hematemisis(吐血), Rhinorrhagia, Hemafecia(下血). In hemorrhage pathological mechanisms, there are two mechanisms. One is that Fire and Heat(火熱) pressure blood. Another is that cold and deficiency(虛寒) disable Ki(氣) from keeping blood flowing within vessels. Blood stasis(瘀血) can be called Extravasated Blood(惡血), Coagulated Blood, Blood retention(蓄血,積血), Dead Blood(死血) and Emaciation due to Blood disorder(乾血). It refer to a morbid state of unsmooth circulation and blood stagnancy often resulting from Ki(氣) stagnation, Ki(氣) deficiency and accumulation of pathogenic coldness. The symptom of Blood stasis are 'Fullness sensation in the chest, Lip Flaccidity, Cyonotic Tongue and Dryness of Mouth'. And the man who have Blood stasis, want to rinse his mouth with the water, but he can't drink the water because there isn't interior Heat of Excess Type. The symptom of Cyonotic Tongue(舌靑) had influence on diagnosing Blood stasis(瘀血) in offspring.

• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.47-55
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• 1996

Narcolepsy is characterized by sleep attack with excessive daytime sleepiness(EDS), cataplexy, sleep paralysis, and hypnagogic hallucination. Paradoxically, narcoleptics tend to complain of frequent arousals and shallow sleep during the night time despite their excessive sleepiness. However, nocturnal sleep fragmentation in narcoleptics is relatively ignored in treatment strategies, compared with sleep attack/EDS and cataplexy. In our paper, we attempted to investigate further on the poor nocturnal sleep in narcoleptics and to discuss possible treatment interventions. Out of consecutively seen patients at Seoul National University Sleep Disorders Clinic and Division of Sleep Studies, we recruited 57 patients, clinically assessed as having sleep attack and/or EDS. Nocturnal polysomnography and multiple sleep latency test(MSLT) were done in each of the subjects. We selected 19 subjects finally diagnosed as narcolepsy(mean age $26.0{\pm}18.3$ years, 16 men and 3 women) for this study, depending on the nocturnal polysomnographic and MSLT findings as well as clinical history and symptomatology. Any subject co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep was excluded. Sleep staging was done using Rechtschaffen and Kales criteria. Sleep parameters were calculated using PSDENT program(Stanford Sleep Clinic, version 1.2) and were compared with the age-matched normal values provided in the program. In narcoleptics, compared with the normal controls, total wake time was found to be significantly increased with significantly decreased sleep efficiency(p<.01, p<.05, respectively), despite no difference of sleep period time and total sleep time between the two groups. Stage 2 sleep%(p<.05), slow wave sleep%(p<.05), and REM sleep%(p<.01) were found to be significantly decreased in narcoleptics compared with normal controls, accompanied by the significant increase of stage 1 sleep%(p<.01). Age showed negative correlation with slow wave sleep%(p<.05). The findings in the present study indicate significant fragmentation of nocturnal sleep in narcoleptics. Reduction of REM sleep% and the total number of REM sleep periods suggests the disturbance of nocturnal REM sleep distribution in narcoleptics. No significant correlations between nocturnal polysomnographic and MSLT variables in narcoleptics suggest that nocturnal sleep disturbance in narcoleptics may be dealt with, in itself, in diagnosing and managing narcolepsy. With the objective demonstration of qualitative and quantitative characteristics of nocturnal and daytime sleep in narcoleptics, we suggest that more attention be paid to the nocturnal sleep fragmentation in narcoleptics and that appropriate treatment interventions such as active drug therapy and/or circadian rhythm-oriented sleep hygiene education be applied as needed.

• Korean Journal of Acupuncture
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• v.18 no.1
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• pp.105-116
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• 2001

We examined and referred to some literatures on the meaning, Dai meridian and Meridian points of joining with circulation of Dai meridian through literatures of every generation. And then we came to get a few conclusions as follows. 1. Dai meridian starts below the hypochondriac region. Running obliquely downward, it runs transversely around the waist like a belt. Its function is to bind up all the meridians to circulate in a proper way. 2. The coalescent points of dai meridian are $D\grave{a}im\grave{a}i$(帶脈), $W\check{u}sh\bar{u}$(五樞) and $W\acute{e}id\grave{a}o$(維道). 3. Location of $D\grave{a}im\grave{a}i$(帶脈) is on the lateral side of the abdomen, 1.8 cun below $Zh\bar{a}ngm\grave{e}n$(章門), at the crossing point of vertical line through the free end of the 11th rib and a horizontal line through the umbilicus. Location of $W\check{u}sh\bar{u}$(五樞) is on the lateral side of the abdomen, anterior to the anterosuperior iliac spine, 3 cun below the level of the umbilicus. Location of $W\acute{e}id\grave{a}o$(維道) is on the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine, 0.5 cun anterior and inferior to $W\check{u}sh\bar{u}$(五樞). 4. Indication of $D\grave{a}im\grave{a}i$(帶脈) is irregular menstruation, leukorrhea with reddish discharge, hernia, pain in the lumbar and hypochondriac region. Indication of $W\check{u}sh\bar{u}$(五樞) is prolapse of the uterus, leukorrhea with reddish discharge, irregular menstruation, hernia, pain in the lower abdomen, constipation and lumbosacral pain. Indication of $W\acute{e}id\grave{a}o$(維道) is edema, pain in the side of the lower abdomen, prolapse of the uterus, hernia and morbid leukorrhea. 5. The Dai meridian binds all meridians, produces pregnancy, grasps lumbar and abdomen region and controls leukorrhea. 6. Diseases of the Dai meridian manifested as distention and fullness in the lumbar region and abdomen, leukorrhea with reddish discharge, pain the navel, lumbar and spinal regions, flaccidity and hypoactivity of the lower limbs, etc.