• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.330-339
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• 2012

Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.

• The Journal of Korean Medicine
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• v.34 no.2
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• pp.41-50
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• 2013

Objectives: As a newcomer to the medical tourism industry, Korea needs to differentiate itself from the leading competing countries to vitalize its early-stage medical tourism industry. This study aims to introduce a strategic plan to vitalize the Korean integrated medical tourism so that Korea can differentiate itself from competing countries and create high added value. Methods: The concept and actual conditions of medical tourism and Oriental medical tourism were examined. A plan to differentiate Korea from the competing countries in the medical tourism industry was studied to create high added-value through strategic vitalization of its medical tourism industry. Results: Korean integrated medical tourism must be developed differently from those of other South-East Asian countries in order to strategically promote the cash-cow medical tourism industry. In order to develop such medical tourism, Korean medical practice, which integrates Western and Oriental medicine, is to be developed through mutual understanding and fusion of other disciplines among medical doctors and Oriental medical doctors who are working in local healthcare for health promotion of local residents and disease prevention and control. This will play a key role in developing a unique medical tourism product of Korea by means of strategic alliances as an integrated medicine. Manpower specialized for integrated medicine is to be specially supplied for Oriental medicine-related business lines at city, county and borough levels, among local governments, that are enthusiastically carrying forward Oriental medical tourism with an interest to promoting more active and strategic business development and raise the effectiveness and efficiency of public health centers handling related medical tourism. Manpower specialized for Korean integrated medical tourism is to be specially supplied for the Ministry of Culture, Health and Tourism, a policy control tower to develop and vitalize high value-added fusion (theme) tourism products such as the Korean integrated medical tourism, in order to discover, promote and support Korean integrated medical tourism's differences from existing medical tourism. Conclusions: The differentiated integrated medical tourism that only Korea can offer in a variety of forms, in order to create a key area of high value-added medical tourism, should be strategically vitalized through a liaison between integrated medicine and tourism and the realization of patient-centered health care services with medical technology developed based on mutual understanding of Western and Oriental medicine.

• Journal of the Korean Society of Radiology
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• v.1 no.2
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• pp.5-11
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• 2007

Intussusception is one of the most common cause of bowel obstruction in infant under the two years old, especially in male. Clinical analysis was enrolled on 54 intussusception cases who were diagnosed by ultrasound and treated by non-operative reduction at the Presbyterian Medical Center from June 2005 to May 2007. The results were as follow. 1) There was the most common(40.7%)between thirteen and twenty four months on the distribution of age. Male(72.2%) and female(27.8%) were in the ratio of 2.6:1 on the distribution of gender 2) The frequent symptoms were abdominal pain with grizzle(100.0%), vomiting(66.7%) and diarrhea(33.3%). There was a significant difference among them(p<0.05). There was the most common(46.3%) between 10,000/$mm^3$ and 15,000/$mm^3$ in the result of WBC. 3) 42.6% of patient at a private hospital performed primary care. The treatment after initiating the symptom of intussusception was performed between 6 hrs and 12hrs (37.0%). 4) The most common type and portion of intussusception were ileo-colon(98.1%) and hepatic flexure (68.5%). 5) 88.0% at air reduction and 86.2% at barium reduction were successful. The reduction rate were similar to both techniques. There was no significant difference between them(p>0.05).

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.193-199
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• 1999

Background: Measurement of body temperature is an important parameter in patient management in many clinical conditions. Failure to reach minimal acceptable body temperature standards has been associated with physiological derangements and has necessitated the application of additional therapy. The authors developed a new, simple, accurate thermometry system, which could be used to undertake precise temperature measurement for various clinical conditions. Materials and Methods: A new thermometry system using a specially designed temperature detecting and display system was developed. This system contains a temperature detecting sensor(LM 35CZ), which enables multiple serial checking of heat, data collection and processing computer, and 3-dimensional display system. It provides real time volumetric visualization of temperature distribution of a defined volume and stores and prints the data. Results: With this system, temperature can be measured at multiple interesting sites simultaneously, demonstrated as a 3-dimensional temperature distribution and stored. In well-controlled, systematic experiments a significant correlation has been observed between standard temperature and temperature using this system at various measuring points. Conclusion: This thermometry system is a real-time measurement system, which can demonstrate 3-dimensional heat distribution in experimental phantom and human body and can be used for diagnosing abnormal clinical conditions. In addition, this system reduces the nursing staff work load, providing them more time for long term care to patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6883-6888
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• 2013

Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.

