• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.160-167
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• 2004

Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.264-269
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• 2009

Seoul National University Dental Hospital opened The Clinic for The Disabled to provide dental treatment under outpatient general anesthesia. 432 patients underwent general anesthesia for dental treatment. The informations such as the pattern of dental treatment, the reasons of general anesthesia, the characteristics of the patients were analyzed. Followings are concluded. 1. The patients below 15 years old made up 50.60%. 2. The reasons for general anesthesia included mental and physical disabilities, systemic disease, dental phobia, and so on. 3. Restorative treatment was the most common procedure with the average of 9.7 teeth treated per one patient. 4. 62(14%) patients underwent general anesthesia for dental treatment more than once. 5. The efforts for better multidisciplinary system to provide more comprehensive and effective dental treatment including periodic recall check, preventive treatment for handicapped patients are necessary.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.264-271
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• 2007

Purpose : It is important to take a precise history of patients to diagnose enuresis. However, this is difficult to perform in the outpatient department, because the consultation time is limited. So by taking the medical histories with questionnaires, we classified the enuresis patients into monosymptomatic and non-monosymptomatic groups and compared the clinical characteristics between the two groups in order to determine whether this would aid in the diagnosis and treatment of enuresis. Methods : Thirty-four enuresis patients seen in the Department of Pediatrics at Yeungnam University Hospital from 2004 January to 2005 July were enrolled in this study. Two to three weeks before starting medical treatment, questionnaires about the patients' urination habits and past medical history were taken from the Parents with consents. Results : There were 21 patients in the monosymptomatic group and 13 patients in the non-monosymptomatic group. There was no difference in the delivery mode, birth weight, birth order, sleep habit, constipation, and treatment results between the two groups. Urinary infection was more frequently observed in the non-monosymptomatic group. There was a higher incidence of daytime incontinence and a past medical history of allergy in the non-monosymptomatic group. Oriental medicine was the most common treatment of enuresis before visiting the hospital, but the treatment effect was minimal. Conclusion : Comparison between the monosymptomatic and non-monosymptomatic group with the questionnaires was helpful for detailed diagnosis and treatment of enuresis. A more effective education for enuresis patients is needed, since before visiting the hospital many of them wasted their efforts with ineffective oriental medicine treatment. (J Korean Soc Pediatr Nephrol 2007;11:264-271)

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1273-1278
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• 2009

Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.

• Korea Journal of Hospital Management
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• v.22 no.1
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• pp.1-9
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• 2017

Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.27-31
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• 1999

Background: In spite of the development of chemotherapy, prognosis of metastatic lung cancer was poor. On the other hand, surgical intervention has proven itself to bring out superior results, therefore more operations are being praticed based on this superiority against chemotherapy and other modalities on metastatic lung cancer. Material and Method : We analyzed the surgical cases performed from 1983 to 1997 on 17 cases and estimated 5 year survival rate using Kaplan-Meier method. Result: Average age was 42.8, ratio between male and female was 10:7. We had 8 single lobe resections,3 pneumonectomies,1 wedge resection,2 bilobectomy and 3 cases of lobar resection with wedge resection. 5 deaths have occured and among the 5, 3 patients were caused by recurrence of ca. The remaining 12 patients are being followed up in OPD basis among these, 3 recurrence were observed and 9 are still free of cancer. The average survival time was 40.5 months and 5 year survival rate obtained through the Kaplan-Meier method was 60.4%. Conclusion: Even though we are a bit short of cases, we recommend that a thoracic surgeon approach this disease through a surgical method as possibly as he could.

• Mood & Emotion
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• v.9 no.2
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• pp.126-132
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• 2011

Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.74-82
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• 2016

Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

• The Journal of the Korean dental association
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• v.11 no.7
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• pp.483-490
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• 1973

저자는 소아치과 환자의 일반적인 치료시 흔히 나타나는 과민성, 불협조, 공포감 등의 아동 취급상의 난점들을 심리적인 충격없이 해소함을 목적으로 Demerol, Phenergan과 Atarax들의 약제를 치료전에 준비투약 함으로써 다음과 같은 결과를 얻었다. 1) 일반 소아과에서 사용되는 약물용량보다 소아치과 외래환자에선 2배의 용량에서 만족스러운 효과를 얻을 수 있었다. 2) 용량결정에 있어서 최초 투약용량을 정확히 산출함으로써 준비투약의 성공을 가져올 수 있었다. 3) 준비투약의 성공은 일정한 기간후 환자의 recall appointment시 준비투약 없이도 보다 나은 협조을 얻을 수 있었다. 4) Demerol, Phenergan, Atarax사용에 있어서 그 부작용은 거의 무시할 수 있을 정도로 경한 것이였으며 환자의 심리적인 지원을 갖어 올 수 있어 아동 취급상에 큰 효과를 얻을 수 있있다.