• Title/Summary/Keyword: public health practice

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AN EPIDEMIOLOGIC STUDY ON THE PEDIATRIC PATIENTS IN DEPARTMENT-OF PEDIATRIC DENTISTRY, CHOSUN UNIVERSITY DENTAL HOSPITAL FOR LAST 10 YEARS(1990-1999) (최근 10년간 조선대학교 치과병원 소아치과에 내원한 신환에 관한 역학적 연구(1990-1999))

  • Ryu, Hyun-Seop;Kim, Hyo-Suck;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.345-354
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    • 2001
  • The purpose of this study was to make public oral health plan more effective and the improvement of the hospital management system for better clinical dental practice. Distribution and trends were examined in all patients who had been examined and diagnosed at Department of Pedodontics, Dental Hospital, Chosun University over 10 year-period from 1990 to 1999 Results were as follows, 1. The number of patients per year was increasing trend after 1996 and higher visiting rate in male(55.9%) than in female(44.1%). 2. Age distribution had shown $3\sim4$ year-old cup being the largest (23.4%) and each percentage of $5\sim6,\;7\sim8,\;0\sim2,\;9\sim10,\;11\sim12,\;13\sim14,\;above\sim15$ year-old group was 19.9%, 17.7%, 14.6%, 12.6%, 8.0%, 3.3%. 0.5%. 3. Geographic distribution showed a majority of patients in Kwang-Ju (83.0%). Group in the suburbs of Kwang-Ju(Jang-Sung group) was 5.4%. 4. Dental caries showed the highest percentage(40.5%) in chief complaints and percentage of oral exam, orthodontic problem, oral pain, trauma, supernumerary teeth, swelling was 13.9% 12.6%, 8.8%, 7.4%, 5.5%, 4.9%. 5. In all patients with traumatic problem, crown fracture showed the highest percentage(41.4%) and percentage of subluxation was 19.4%. 6. Majority(78.7%) of patients were not refered, and percentage of patients refered from local clinic was 20.5%. 7. Patients who had periodic check-up comprised 19.6%, and percentage of after 3, 6, 9, 12, 18, 24month was 36.7%, 22.2%, 13.5%, 11.3%, 5.4%, 11.0%.

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Analysis of online breast-feeding consultation on the website of the Korean Pediatric Society (대한소아과학회 홈페이지의 모유수유 상담내용 분석)

  • Kim, Jung Yun;Hwang, Seung Jae;Park, Hyun Kyung;Lee, Ha-beck;Kim, Nam Su
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1152-1157
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    • 2008
  • Purpose : Since the infant formula milk has been produced in Korea, it has faced a low rate of breast milk feeding, though breast milk feeding is a little increasing. Therefore, the Korean Pediatric Society launched its website for breast-feeding consultation to provide information to the general public and enhance the health of growing infants. The consultation results were analyzed to identify the problems that mothers encounter during breast-feeding. Methods : From August 1, 2004 to July 31, 2007, 1001 mothers who visited the online consultation webpage (www. pediatrics.or.kr) of the Korean Pediatric Society asked 1,021 questions. The questions were divided into 3 major categories and 14 specific categories. Interesting questions asked more than 100 times were retrospectively analyzed. Results : The results for the major categories were as follows: 413 questions (40.3%) were on how to breast-feed, 315 (30.8%) on problems of feeding mothers, and 293 (28.8%) on problems of the fed babies. In the specific categories, 22.2% of the questions were on how to breast-feed. With the increasing number of working couples and working mothers, many questions were asked on the problems of breast-feeding after returning from work. Conclusion : The author expects that analyses of these consultations will contribute to the enhancement of information on the consultation website, thus enabling to provide clearer answers to people's increased interest in and concerns on breast-feeding. Furthermore, this research will help to establish correct breast-feeding practice.

Practice guidelines for managing extrahepatic biliary tract cancers

  • Hyung Sun Kim;Mee Joo Kang;Jingu Kang;Kyubo Kim;Bohyun Kim;Seong-Hun Kim;Soo Jin Kim;Yong-Il Kim;Joo Young Kim;Jin Sil Kim;Haeryoung Kim;Hyo Jung Kim;Ji Hae Nahm;Won Suk Park;Eunkyu Park;Joo Kyung Park;Jin Myung Park;Byeong Jun Song;Yong Chan Shin;Keun Soo Ahn;Sang Myung Woo;Jeong Il Yu;Changhoon Yoo;Kyoungbun Lee;Dong Ho Lee;Myung Ah Lee;Seung Eun Lee;Ik Jae Lee;Huisong Lee;Jung Ho Im;Kee-Taek Jang;Hye Young Jang;Sun-Young Jun;Hong Jae Chon;Min Kyu Jung;Yong Eun Chung;Jae Uk Chong;Eunae Cho;Eui Kyu Chie;Sae Byeol Choi;Seo-Yeon Choi;Seong Ji Choi;Joon Young Choi;Hye-Jeong Choi;Seung-Mo Hong;Ji Hyung Hong;Tae Ho Hong;Shin Hye Hwang;In Gyu Hwang;Joon Seong Park
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.161-202
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    • 2024
  • Backgrounds/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions: The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.