• Journal of Gastric Cancer
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• v.19 no.2
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• pp.157-164
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• 2019

Purpose: Although standard radical gastrectomy is recommended after noncurative resection of endoscopic submucosal dissection (ESD) for early gastric cancer in most cases, residual tumor and lymph node metastasis have not been identified after surgery. The aim of this study is to evaluate the feasibility of sentinel node navigation surgery after noncurative ESD. Materials and Methods: This trial is an investigator-initiated, multicenter prospective phase II trial. Patients who underwent ESD for clinical stage T1N0M0 gastric cancer with noncurative resections were eligible. Qualified investigators who completed the prior phase III trial (SENORITA 1) are exclusively allowed to participate. In this study, 2 detection methods will be used: 1) intraoperative endoscopic submucosal injection of dual tracer, including radioisotope and indocyanine green (ICG) with sentinel basins detected using gamma-probe; 2) endoscopic injection of ICG, with sentinel basins detected using a fluorescence imaging system. Standard laparoscopic gastrectomy with lymphadenectomy will be performed. Sample size is calculated based on the inferior confidence interval of the detection rate of 95%, and the calculated accrual is 237 patients. The primary endpoint is detection rate, and the secondary endpoints are sensitivity and postoperative complications. Conclusions: This study is expected to clarify the feasibility of laparoscopic sentinel basin dissection after noncurative ESD. If the feasibility is demonstrated, a multicenter phase III trial will be initiated to compare laparoscopic sentinel node navigation surgery versus laparoscopic standard gastrectomy in early gastric cancer after endoscopic resection.

• 한국노년학
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• v.31 no.1
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• pp.129-141
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• 2011

This study aims to find out effects of a tailored occupational activity program(TOAP) on the activities of daily living(ADL), cognitive function, depressive mood, and caregiver burden, who live in the community. Method : From October 2009 to May 2010, the TOAP was applied to 15 dementia patients and 15 of their caregivers, who was visitors of the Y-city Center for Managing Dementia in Gyunggi-do. The TOAP was designed for habituating patients and caregivers to the techniques acquired through goal activities and task and making it capable of being routinized regularly. The TOAP was applied to dementia patients and their cvaregivers twice a week for 7 weeks(one-time home visit, one-time phone inspection), a total of 14 times. Results: Significant differences among pre-test and post-test were found in the AMPS motor skills(1.10±1.14 and 1.34±1.2 respectively) scores, AMPS process skills(0.32±0.55 and 0.77±0.66 respectively) scores, ACL(3.86±0.65 and 4.17±0.64 respectively) scores, MMSE-KC(17.33±4.6 and 19.33±4.97 respectively) scores, GDS(11.73±6.87 and 8.53±7.09 respectively) scores, and caregiver burden(31.80±20.06 and 26.13±18.07 respectively) scores(p<0.05). A significant effect was confirmed from the TOAP which ADL, cognitive function, reduced patient's depression and caregiver burden(p<0.05). Conclusion: From the above results that a TOAP has an effect on the improvement of the ability to ADL, cognitive function and reduced depression and caregiver burden of dementia patients living in community. The present author hopes that, in the future, more diverse community based on tailored occupational activity programs will be developed to improve the functions of dementia patients living in community.

• Journal of Gastric Cancer
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• v.18 no.1
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• pp.30-36
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• 2018

Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.354-363
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• 2006

Headaches are common in children and become more common and increase in frequency during adolescence. There are various causes of headaches. The majority of cases are considered as primary and include migraine and tension headaches. The rational evaluation of headache begins with careful history. Migraine is genetically determined recurrent pain syndrome accompanied by neurological and gastrointestinal features, involving interaction of external triggers and internal pathophysiology and the causes of considerable disability to suffers. Establishing the correct diagnosis is essential for successful treatment. Treatment of pediatric migraine includes an individually tailored regimen of both nonpharmacologic and pharmacologic measures.

