Understanding the biopsychosocial model of illness is crucial for any meaningful advance of health. The maintenance and promotion of health is achieved by different combinations of physical, mental, social and spiritual well-being. Health is not an objective of living. It is not only a state, but also a resource for everyday life. Health is a positive concept that emphasizes personal and social resources, as well as physical capacities. Understanding the biopsychosocial model of health and disease is very important in the medical system. George Engel challenged the medical profession to reconsider a strict biomedical approach to medical education and care, and to embrace a "new medical model," the biopsychosocial model. He argued that humans are at once biological, psychological, and social beings who behave in certain ways that can promote or harm their health. Although understanding the biopsychosocial model of illness is important, Korea's medical system have mainly been focusing on the biomedical model of illness. I would like to highlight the importance of biopsychosocial model of illness for Korea's medical system and real clinical field according to the 20th anniversary of Korean Society of Psychosomaitc Medicine.
Anniversaries and Special Events ; Education, Medical ; Health Promotion ; Humans ; Korea ; Psychosomatic Medicine

No abstract available.

Delirium is a common psychiatric disorder and occurs in many hospitalized older patients and has serious consequences including increased mortality rate. Despite its importance, health care clinicians often fail to recognize delirium or misdiagnosed as other psychiatric illness. Awareness of the etiologies and risk factors of delirium should enable clinicians to focus on patients at risk and to recognize delirium symptoms early. To improve early recognition of delirium, emphasis should be given to terminology, psychopathology and knowledge regarding clinical rating scale for delirium in the specific medical and surgical clinical settings. In this study, authors introduce rating scales for delirium and knowledge of clinical diagnostic process for delirium and give rise to appropriate assessment of delirium in the clinical situation.
Delirium ; Delivery of Health Care ; Humans ; Psychopathology ; Risk Factors ; Weights and Measures

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic* ; Sterilization, Tubal*

No abstract available.
Pregnancy*

As the span of life is prolonged by socioeconomic and medical development, the percentage of the geriatric population is increasing annually. Now, surgical therapy for the geriatric patients is an important area of medicine. To understand the clinical significance of surgical geriatric patients, an analysis was made of the records at the Surgical Department of City hospital, East Seoul, for 182 patients over 65 years of age, who were treated from January 1990 through December 1995. The results are as follows: 1) The number of surgical patients admitted during the 6 years was 2,734, and the number of surgical geriatric patients admitted during the same period was 257 patients (9.4% of all surgical patients). The percentage of geriatric patients show an increasing tendency from 8.1% in 1994 to 11.3% in 1995. 2) The sex distribution was 140 male patients (54.5%) and 117 female patients (45.3%), a ratio of 1 : 0.83. 3) The average duration of admission was 18.2 days and durations of admission of less than 1 week were most common (21.8% of all geriatric admissions). 4) Of the 182 cases treated surgically, 139 cases (76.4%) involved general anesthesia, 32 cases (17.6%) anesthesia administered spinally, and 11 cases (60%) local anesthesia; One hour or less of general anesthetic time was most common (41.7%). 5) Malignant disease was found in 46 patients (25.3%); stomach cancer was the most frequently found malignant disease. Non-malignant disese was found in 136 patients (74.7%); appendicitis was the most frequently found non-malignant disease. 6) Coexistent disease was noticed in 108 patients (59.3%); cardiovascular disease was the most frequently found (27.1%), and chronic pulmonary disease (21.3%) and hypoproteinemia (14.2%) were next. 7) Operations were performed on 182 patients of the total 257 patients, operation rate of 70.8%. The old age group had a low operation rate. 8) Postoperative complications were occurred in 43 cases (23.6%), and operative mortality was 2.7%. The significant factors affecting postoperative morbidity and mortality were malignancy, long duration for the general anesthetic time, coexistent disease, and emergency operation. The results suggest that the number and the rate of surgical geriatric patients have increased and that age has little effect on the postoperative prognosis. Thus, we believe that more active preoperative treatment, complete therapy for coexistent disease, execution of elective surgery and a short anesthetic time for intentional surgery are important factors for decreasing postoperative morbidity and mortality for surgical geriatric patients.
Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Appendicitis ; Cardiovascular Diseases ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Hypoproteinemia ; Lung Diseases ; Male ; Mortality ; Postoperative Complications ; Prognosis ; Seoul ; Sex Distribution ; Stomach Neoplasms

OBJECTIVES: This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. METHODS: Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. RESULTS: The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age (55.8%) were significant explanation variables for health related quality of life. CONCLUSIONS: The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Humans ; Personality Assessment ; Prevalence ; Quality of Life

Medical device industry has characteristics of multi-disciplinary convergence and is easy to apply with information communication technology. Such nature makes Korea medical device industry more globally competitive than the pharmaceutical industry. The foreign direct investment (FDI) of service industry in Korea continues to be at a standstill and the medical device industry is not an exception. Among this stagnant FDI situation in Korea, Covidien, a global medical device company has established the Covidien Center of Innovation as both an education and training facility for domestic and foreign healthcare professionals and a medical device research and development (R&D) center in August 2013. Along with the global attractiveness of superior clinical outcomes generated by healthcare professionals, the future medical device industry development will be fueled by continued R&D investments, researchoriented hospital R&D activities, and clinical studies, etc. It is important to provide attractive investment environments to embrace FDI similar to Covidien Center of Innovation into Korea in order to leverage healthcare professionals' competency at maximum and lead collaboration between medical device companies and healthcare professionals. It is imperative that 'innovative medical device enterprise' certification system similar to the curent 'innovative pharmaceutical enterprise certification' is created. If additional premium reimbursement prices are granted to medical devices developed and manufactured by the innovative enterprises which contribute to domestic R&D and healthcare professional education and training through FDI in Korea, it will help FDI activation in Korea to a great extent. And the reimbursement coverage for routine care costs in clinical trial will stimulate FDI in Korea.
Certification ; Cooperative Behavior ; Delivery of Health Care ; Drug Industry ; Education ; Education, Professional ; Equipment and Supplies ; Financing, Organized ; Investments* ; Korea

