• The Journal of Pediatrics of Korean Medicine
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• v.12 no.1
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• pp.63-76
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• 1998

BACKGROUND : The purpose of this study was to investigate the new effective oriental medical treatments in pediatric diseases and its clinical applicability. METHOD : The study was composed of 1725 new patients who had been treated at the pediatric unit in the Dongguk Bun-Dang Oriental Medicine Hospital for 1 year, from 1 January 1997 to 31 December 1997, and had ages between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. RESULT 1. The ratio of male to female was 1.35:1 and the number of each age group and its percentage distribution was 228 patients (13.2%) for the age group between 0 and 1 year, 746 patients (43.2%) between 2 and 6 years, and 751 patients (43.6%) for the age group over 7 years. 2. The chief complaint of the new outpatients was weakness, asthma, common cold, sinustis, skeletal disease, atopic dermatitis, stomach-ache, short stature, diarrhea, nasal blooding, night terror, allergic rhinitis, gastric disorder, enuresis, dermatitis, strabismus in the order of majority.3. The number of patients and its percentage for the most three complaints was 494 patients (28.6%) for weakness, 647 patients (37.4%) for respiratory disease, 144 patients (8.3%) for digestive disease. 4. The digestive disease tended to increase in summer, and appeared mostly in the age group between 0 and 2 years. The respiratory disease increased In inter-season and winter, but decreased significantly in summer. The age group between 1 and 5 years was the largest group of respiratory disease. CONCLUSION 1. The chief complaint in pediatric diseases that needed an oriental medical treatment was mainly the disease that tends to take long time and the weakness, and appeared frequently in digestive and respiratory diseases. 2. The oriental medical treatment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In particular, the study shows that the oriental medical treatment should be emphasized in terms of preventing the disease. 3. The new diseases, which were developed with the change of human life and environment, (atopic dermatitis, enuresis, short stature, obesity, dysthymic disorder, strabismus), should be investigated as a new field of oriental medical treatment.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.4
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• pp.71-77
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• 2017

Objectives This study aims to build the baseline data for school health care program by analyzing the questionnaires about satisfaction regarding Oriental Medical Doctor's (Korean Medicine) student health and wellness program. Methods The association of Korean medicine doctor in Sung-nam city conducted Oriental Medical Doctor's student health and wellness program for 12 middle schools and 8 high schools in Sung-nam from August to December, 2015. The participating Oriental Medical Doctor visited each school for 8 times during 5 months period, and conducted health consultations, health education classes and Korean medicine treatment for the school students and school employees. Teachers and administrators from the participating schools answered the self-reported satisfaction questionnaires and the satisfaction questionnaires results were analyzed. Results 85 people responded the program satisfaction questionnaires; 69% responders were very satisfied and 28% were satisfied about the program specifically about the student's health check-ups, informatory brochures for the parents, good participation enrollment process. Responders were pleased about doctor's consultations regarding 'Advising students about their general health', 'Ways to cure sick students fast', 'Providing students with useful information about health', and 'Teaching students how to manage their health in a good shape'. 92.94% of participants agreed to the needs of the school health and wellness program. Conclusions One of the fundamental national health policies is to provide students opportunities to maintain their good health. We have developed a successful pilot program called, "Oriental Medical Doctor's student health and wellness program". We got positive feedback from the participating school teachers regarding our program. Further studies based on this study are needed to show the benefit of the program to broaden its use.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1301-1307
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• 2006

Purpose : Hearing loss is one of the most common birth defects, and early detection and intervention positively impact language/speech and cognitive development. It has been reported that NICU graduates have a high incidence of hearing loss. So we investigated the incidence, risk factors and clinical outcome of hearing loss in NICU graduates. Methods : This study involved neonatal auditory brainstem response (ABR) testing of newborn infants who graduated from the NICU of Kyungpook National University Hospital during a 3-year period (between July 2002 and June 2005) and subsequent follow-up of these infants. Results : ABR evaluations were performed on 474 infants. Of these infants, 64 showed abnormal ABR (13.5 percent). Of 128 ears from these 64 infants, two ears (1.6 percent) and 10 ears (7.8 percent) were classified as severe and profound hearing loss, respectively. The infants with abnormal ABR had higher incidence of prematurity, low birth weight, very low birth weight, neonatal asphyxia, cranio-facial malformation and amikacin treatment over 15 days (P<0.05). In infants with hyperbilirubinemia, the peak level of serum bilirubin, duration of phototherapy and exchange transfusion were not associated with the higher incidence of hearing loss. Follow-up ABR evaluation was performed on 15 infants with abnormal ABR at $8.8{\pm}4.4months$. In follow-up ABR, 80.0% showed improvement or normalization of threshold sensitivity. Conclusion : NICU graduates exhibit high risk for hearing loss. Systemic and effective hearing assessment program is needed for these high risk infants.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.655-660
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• 2003

Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio($a/APO_2$) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care Unit of Kyunghee University Hospital from 1996 to 2000 were analyzed retrospectively. Chest radiographs taken at the time after birth were classified into four groups according to Bomsel's classification. The $a/APO_2$ and VI values were calculated and compared with the corresponding chest radiographs. Results : Among the 50 cases of RDS examined, three cases were classified into grade I(6%), eight cases into grade II(16%), 20 cases into grade III(40%), and 19 cases into grade IV(38%). The mean $a/APO_2$ of the cases classified into grades I or II was 0.32 and the mean $a/APO_2$ of those classified into grades III and IV was 0.18 and 0.09, respectively. The mean VI was 0.049 for the cases classified into grades I or II and 0.076 and 0.161 for those classified into grades III and IV, respectively. Conclusion : The severity of RDS according to chest X-ray findings correlate to the values of respiratory indices, $a/APO_2$ and VI.

