병사의 현역병건강보험 이용행태와 이에 영향을 미치는 요인 분석

하범만 ( Beom-man Ha ),박지훈 ( Ji-hoon Park ) 국군의무사령부 2011 대한군진의학학술지 Vol.42 No.1

Objective: The purpose of this study was to investigate enlisted man's health utilization behavior of national health insurance system and it's factors influencing. Methods : Questionnaire was made through literature review, and pilot study. 1,077 enlisted men who utilized civilian medical facility responded to the survey. Data was collected by self-administered questionnaire between Aug. and Sep. 2010, and analysis by SPSS WIN 14.0. employing chi-square, multiple logistic analysis. Results: The rank which enlisted men's first visit to civilian medical facility was a private, and mean number of civilian medical facility visit was 1.73. Most common facilities they used are medical(78.8%), dental(17.5%), and oriental medicine(3.7%). 64.3% of facility they used was near his home. 40.9% of respondents said they selected facility for near the home. 37.3% of respondents said the reason utilizing civilian medical facility was civilian medical facility is superior to military medical facility. 51.4% of respondents didn't satisfy the explanation for this system. Their parents(55.3%) was most influenced on enlisted men's choice of facility. The factors influencing enlisted man's health utilization behavior of national health insurance system were non-combat branch of the service(OR=1.96), having private insurance(OR=1.90), not recognize the burden of medical cost(OR=1.21). Conclusion: In conclusion above results were helpful to develop the policy witch decreasing the costs of health insurance.

Case Report : Hepatoid Carcinoma of the Pancreas Combined with Neuroendocrine Carcinoma

( Ji Ye Jung ),( Yoon Jae Kim ),( Hee Man Kim ),( Hong Jeoung Kim ),( Seung Woo Park ),( Si Young Song ),( Jae Bock Chung ),( Chang Moo Kang ),( Joo Yeon Pyo ),( Woo Ick Yang ),( Seung Min Bang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.1

Hepatoid carcinoma is a primary extrahepatic carcinoma whose morphology, immunohistochemistry, and behavior are similar to those of hepatocellular carcinoma. The most common sites of extrahepatic carcinoma are the stomach and ovary, but nine cases of hepatocellular differentiation of the pancreas have been reported in the literature. We report another case of hepatoid carcinoma of the pancreas that was associated with the development of a pancreatic endocrine carcinoma in a 46-year-old man. Serum alpha-fetoprotein (AFP) was elevated to 262.49 IU/mL and radiological examinations revealed a mass measuring 7.5 cm in diameter in the head of the pancreas. He underwent a conventional Whipple operation, and light microscopy showed adenocarcinoma that was immunopositive for AFP, hepatocyte antigen, cytokeratin, chromogranin, synaptophysin, and alpha-1 antichymotrypsin. Although hepatoid differentiation was not shown unequivocally histologically, other immunohistochemistry findings supported the diagnosis of hepatoid carcinoma combined with neuroendocrine carcinoma. The patient was healthy and had no evidence of recurrence at 4 months after the surgery. This report describes why hepatoid carcinoma should be considered as a differential diagnosis of a pancreatic mass, especially when serum AFP is elevated. (Gut Liver 2010;4:98-102)

Incisional Hernia in Adult Liver Transplant Recipients

( Ji Soo Lee ),( Kyeong Sik Kim ),( Chan Woo Cho ),( Kyo Won Lee ),( Gyu-seoung Choi ),( Jong Man Kim ),( Choon Hyuck David Kwon ),( Jae-won Joh ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Incisional hernia is one of the complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing an incisional hernia because of immunosuppression. The purpose of this study is to review incisional hernia cases after liver transplantation and to identify the risk factors for hernia formation. Methods: We retrospectively reviewed and analyzed the medical records of the ninety-four incisional hernia patients after liver transplant recipients from January 2000 to December 2015 in single center institution. Results: 1463 underwent adult liver transplantation during the study period. 94 Incisional hernia patients were found among them. The overall incisional hernia rate was 6.4 %. Mean age was 54 years old and 76.6 % were men. No significant difference was observed for sex, diagnosis, smoking, alcohol, albumin, Child-Pugh score, MELD score, intensive care unit stay, hepatorenal syndrome, ventilator, spontaneous bacterial peritonitis, diabetes, bile leakage, wound problems between patients with incisional hernia and patients without incisional hernia. The characteristics of patients with incisional hernia showed old recipient, more body weight, higher body mass index, living donor recipient compared with patients without incisional hernia. Hypertension, tuberculosis, rejection, postoperative complication event before hernia were significant risk factor (p<0.05). Conclusions: Present study identifies the risk factors for incisional hernia. Surgeons should strive to reduce the risk of incisional hernia after adult liver transplantation.

Clinical Characteristics and Treatment Outcomes of Chronic Pulmonary Aspergillosis: a Retrospective Analysis of 70 Patients

( Byung Woo Jhun ),( Kyeong Man Jeon ),( Jung Seop Eom ),( Ji Hyun Lee,),( Gee Young Suh ),( Man Pyo Chung ),( O Jung Kwon ),( Won Jung Koh ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Backgroud: Chronic pulmonary aspergillosis (CPA) is uncommon and there are few data on the clinical characteristics, optimal therapeutic strategies, and outcomes. Methods: We retrospectively reviewed the records of patients with newly diagnosed CPA and assessed the clinical, radiologic, and laboratory responses, and outcomes between January 2008 and January 2012. Results: A total of 70 CPA patients were included. Median age was 55 years and 51 patients (72.9% ) were men. Fifty-seven patients (81.4%) had a history of pulmonary tuberculosis and 32 patients (45.7%) had non-tuberculosis mycobacterium (NTM) lung disease, 17 of whom had a history of NTM treatment and 15 was under NTM treatment. Sixty-nine patients (98.6%) received oral itraconazole, except one with oral voriconazole for a median duration of 6.2 months. Symptomatic improvement occurred in 52 patients (74.3%), radiologic improvement occurred in 29 (41.4%), and laboratory tests improved more than 60% of all patients. Thirty-six patients (51.4%) achieved treatment success, defined as symptomatic improvement after at least 6 months of therapy regardless of radiological improvement, and 4 of whom needed retreatment after a median of 8.4 months. There was no difference in clinical characteristics and outcomes according to NTM status and 10 (14.3%) discontinued therapy due to adverse reactions. Death occurred in 10 (14.3%) and median follow-up duration was 11.2 months. Conclusion: Antifungal therapy for about 6 months and reassessment of disease might be feasible treatment strategy in managing patients with CPA.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

