• Journal of Acupuncture Research
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• v.33 no.4
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• pp.109-119
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• 2016

Objectives : The aim of this study is to give a statistical basis for the characteristics of patients who received cooperative medical care after being referred from Western medical departments to the Department of Acupuncture and Moxibustion in a Korean medical hospital. Methods : The request records were searched for cooperative medical treatment at the Department of Acupuncture and Moxibustion in a Korean medical hospital between September 1st, 2011 and August 31, 2016, based on the Order Communication system(OCS). The records were reviewed and retrospectively analyzed according to the patient's general characteristics, the chief diagnosis code based on the 7th Korean standard classification of diseases(KCD-7) before and after the cooperative medical care in the Department of Acupuncture and Moxibustion, and the actual treatment measures which patients received as a result of the cooperative medical care. Results : Among the 2702 records, 1549 patients were included in the analysis. The male to female ratio was 1 : 1.17. Sexagenarians formed the highest age group and the number of patients whose age was over 50 was 1176(75.92 %). The surgery department requested the cooperative care from the department of Acupuncture and Moxibustion for the highest number of patients, 1194(77.08 %). When analysing specific medical departments, Neurosurgery, General Surgery, Neurology, Otorhinolaryngology, and Physical medicine and rehabilitation followed. The frequency of chief diagnosis code used before the cooperative medical care was in the order of I, C, G, S, and M code, from highest to lowest. The order of the codes after the cooperative medical care was the same. Acupuncture treatment was the most frequently-used measure after the cooperative medical care. Following were infrared, moxibustion, transfer, herbal acupuncture, cupping, electroacupuncture, and so on. Conclusion : This study provides a statistical basis for the demands placed on the Department of Acupunture and Moxibustion for cooperative medical care with the Western medical department. Based on the present condition of cooperative medical care, more preparation and effort is required for its activation.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.41-61
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• 2001

The purpose of this study was to assess pregnant women's knowledge of, attitude to, and satisfaction with prenatal ultrasound and to determine the factors that influence their perception. A self-administered questionnaire survey was completed by two hundred eighty five pregnant women who visited the obstetric departments of three hospitals located in Seoul from October 17, 2000 to October 28, 2000. The major results are as follows. 1. Overall, the respondents did not fully understand the purpose of prenatal ultrasound. 92.2% of respondents stated that the main purpose of prenatal ultrasound was to check the fetus' age, growth and development but only 44.5% of respondents were aware of the fact that chromosomal abnormalities cannot be diagnosed only by prenatal ultrasound. The majority of respondents were aware of the diagnostic limitations of ultrasound. 2. While the majority of respondents were aware of the importance of pre-examination information, only 31.8% of respondents received such information from their health care providers. 3. Regarding the examination quality, 80.3% of respondents were satisfied with the competency of the examination. But more than 50% of respondents stated the cost and waiting time were not acceptable. 4. The knowledge of, attitude to, and satisfaction with prenatal ultrasound showed statistically significant differences according to the characteristics of each hospital. 5. From multiple regression analysis, the major components for knowledge of prenatal ultrasound were characteristics of hospitals, religion, income and gestational age. The major components for attitude toward prenatal ultrasound were characteristics of hospitals, religion and gestational age. The major components for satisfaction with prenatal ultrasound were characteristics of hospitals, income and drinking during the pregnancy. In conclusion, the respondents' perception of prenatal ultrasound is considerably low. More effective educational material or programs with prenatal ultrasound information should be provided to pregnant women prior to prenatal ultrasound examination. New strategies such as process reengineering are recommendable to increase the satisfaction with prenatal ultrasound.

• Health Policy and Management
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• v.23 no.1
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• pp.66-77
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• 2013

The purpose of this empirical study is to investigate the factors of self-leadership depending on individual characteristics, job characteristics, and qualities of leader-member exchange. Additionally, this study aims to discover the effect of self-leadership's outcome factors on organizational citizenship behavior and innovative activities. In order to verify research model and hypothesis, questionnaires were collected from department members working at general hospitals, hospitals, and clinics in metropolitan area of Seoul, which were 85 departments and 344 respondents. Collected data were analyzed with SPSS ver. 19.0 and Amos ver. 18.0 statistical package using Structural Equation Model. The results of the analysis showed that both individual characteristics and job characteristics have significant positive effect on self-leadership. Also, self-leadership had significant positive relationship on innovative action and organizational citizenship behavior. The implications of this study are as follow. First, this study empirically explained how self-leadership is applied in healthcare organizations. Second, it verified the relationship between causal factors and outcome factors of self-leadership. Also, prior researches of self-leadership have been conducted on business companies, but this study explored self-leadership at healthcare organizations, which increased external validity. Nowadays, many people are interested in the effect of leadership in order to overcome issues coming from enlarged organizations and to improve performance. Self-leadership will contribute to maximizing voluntary efforts of human resources and performance in a rapidly changing healthcare industry.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.53-63
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• 2012

