• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.159-166
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• 2024

Objective: The purpose of this case study is to report the effectiveness of the Korean medicine Beewha-eum as a treatment for functional dyspepsia (FD). Methods: A patient diagnosed with a spleen-stomach deficiency-cold pattern in Korean medicine was treated with herbal medicines, including Beewha-eum. Symptom severity was assessed using the degree of self-reported dyspepsia (%), self-reported energy level, amount of food intake (%), total parenteral nutrition rate (cc/hour), body weight (kg), Nepean dyspepsia index (NDI-K), functional dyspepsia-related quality of life questionnaire (FD-QoL), and short form 36-item health survey (SF-36) score. Results: After treatment, the symptom severity of self-reported dyspepsia decreased from 100% to 10 to 15%, and the self-reported energy level increased from 20 to 80. The amount of food intake increased from 5% to 100%, and the total parenteral nutrition rate started from 60 cc/hour end in week 5. Body weight increased from 53.1 kg to 62 kg. The NDI-K score decreased from 105 to 31. The FD-QoL score increased from 19 to 68. The SF-36 score also increased from 102 to 116. Conclusion: The results suggest that the Korean medicine Beewha-eum could be an effective option for treating FD.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.299-314
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• 1977

Clinical experience on 16 cases of open heart surgery under the extracorporeal circulation with mild or moderate hypothermia and partial hemodilution technique at the National Medical Center during the period from June 1976 to October 1977. Nine of sixteen were congenital heart disease and seven were acquired heart disease. The age of the patient ranged between 6 and 48 years. The body weight varied from 18.5kg to 60kg and body surface area 0. 79-1.70m2. The average priming volume of pump oxygenator was 2080 ml, which was consisted fresh ACD blood, buffered Hartmann`s solution, Mannitol, 50% dextrose in water and Vit. C. The average hemodilution rate was 27%. The average flow 2.3 L/min/m2 or 80 ml/min and the duration of perfusion varied from 31 min to 270 min with average of 107 min. The perfusion was carried out under the mild or moderate hypothermia using core cooling alone in 10 cases, core cooling and local myocardial cooling with $0-4^{\circ}C$ physiologic saline in 2 cases. From a hemodynamic point of view, the blood pressure dropped down around 80 mmHg after the initiation of perfusion follwed by increase to safety level and stable during the perfusion. The central venous pressure remained within normal limits. In most cases, hemoglobin and hematocrit decreased during and after the perfusion. Hemogiobin level was decreased, average of 20.6 %, hematocrit 18.6%, pletelets 55% postoperatively. Plasma hemoglobin increased moderately, from preperfusion average valve of 7.79 mg % to post-perfusion value of 54.7 mg %. Electrolytes changes during cardiopulmonary bypass showed definite hypokalemia but changes of Na, Ca were not definite. Arterial blood gas analysis during cardiopulmonary bypass suggested that the metabolic acidosis which was accompanied by respiratory alkalosis which was corrected postoperatively. As the opera tive complication, transient hemoglobinuria in 4 cases and neurological signs in 2 cases were all cured. There were 2 death cases and operative mortality rate was 12.5%.

• Health Policy and Management
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• v.23 no.1
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• pp.19-34
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• 2013

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

• Journal of the Ergonomics Society of Korea
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• v.36 no.4
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• pp.305-323
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• 2017

Objective: The purpose of this study was to determine breast shape and ratio of breast enlargement women prior to development of breast enlargement patient's bra. Background: Although there are many previous studies on women's breast that did not undergo breast augmentation surgery, no studies have examined the breast type and proportion of women with breast augmentation. Method: In this study, we analyzed ratios and angles with photographs taken before and after breast augmentation on the frontal and lateral views of the breast, UPF and projection were analyzed too. We also compared the pre-operative and post-operative rates with those of previous breast studies, as well as the post-operative breast types for the desirable breast types. Results: The length and width of the breast base and the height of the breast projection increased after the operation. The rate of increase in width is larger than the vertical distance in the breast base, and the rate of increase in height of the projection is larger than the increase in the width. Specifically, in the vertical distance, the rate of increase in the lower portion is larger than that in the upper portion. In the width, the rate of increase on the inside is larger than that on the outside. Conclusion: The angles of the static relationship with the projection increased and the angles of the minor relation decreased. The changes in the size of the breast were visually observed in the overlapping of the triangle shape before and after the surgery. The changes were composed of the line connecting the angle and the measurement points. The pre-operative upper pole fullness (UPF) was mostly 0 and - 1, but after the surgery, +1, 0, -1, +2 were distributed, while post-operative levels of projection were distributed in the order of level 3> level 1> level 2. In comparison with the desirable breast type, it was found that the anatomical type was a more natural breast type than the round type of implant. Application: These results can be useful as basic data for the breast analysis of breast enlargement patients and their bra patterns.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.2
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• pp.111-117
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• 2017