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.523-534
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• 2010

Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.

• Journal of the Korean Society of Radiology
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• v.9 no.1
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• pp.23-30
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• 2015

Recently in the health service the globalization and opening their market to foreigners are realized in Korea. So, it becomes necessary for the health service institutes to execute their management to focus on service quality to satisfy their customers. We examined the customer orientation of the individual health professional rather than the market orientation concept based on the health institute. For the market orientation of the health institute should require the individual health professional worked there. The hypotheses for the effect of the role conflict, ambiguity, and job satisfaction of the health professionals to their customer orientation were established based on the literature review and previous researches and tested to the 250 health professionals such as health technician, nurse, radiologist, and management clerk in D hospital located in Busan, in summer 2008. First, the hypothesis 'The role conflict between the individual health professionals might effect to the customer orientation' was rejected. Second, the hypothesis 'The role ambiguity of the individual health professional might effect to the customer orientation' was accepted. Third, the hypothesis 'The satisfaction of the individual health professional might effect to the customer orientation' was rejected. and the multiple regression analysis was taken with the dependent variables as each construct of customer orientation-responsiveness, empathy, tangibility, and reliability, and independent variables as role conflict, role ambiguity, and job satisfaction. With these analysis, we found also the role ambiguity effected to the customer orientation.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Therapeutic Science for Rehabilitation
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• v.7 no.1
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• pp.37-50
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• 2018

Objective : The purpose of this study was to develop a competency indicators of occupational therapists for occupation-based intervention by conducting a Delphi survey to occupation-based intervention experts. Methods : After analyzing the data related to occupational therapists indicators in korea, the results of Delphi survey were collected three times from October to December 2016. Based on the results, we developed occupational therapists competency indicators for occupation-based intervention through expert panel's opinions. Results : Based on the eight competency elements, the competency indicators were examined by 133 primary and 133 secondary competency indicators. Finally, 131 competency indicators were developed based on 8 components as occupational therapist competence indicators for occupation-based intervention. The results of the third delphi showed a high level of content validity of .95, stability of .10, convergence of 0, and consensus of 1. Conclusion : The developed occupational therapist competence indicators for occupation-based intervention could be used in various clinical decision making such as occupation-based intervention, education training, education development and evaluation.

• Journal of the Korean Society for information Management
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• v.33 no.1
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• pp.161-180
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• 2016

Physicians have information needs related to academic research and clinical practice but encounter difficulties seeking appropriate medical resources and information. The goal of this study is to develop a search system to support Korean physicians' information needs. To access sources to meet the identified need, in-depth interviews were conducted, and MediSearching, a new search system, was developed accordingly. To verify its usefulness and to obtain users' suggestions, interviews were conducted and feedback was solicited via collected test searches. The initial set of interviews indicated that physicians' information needs and search behaviors differed by type of hospital and clinical department. Physicians in university hospitals with a greater need for research materials searched for academic articles, whereas physicians in specialty hospitals or primary care clinics with a stronger need for materials related to clinical practice asked their colleagues for information. Consequently, MediSearching was designed to satisfy both groups' needs, and the test search provided useful search results compared with existing services. Korean physicians have previously had to repeat their search process on separate sites that provide different services according to type of information and search method. MediSearching may reduce this inconvenience and add documents in various formats and languages.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.218-223
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• 2020

This study examined the accessibility of emergency rooms according to the population density and distance in Daegu Metropolitan City to help improve the quality and emergency medical accessibility problems in Daegu Metropolitan City. To observe the geographical requirements, the number of population in eup, myeon, dong, available emergency, and available emergency compared to the population were mapped through the S-GIS of Statistics Korea to visualize the data based on the 3km radius. To determine the difference in accessibility to emergency rooms for each district in Daegu Metropolitan City, the data were analyzed by ANOVA and Scheffe. According to the average number of emergencies available in Daegu Metropolitan City within a 3-kilometer radius were 5.7 in Jung-gu, 5.0 in Nam-gu, 1.6 in Buk-gu, 0.4 in Dong-gu, 2.4 in Seo-gu, 0.9 in Suseong-gu, 3.5 in Dalseo-gu, and 0.1 in Dalseong-gun; there was a statistically significant difference (p<.001). The available emergency within a 3km radius and available emergency per 1,000 people were concentrated in the center. Therefore, it may be necessary to institute an urban emergency medical network by establishing a point that serves as an intermediate hub to provide emergency medical care to citizens far from the center.