• Health Policy and Management
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• v.26 no.1
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• pp.1-3
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• 2016

The prevalence of non-communicable disease (NCD) has been continuously increasing due to population ageing, and the change in consumption and lifestyle patterns. Cancers, cerebrovascular diseases, and hypertensive diseases have been the major causes of deaths in the Republic of Korea since 1983. Numerous studies have suggested the need for a sustained comprehensive treatment tailored for individual patients and recommend the development of a systematic program to manage NCD patients to provide such care. It's necessary to develop the Korean model of the community based NCD prevention and control, consisting strategy of community movement, education for the NCD patients, and partnership the primary care clinic with public health organization to meet the needs in community people.

• Korean Journal of Bronchoesophagology
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• v.19 no.1
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• pp.5-10
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• 2013

Bilateral vocal cord palsy (BVCP) present a challenging condition which result from various etiologies including iatrogenic recurrent laryngeal nerve injury, progressive neurological disorder, intubation, trauma, tumor and idiopathic cause. Careful history taking, laryngoscopic evaluation, laryngeal EMG, and imaging studies are helpful for providing a precise diagnosis and planning appropriate treatment. BVCP causes airway restriction and not vocal dysfunction. In patients with BVFP, treatment is directed at maximizing the airway, while attempting to limit the negative effects of treatment on vocal function. A variety of surgical procedures are available for mangement of BVCP. The most conservative, limited procedure should be selected initially, and then further surgery and more extensive surgery can be tailored to the patient's airway and voice needs. This review will address the etiology, diagnosis, and managements of BVCP.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.277-280
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• 2018

Although small bowel the mainly occupies the most part of the gastrointestinal tract, small intestine tumors are rare, insidious in clinical presentation, and frequently represent a diagnostic and management challenge. Small bowel tumors are generally classified as epithelial, mesenchymal, lymphoproliferative, or metastatic. Familial adenomatous polyposis and Peutz-Jeghers syndrome are the most common inherited intestinal polyposis syndromes. Until the advent of capsule endoscopy (CE) and device-assisted enteroscopy (DAE) coupled with the advances in radiology, physicians had limited diagnostic examination for small bowel examination. CE and new radiologic imaging techniques have made it easier to detect small bowel tumors. DAE allows more diagnosis and deeper reach in small intestine. CT enteroclysis/CT enterography (CTE) provides information about adjacent organs as well as pictures of the intestinal lumen side. Compared to CTE, Magnetic resonance enteroclysis/enterography provides the advantage of soft tissue contrast and multiplane imaging without radiation exposure. Treatment and prognosis are tailored to each histological subtype of tumors.

• Archives of Obesity and Metabolism
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• v.2 no.1
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• pp.11-16
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• 2023

Nutrition counseling and dietary intervention are essential to obesity management because weight reduction is the consequence of negative energy balance. The first step of the nutrition counseling in patients with obesity is thorough evaluation of the nutritional status. During the nutritional evaluation, amount of energy consumption, dietary habits, and medical and socioeconomic factors influencing diets should be evaluated. Diet interventions including low calorie diet, low fat diet, low carbohydrate diet, and high protein diet are all effective in weight reduction as long as decrease in energy consumption is accompanied. Amount of energy restriction and choice of diet interventions should be individualized based the medical condition and characteristics of each patient.

• Journal of Korean Medical classics
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• v.36 no.4
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• pp.41-54
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• 2023

Objectives : To examine Korean Medical treatment of abnormal uterine bleeding in classical texts, along with their clinical applicability. Methods : The Benglou chapters in the Donguibogam, Fuqingzhunuke, Xuezhenglun were examined in terms of diagnostic pattern and treatment. Benglou chapters of other medical texts were referenced as well. Basic Korean Medical knowledge of abnormal uterine bleeding and its clinical application were studied. Results : As abnormal uterine bleeding is generally caused by internal damage or deficiency from excessive labor, sexual activity, food, emotional stress, specific causes for each individual should be considered when approaching each case. Conclusions : Korean Medical treatment allows for a tailored approach to each pathology according to age and duration of illness, and has strength in dealing with various situations such as emergency situations, excessive bleeding, blood stagnation. As such, application of Korean Medicine in abnormal uterine bleeding is highly appropriate.

• Journal of Preventive Medicine and Public Health
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• v.51 no.4
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• pp.173-180
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• 2018

Objectives: Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination. Methods: The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found. Results: A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups. Conclusions: The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.