• Women's Health Nursing
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• v.1 no.1
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• pp.119-137
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• 1995

Maternity nurses' roles are to find out women's various responses related to the health problems during pregnancy, to intervene adequate nursing and supports, and to help them adapt satisfactorily to new situation, such as hospitalization. The purposes of this study are : firstly, to inquire about women's emotional status, feeling of discomfort, and the nursing need during hospitalization because of discomfort, and the nursing needs during hospitalization because of the possibility of abortion by threatened and habitual abortion : secondly, to provide fundamental data for developing adequate nursing intervention and improving hospital management. The subjects of this study were 62 women who were hospitalized, visited out-patient clinic for follow-up, and stayed at home after discharge since August, 1993 from one hospital located in Seoul, from March 23 to April 13, 1994. The questionnaire was consisted of 21 items of emotion(Reliability Cronbach's alpa, .77), 19 items of feeling of discomfort(.79), and 21 items of nursing needs (.89), and nurses' performance according to nursing needs,(.90). These were measured by using Likert Scale and analyzed by using SPSS / $PC^+$ with the descriptive statistics, $X^2$-test, and ANOVA. Research findings are as follows : 1) The subjects' average age, hospitalized days, and gestational age are 32.2, 15.7, 12.9 by respectively. 2) 88.7% of the subjects are getting antepatal care, 66.1% are experiencing 1.75 times of spontaneous abortion, and 82.3% are nuclear family. 3) The Emotions were mainly comprized negative and subjective state of minds such as uneasiness, anxiety, and discomfort. The domains of emotions were related to 'fetus', 'herself', 'hospitalization', and 'husband's 'families', in rank. The highest scored item was "I, above anyone else, am mostly stressed from abortion." 4) The feelings of discomforts were firstly related to 'personal discomfort arising from absolute bed rest', 'meals provided', Usage of hospital, perse', 'health team', in rank. 5) The nursing needs frequently pointed out were 'Nurses kindly explain of me the purpose, method, and results of the lab. test', 'Nurses sincerely pay attention to my word in communication'. The least nursing needs were 'Nurses observe my feces and whether I have constipation or not'. 'When I can't move, nurses help me by holding my arms or pulling my bed'. 6) The highest performed items were 'Nurses observe whether I bleed or not', and 'Nurses give me drug with exact dose in time'. The least performed items was about hospital environment, such as 'Temperature, ventilation & humidity in the room should be controlled'. 7) Besides religion that is related to nursing need with statistically significant difference, none of general characteristics were related to emotion, feeling of discomfort, and nursing needs.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.65-70
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• 2009

Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was $33.9{\pm}14.2$ years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was $11.26{\pm}2.52$, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was $5.80{\pm}14.56$, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.50-59
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• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• Journal of Digital Convergence
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• v.13 no.2
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• pp.245-256
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• 2015

In this study, to provide the implications of dental health care training direction in the future after researching the effect on the use of dental hygiene devices, data were collected from 320 patients who visited dental clinics located in Seoul and Gyeonggi-do for about 6 months between December 2013 and May 2014. Among them, the following results were obtained by analyzing 299 copies accounting for 93.4% of the collected data after excluding 21 copies lacking in answer. It was shown that education about dental hygiene devices had statistically significant effects on the dependent variables, perception of dental hygiene devices (p<0.001). Based upon the results above, it is considered that for the sake of prevention of oral diseases, more opportunities to learn correct knowledge and usage of suitable dental hygiene devices for individual oral conditions should be provided for patients, and active patient education as well as the development, implementation and publicity of systematic and popular oral health education programs will contribute to improved oral health.

• Journal of Korean Academy of Rural Health Nursing
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• v.4 no.1
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• pp.13-21
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• 2009

Purpose: This study was done to investigate the prevalence and related factors of Clonorchis Sinensis for inhabitants of the Han riverside area and to identify knowledge related to Clonorchis Sinensis and intended behavioral changes to decrease risk of infection. Method: The data were collected from December 16, 2008 to January 10, 2009. Participants were 555 people who responded to a questionnaire. Frequency, percentage, $X^2$-test, and t-test were used to analyze the data. Results: The prevalence of Clonorchis Sinensis was 7.9% in this population. Related factors for Clonorchis Sinensis were gender (male=10.8%, female=3.6%, p=0.002) and smoking (p=0.007). but habits related to ingestion of alcohol and raw fish were not significant. As for knowledge of Clonorchis Sinensis, the Clonorchiasis group had a mean score of 10.09 $({\pm}3.95)$ of a possible 17 compared to a score of only 8.27$({\pm}4.60)$ for the negative group (p=0.011). The intended behavioral change related to risk of infection, according to presence of infection or not, was significant (p=0.004). Conclusion: These results suggest that Clonorchiasis is still highly endemic in all risk areas such as the Han riverside, indicating that it is necessary to set up effective management programs for patient care and prevention of Clonorchis Sinensis.