Objective: The aim of this study was to evaluate pregnancy outcomes and the live birth rate at 1-year age increments in women aged ${\geq}40years$ undergoing fresh non-donor in vitro fertilization (IVF) and embryo transfer (ET), and to identify predictors of success in these patients. Methods: This retrospective study was performed among women ${\geq}40years$ of age between 2004 and 2011. Of the 2,362 cycles that were conducted, ET was performed in 1,532 (73.1%). Results: The clinical pregnancy rate and live birth rate in women ${\geq}40years$ significantly decreased with each year of increased age (p<0.001). Maternal age (odds ratio [OR], 0.644; 95% confidence interval [CI], 0.540-0.769; p<0.001), basal follicle-stimulating hormone (FSH) levels (OR, 0.950; 95% CI, 0.903-0.999; p=0.047), the number of high-quality embryos (OR, 1.258; 95% CI, 1.005-1.575; p=0.045), and the number of transferred embryos (OR, 1.291; 95% CI, 1.064-1.566; p=0.009) were significant predictors of live birth. A statistically significant increase in live birth rates was seen when ${\geq}3$ embryos were transferred in patients 40 to 41 years of age, whereas poor pregnancy outcomes were seen in patients ${\geq}43years$ of age, regardless of the number of transferred embryos. Moreover, the cumulative live birth rate increased in patients 40 to 42 years of age with repeated IVF cycles, but the follicle-stimulating hormone in those ${\geq}43years$ of age rarely showed an increase. Conclusion: IVF-ET has acceptable outcomes in those < 43 years of age when a patient's own oocytes are used. Maternal age, basal FSH levels, and the number of high-quality embryos and transferred embryos are useful predictors of live birth.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.1
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• pp.31-37
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• 2016

Objectives: The aim of the present study was to evaluate changes in the management and 5-year survival rates of patients with oral cancer in our department over a 30-year period. Materials and Methods: We investigated the patient distributions, treatment methods, method of neck dissection according to cancer stage, and 5-year survival rates for 700 oral cancer patients over the periods of 1982-1996 (256 patients), 1999-2006 (248 patients), and 2007-2011 (196 patients). Results: Stage IV patients were the largest group in all of the time periods evaluated. Although surgery and radiotherapy were the most common methods in all periods (over 50%), the prevalence of patients who underwent concomitant chemoradiotherapy increased from 7.0% to 16.2%. The use of radical neck dissection decreased from 43.0% to 5.3%, while conservative surgical methods increased from 24.1% to 76.3%. Lastly, the overall 5-year survival rate increased from 31.6% to 63.5% during the study period. Conclusion: Although the 5-year survival rate reached the same level as that of other developed countries during the course of our study, most patients continue to come to the hospital with stage IV disease. In order to increase the 5-year survival rate of oral carcinoma, it may be necessary to improve public education and social efforts relevant to early diagnosis.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.135-142
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• 2023

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

• Journal of Korean Traditional Oncology
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• v.16 no.1
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• pp.15-31
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• 2011

Objective : The study aims to investigate the effect of moxibustion treatments on autonomic nervous system function of cancer patients through the evaluation of heart rate variability (HRV) biofeedback testing. Materials and Methods : Six cancer patients from inpatient care unit of Dunsan Oriental Hospital, Daejeon University were given three moxibustion treatment sessions every other day over one week period on five Oriental Medicine meridian points CV4, CV6, CV12, KD1, and PC8. HRV biofeedback was conducted before and after each treatment sessions. Three areas of analyses were done from the test conducted; Time Domain Analysis, Frequency Domain Analysis and Autonomic Nervous System (ANS) balance analysis. Results : Time Domain Analysis has shown increased Standard Deviation of all Normal R-R Intervals (SDNN), and decreased Mean Heart Rate and Physical Stress Index (PSI) levels, with statistical significance (P<0.05). In Frequency Domain Analysis, series of moxa treatments have increased Total Power (TP), Very Low Frequency Oscillation Power (VLF), High Frequency Oscillation Power (HF), normalized HF values while decreasing Low Frequency Oscillation Power (LF), normalized LF and LF/HF ratio with statistical significance (P<0.05). The values of ANS activity, ANS balance, Stress resistance, Stress index, have also shown significant changes. For cardiac stability stroke volume power (SP) and Blood Vessel Tension (BVT) were followed, which were both increased after treatment. All changes were statistically significant (P<0.05). Conclusion : The results have shown a positive correlation between the moxibustion treatments and autonomic nervous system responses on cancer patients through the HRV biofeedback testing. This study suggests possible application of moxibustion treatments for managing ANS functions of cancer patients, although additional studies with larger population are necessary to confirm the data.

• Korean Journal of Acupuncture
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• v.24 no.1
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• pp.27-41
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• 2007

Objectives : The aim of this study was to investigate the antihypertensive effect of Korean Gogoon Acupuncture in hypertensive patients. Methods : We measured the blood pressure of 17 patients who were admitted in the Oriental Medical Clinic of Gogoon Institute from 14th April 2006 to 29th August 2006. Eligible participants had systolic blood pressure ${\geq}120$ mmHg or diastolic blood $pressure{\geq}80$ mmHg. Blood pressure and pulse rate measurements were after the patient had been in bed rest for at least 30 min. Six sessions of Gogoon Acupuncture treatment over three weeks were performed in the patients. Blood pressure and pulse rate were measured twice before and after each acupuncture treatment. Results : After 3 weeks, there were significant decreases in systolic blood pressure(p=0.0028), diastolic blood pressure (p=0.0111) and pulse rate (p=0.0150). The effects of Gogoon Acupuncture by measuring time on blood pressure were as follows : In a systolic blood pressure (p<.0001) and diastolic blood pressure (p=0.0028) was gradually deceased significantly from 1st to 6th but pulse rate was not significantly decreased. Conclusions : Controlled trials investigating the efficacy of Gogoon acupuncture for lowering blood pressure are warranted.