저소득 독거노인의 생활만족도 관련요인

강지연,전만중,유병철,이용환 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Background : To access the influential factors of life satisfaction in low-income and living alone old people for solving the problem of the estranged elderly. Method : We conducted a questionnaire survey during the period from June 2007 till September 2007. Investigation subjects were 152 elderly people registered in two welfare centers in Busan. We measured life satisfaction of low-income and living alone old people and analyzed with descriptive analysis, t-test, one-way ANOVA and dummy variable regression analysis using SPSS Win(ver 12.0k) program. Result : The mean score of life satisfaction in low-income and living alone old people was 2.52 ± 0.56. Life satisfaction in low-income and living alone old people was relatively high in groups of 65-69 years old, elementary school graduates, subjectively healthy, exercise, hobby or leasure activity, regular repast, 3 times repast per day and income satisfaction. Life satisfaction in low-income and living alone old people was influenced by age, religion, satisfaction of income, subjective health conditions and regular repast. Conclusion : From the result, we can concluded that life satisfaction in low-income and living alone old people was low and influenced by various social and economic factors. Therefore, methods for improving life satisfaction level of low income and living alone old people are required for discerning our society's equality and healthiness.

지속성 외래복막투석 환자들의 예후에 영향을 미치는 요인들에 관한 고찰

권혁만,김찬덕,조지형,장민화,최혁준,이현철,박자용,박선희,김용림 대한신장학회 2004 대한신장학회잡지 Vol.23 No.2

腦硬塞을 同伴한 糖尿病性 腎症 患者에 對한 一例報告

이지영,김만호,최병렬,이정원,조충식 대전대학교 한방병원 2001 惠和醫學 Vol.10 No.1

A clinical study was done in one case of Diabetic Nephropathy patient for Oriental Medicien Hospital of DaeJeon Univeristy one month, Dec 1-30, 2001. The following results were obtained. Patient, 60 years old man had complained tibia edema, itching sense, an early uremia and Rt. Hemiparesis. After treatment of Acupuncture and Moxibustion and Herbmed with physical therapy during about one month, patient could self working with assistance and showed improvedment of chief compalin and uremia.

河東-山淸地域의 灰長岩質岩에 대한 變成作用에 관한 硏究

鄭地崑,李商萬 충남대학교 1985 忠南科學硏究誌 Vol.12 No.2

By the studies on the geologic structure, fabric, igneous and metamorphic minerals, and plagioclase twinning of Hadong-Sancheong anorthositic rocks, the metamorphic facies, intrusive age and metamorphic influences for the origin of the rocks are figured out. The anorthositic rocks are mono-metamorphosed and retrograded from epidote-amphibolite facies to greenschist facies. A transitional phase takes place between the above two facies. The metamorphism in anorthositic rocks is in accord with the third period of the retrograssive metamorphism having a multiple influence on the Sobaegsan Gneiss Complex intruded by the anorthositic rocks. The anorthositic rocks were metamorphosed from late Proterozic and that finished by the time of Jurassic, Daebo Orogeny, which is the same period as that of the so-called Julri Group. The anorthositic rocks are assumed to be intruded in the late Pre-Cambrian age and have no relation with the metamorphism in their origin.

림프절외 림프종의 WHO 분류 : 임상적 및 면역학적인 표현형의 분석 Clinical and Immunophenotypic Analysis

김진만,설지영,강대영 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

The authors retrospectively reviewed extranodal malignant lymphomas which include various distinctive clinicopathologic entities according to the new WHO lymphoma classification system. The aim of this study was to analyze the clinical characteristics of extranodal lymphomas and the relative frequency of the subtypes with immunophenotype in the Daejeon city and Chungcheong province. The authors reviewed 134 cases of extranodal lymphoma out of 220 cases of total non-Hodgkin's lymphoma which was diagnosed during the last 10 years. Among the cases, gastric lymphomas (26.1%) were the most common anatomic site. Nasal and paranasal (14.4%), skin (13.4%), and Waldeyer's tonsillar ring (11.2%) lymphomas were relatively common in order of frequency. The most frequent subtypes of extranodal lymphoma were marginal zone B-cell lymphoma of MALT (31%), diffuse large B-cell lymphoma (20%), peripheral T-cell lymphoma, unspecified (15.7%), and nasal NK/T cell lymphoma (13.4%), in decreasing order. Compared with a previous studies, the relative frequency of nasal NK/T cell lymphoma was much higher in our study than western countries and similiar to East Asia. The immunophenotype of our extranodal lymphomas was mainly B-cell type (68%) and the remaining cases were T- or NK-cell origin. In conclusion, the occurrence rates for various subtypes of extranodal lymphoma in Daejeon and Chungcheong province were distinct from those in western countries and similiar to those in East Asian countries. The most distincitive entities in our study were marginal zone B-cell lymphoma of MALT and nasal NK/T cell lymphoma. It also appears that the frequency of lymphoma subtypes is changing according to the classification system.