The importance of facet joint asymmetry has been debated as a cause of the low back pain and sciatica. And many studies have been proposed about the relationship between facet joint angle or facet joint asymmetry and the development of the disc degeneration or disc herniation. In the diagnosis of the spinal disorder, we have been used mainly myelogram and computed tomography. Several years ago, more advancement has been achieved by use of magnetic resonance image (MRI). Author studied the relationship between the facet joint angle and facet joint asymmetry and the development of the herniated nucleus pulposis (HNP) or spinal stenosis by comparision of the facet joint angle and facet joint asymmetry in each groups. Author reviewed the patients who were diagnosed as HNP or spinal stenosis with computerized tomography (CT) or MRI and treated with operative method at the department of orthopaedic surgery, Dong-A University Hospital. Facet joint angles were measured on the mid-disc cut, which was parallel to the inferior vertebral end-plate of the superior vertebra. The angles were measured by a midsagittal line through the disc and intersecting lines formed by conneqting the two end points of each facet. Facet joint asymmetry was determined by the difference between right and left facet joint angles. The results were compared between each groups and comparison group and statistical analysis was performed with the Kruskal- Wallis test in 95% confidence interval. The patients had only one level involved and had no other spinal disorder. 85 cases of HNP (central in 35 cases and lateral in 50 cases) and 50 cases of spinal stenosis were evaluated. The results were as follows: l. At the level of L4-5, the mean facet joint angles (+/-SD) were 42.50+/-5.52 (Rt.), 46.71+/-9.68 (Lt.) in central HNP, 40.91+/-9.11 (Rt.), 41.23+/-8.51 (Lt.) in lateral HNP, 37.77+/-11.41 (Rt.), 37.95+/-11.91 (Lt.) in spinal stenosis and 42.38+/-5.07 (Rt.), 41.25+/-5.85 (Lt.) in control group. 2. At the level of LS-S1, the mean facet joint angles were 48.83+/-5.64 (Rt.), 48.17+/-4.62 (Lt.) in central HNP, 52.20+/-11.30 (Rt.), 51.60+/-9.06 (Lt.) in lateral HNP, 42.67+/-8.89 (Rt.), 43.50+/- 9.85 (Lt.) in spinal stenosis and 43.91+/-7.88 (Rt.), 43.76+/-7.81 (Lt.) in control group. 3. At the level of L4-5, the mean facet asymmery was 6.35+/-6.04 in central HNP, 6.95+/-6.76 in lateral HNP, 6.47+/-5.56 in spinal stenosis and 4.31+/-5.42 in control group. 4. At the level of L5-S1, the mean facet asymmetry was 4.95+/-5.18 in central HNP, 4.72+/-5.25 in lateral HNP, 5.50+/-4.83 in spinal stenosis and 4.42+/-4.96 in control group. In conclusion, there were no statistically significant relationships between the magnitude of the facet joint angle and development of the HNP and spinal stenosis, and between the facet asymmetry and development of the HNP and stenosis.
Constriction, Pathologic ; Diagnosis ; Humans ; Intervertebral Disc Degeneration ; Low Back Pain ; Magnetic Resonance Imaging ; Sciatica ; Spinal Stenosis* ; Spine* ; Zygapophyseal Joint*

PURPOSE: This study examined two trunk strategies - medio-lateral ramp and anterior-posterior ram - and their effects on pelvis and trunk movements, providing basic material for safe ramp utilization. METHODS: The present study included 20 asymptomatic males recruited from a local university. Participants were asked to stand with their feet shoulder-width apart. Their dorsal side faced the camera, and measurements were performed while standing in a neutral double stance, one leg stance, 15° of medial and lateral ramp, and 15° of anterior and posterior ramp. Participants were allowed to practice for 3 minutes, and each participant had a 30 seconds rest between the two ramp conditions. One-way repeated measures analysis of variance was used to determine the effects the ramp conditions on spinal alignment. In all analyses, p<0.05 was used to indicate statistical significance. RESULTS: The trunk-inclination angle on the posterior ramp was significantly lower than that of the double stance position (p<0.05). The trunk imbalance angle was significantly higher on the medial ramp, than that on the double stance position (p<0.05). The pelvic position and pelvic torsion angles were significantly higher in the medial, lateral, and anterior ramp positions than that of the double stance position (p<0.05). The pelvic rotation angles on the medial, lateral, and anterior ramps were significantly lower than that of the double stance position (p<0.05). CONCLUSION: These findings suggest that when people are exposed to the same form of ramp for an extended period, posture modifications may be triggered.
Architectural Accessibility* ; Foot ; Humans ; Leg ; Male ; Pelvis ; Posture