Purpose: This study examines and compares the differences between self-esteem and health promotion behavior of health department and non-health department college students. Method: The research instruments were as follows : The first one is RSES developed by Rosenberg and translated into Korean by Jeon. The second one is HPLP developed by Walker et al, and including six subareas by Lee and modified to be suitable to Korean culture by Suh. Data were statistically analyzed with SPSS PC/12.0. Results : 1. Comparison of self-esteem had no significant difference(p=.190) and health promotion behaviors had significant differences(p=.000) between the two groups. 2. According to general characteristics and health-related characteristics, the differences of self-esteem in health department showed significant differences in grade(p=.020), sex(p=.000), age(p=.000), parents' economic conditions(p=.048), and smoking(p=.030) while non-health departments revealed significant differences in grade(p=.003), sex(p=.000), age(p=.000) and smoking(p=.001). 3. According to general characteristics and health-related characteristics, the differences of health promotion behaviors in health department showed significant differences in grade(p=.008), sex(p=.021), age(p=.000) and parents' economic conditions(p=.017) while non-health department revealed significant differences in sex(p=.000) and age(p=.000). 4. There were positive correlations between self-esteem, health promotion behaviors and subareas in health department (r=.422) and non-health department (r=.383). Conclusion: There were significant positive correlations between self-esteem and health promotion behaviors in health and non-health department college students. Therefore, health related programs should be developed to enhance self-esteem and health management by college students can influence themselves on self-esteem and health promotion behaviors.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.381-390
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• 2002

Purpose : To develop a dose calibration program for the IAEA TRS-277 and AAPM TG-21, based on the air kerma calibration factor (or the cavity-gas calibration factor), as well as for the IAEA TRS-398 and the AAPM TG-51, based on the absorbed dose to water calibration factor, so as to avoid the unwanted error associated with these calculation procedures. Materials and Methods : Currently, the most widely used dosimetry Protocols of high energy photon beams are the air kerma calibration factor based on the IAEA TRS-277 and the AAPM TG-21. However, this has somewhat complex formalism and limitations for the improvement of the accuracy due to uncertainties of the physical quantities. Recently, the IAEA and the AAPM published the absorbed dose to water calibration factor based, on the IAEA TRS-398 and the AAPM TG-51. The formalism and physical parameters were strictly applied to these four dose calibration programs. The tables and graphs of physical data and the information for ion chambers were numericalized for their incorporation into a database. These programs were developed user to be friendly, with the Visual $C^{++}$ language for their ease of use in a Windows environment according to the recommendation of each protocols. Results : The dose calibration programs for the high energy photon beams, developed for the four protocols, allow the input of informations about a dosimetry system, the characteristics of the beam quality, the measurement conditions and dosimetry results, to enable the minimization of any inter-user variations and errors, during the calculation procedure. Also, it was possible to compare the absorbed dose to water data of the four different protocols at a single reference points. Conclusion : Since this program expressed information in numerical and data-based forms for the physical parameter tables, graphs and of the ion chambers, the error associated with the procedures and different user could be solved. It was possible to analyze and compare the major difference for each dosimetry protocol, since the program was designed to be user friendly and to accurately calculate the correction factors and absorbed dose. It is expected that accurate dose calculations in high energy photon beams can be made by the users for selecting and performing the appropriate dosimetry protocol.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.930-937
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• 2009

Purpose : We evaluated the effectiveness of treatment and cardiac complications of replacing a high dose of aspirin with a high dose of ibuprofen for children in acute phase of Kawasaki disease. We also analyzed the possibility of replacing a high dose of aspirin with a high dose of ibuprofen to prevent complications such as Reye󰡑s syndrome caused by aspirin. Methods : One hundred eight children with Kawasaki disease were admitted in the pediatrics department from January 1, 2004 to December 31, 2008. Echocardiography and laboratory tests were performed during diagnosis, and the children were followed-up at 6-8 weeks after the diagnosis. We retrospectively analyzed their characteristics and clinical results. Results : The children were assigned to receive either a high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or a high dose of ibuprofen with IVIG (ibuprofen group). A total of 55 and 53 children were included in the aspirin and ibuprofen groups, respectively. The mean defervescence period was 6.5${\pm}$2.1 days in the aspirin group, and $6.9{\pm}1.9$ days in the ibuprofen group (P=0.309). The number of failed treatments, during and after treatment, was 8 in the aspirin group and 10 in the ibuprofen group (P=0.547). There were 11 initial cardiac complications in the aspirin group, and 14 in the ibuprofen group, but children who showed improvement at follow-up was 7 and 13 in the aspirin and ibuprofen groups, respectively (P=0.133). Laboratory findings were also improved in both groups. Conclusion : We can be considered whether we will replace high dose of aspirin by high dose of ibuprofen in acute phase of Kawasaki disease. Therefore, we can prevent the severe complications of aspirin use, such as Reye's syndrome.

• Radiation Oncology Journal
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• v.26 no.1
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• pp.56-64
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• 2008

Purpose: Cathepsin D(CD) is a lysosomal acid proteinase that is related to malignant progression, invasion, and a poor prognosis in several tumors. The aim of this study was to evaluate the prognostic clinical significance of CD and p53 expression in pretreatment biopsy specimens from patients with locally advanced rectal cancer who were treated with preoperative chemoradiation. Materials and Methods: Eighty-nine patients with locally advanced rectal cancer(cT3/T4 or N+) were included in this study. Preoperative chemoradiation consisted of a dose of 50.4 Gy of pelvic radiation and two concurrent cycles of administration of 5-fluorouracil and leucovorin. Surgery was performed six weeks after chemoradiation. CD and p53 expression in pretreatment formalin-fixed paraffin-embedded tumor biopsy specimens were assessed by immunohistochemical staining using a CD and p53 monoclonal antibodies. The threshold value for a positive stain in tumor tissue and stromal cells was 1+ intensity in 10% of the tumors or stromal cells, respectively. Results: Positive CD expression was found in 57(64%) of the tumors and 32(35%) of the stromal cell specimens. There was no association with CD expression of the tumor or stromal cells and patient characteristics. There was a correlation between tumor CD expression with stromal cell CD expression(p=0.01). Overexpression of p53 was not a significant prognostic factor. The 5-year overall survival(OS) and disease-free survival(DFS) rates were not different between tumor CD-negative and positive patient biopsy samples(69% vs. 65%, 60% vs. 61%, respectively). The 5-year OS rates in the tumor-negative/stromal cell-negative, tumor-negative/stromal cell-positive, tumor-positive/stromal cell-negative and tumor-positive/stromal cell-positive biopsy samples were 75%, 28%, 62%, and 73%, respectively. Stromal cell staining only without positive tumor staining demonstrated the worst overall survival prognosis for patients(p=0.013). Conclusion: Overexpression of p53 in rectal biopy tissue was not associated with prognostic significance. In the pretreatment biopsy specimens, an exclusive increase in CD expression in stromal cells without tumor expression was related to poor overall survival in patients with locally advanced rectal cancer treated with preoperative chemoradiation.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.17-28
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• 2008

Purpose: It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Methods and Materials: Two hundred nineteen patients (M: 70, F: 149, mean age: $62.9{\pm}6.9$ y/o) who were diagnosed as PD without dementia clinically and 55 patients (M:15, F:40, mean age: $61.4{\pm}9.2$ y/o) as normal controls who had no past illness history were performed $^{99m}Tc$-HMP AO brain perfusion SPECT and neuropsychological test. Results: At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood perfusion in 32 (14.7%) of 219 patients with PD, decreased perfusion on the frontal lobe in 45 patients (20.6%), the temporal lobe in 39 patients (17.4%), the parietal lobe in 39 patients (17.9%), the occipital lobe in 40 patients (18.3%), diffuse area in 14 patients (6.4%) and unclassified in 10 patients (4.6%). Fifthly, we compared the results of the neuropsychological test and cerebral perfusion pattern. There was no correlation between two tests except visuospatial function. Conclusion: Various perfusion state were found in patients with PD according to the age and sex. Also we were able to classify perfusion state into several groups and compare the neuropsychological test with cerebral perfusion.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.1
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• pp.17-26
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• 2015

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient's characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.

• Health Policy and Management
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• v.32 no.3
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.