Objective: To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). Methods: We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. Results: In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. Conclusion: Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA.
Background: Recently, pain clinic is attracting attention and interest of both physicians and laymen. It is the purpose of this article to analyze our 10 years' experience to seek and improve better protocol of treating pain. Methods & Materials: We analyzed retrospectively 11,235 patients who visited the clinic during 10 years from 1986 to 1996. Total number of hospital visits was 51,908. Male to female ratio was 35:65(3910:7325). Treatment modalities employed were SGB(stellate ganglion block), TPI(trigger point injection), etc. Results: Yearly distribution showed a gradual upward curve until 1992 and remains in a horizontal pattern thereafter. Of age distribution, 6th decades occupied the largest proportion(27.29%). As of disease entities, Low back pain & lower extremities pain comprised of the majority(34.01%) and the epidural block was most frequently given as a treatment. Conclusion: Pain clinic is improving rapidly as an important part of medical science in Korea and outpatients of clinic are on an increasing trend. So, anesthesiologists should be make every efforts to research for treatment of good quality.
Ham, Chang Hwa;Moon, Hong Joo;Kim, Joo Han;Park, Youn-Kwan;Lee, Tae Hoon;Kwon, Woo-Keun
Journal of Korean Neurosurgical Society
/
v.63
no.4
/
pp.407-414
/
2020
Objective : Since the first discovery of the 2019 novel coronavirus (COVID-19), rapid and wide spread of the disease has been reported and the World Health Organization announced that a 'pandemic' has started. Up to date there is little known regarding the impact of this outbreak on spinal specialists' daily clinical practice. We intended to evaluate how COVID-19 has affected the number of spinal disease patients we meet and operate in daily practice. Methods : The de-identified data regarding number of patients visiting the spine clinic at a tertiary referral hospital and a secondary level hospital from January, February and March of 2017 to 2020 were retrospectively reviewed. The number of out-patient department (OPD) visits, number of emergency room (ER) visits as well as number of surgeries performed during the reviewed period were collected and analyzed, comparing 2020 to the previous 3 years. Results : The number of daily OPD visits showed a steady decrease starting from January, and presented a statistically significant decrease by early March 2020, compared to the previous 3 years. During the same period, decrease in number of daily ER visits was statistically significant as well. The number of elective surgeries or number of surgeries for patients admitted via ER during COVID-19 outbreak remained similar to that of 2017-2019 suggesting, despite the decrease of patients visiting the hospital for spinal diseases, those whom required surgery still visited the hospital. The results were consistant among other hospital level. Conclusion : The outbreak of COVID-19 affected our daily practice as OPD and ER visits reduced but did not affect the number of surgeries. We believe that this report will be informative to spinal specialists worldwide fighting the COVID-19 pandemic.
The Journal of Korea Assosiation for Disability and Oral Health
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v.9
no.1
/
pp.18-24
/
2013
Objectives: The goal of this study is to establish data baseline to ameliorate oral health policies for patient. The research was conducted in dental clinic at Seoul Metropolitan Children's Hospital - the major municipal hospital for the disabled. The outpatients' visiting patterns to the dental clinic were analyzed, compared to other medical departments. For further research related to TMD, the questionnaires were given to the subjects. Material and methods: Data for visiting patterns/frequencies was collected from patient records of 1419 outpatients who visited the dental clinic at Seoul Municipal Children's Hospital in 2011. Then TMD-related questionnaires were given to 127 outpatients who were over 13 years old. Results: 1. 219 out of 1419 patients (15.4%) who visited the dental clinic at Seoul Municipal Children's Hospital in 2011 were the disabled. 2. Compared to normal patients, disabled patients visited the dental clinic and rehabilitation medicine department more frequently.(p<0.05) However, there was no apparent difference in visiting frequencies between the disabled and the normal patients in the psychiatric department.(p=0.3237) 3. 44% of the TMD-related questionnaire subjects responded that they often consumed relatively hard or tough food, 53% answered they had unilateral chewing habit, 3% had bruxism, and 12% had clenching habit. Conclusion: In the dental clinic at Seoul Municipal Children's Hospital, 19% of outpatients over 13 years old had TMD such as clicking and pain. Also, the disabled patients' visits to the dental clinic were considerably more frequent, compared to the normal patients and to other medical departments. Accordingly, the result may suggest that the proper systematic supports from the government are essential to the dental clinic at municipal hospital for the disabled.
Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.
Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.
Journal of the korean academy of Pediatric Dentistry
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v.2
no.1
/
pp.57-66
/
1975
The study was performed to evaluate the Parent's knowledge and attitudes concerning the dental health of their children. A questionnaire consisting of 17 questions was given to each of the 664 parents by their children who are attending in primary school and was completed by them. The collected information from the questionnaire was analyzed by the visits to dental clinic, age and education. The results obtained from this study are as follows: 1) The more educated parents were more interested to the dental health of children. 2) In the know ledge concerning the dental health of their children, the parents who were more educated and had visited the dental clinic gave the better. responses. 3) There were no clear differences in age groups in the knowledge and attitudes on their children's dental health. 4) The reason for first visiting the dental clinic was dental treatment 43.2%, toothache 35.4%, for the purpose of oral examination 21.2%, and others were 9.2%. 5) 13.1% of the parents who had visited the dental clinic couldn't or didn't follow the recommended treatment because of economic difficulty 53.3%, lack of time 25%, lack of understanding of child's dental needs 18.3%, and other reasons were 3.3%.
This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.
This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.
Yun-Jin Lee;Jeong-In Kang;Yun-Ha Kim;Eun-Chae Min;Young-Woo Lim;Eunjoo Kim
The Journal of Korean Medicine
/
v.45
no.1
/
pp.65-79
/
2024
Objectives: The purpose of this study is to evaluate weight change and analyze adverse events in post-menopausal obese women with Gamitaeeumjowee-tang for weight loss. Methods: A retrospective chart review was conducted for medical records of 115 post-menopausal obese women (body mass index, BMI≥25 kg/m2) who were administered with Gamitaeeumjowee-tang for 12 weeks for the purpose of weight loss. Weight, skeletal muscle ratio and BMI changes were compared before and after the program. Adverse events were evaluated by causality, severity and system-organ classes. Results: A total of 115 patients were included in this study. The average total weight loss in post-menopausal women was 5.72±2.04kg(p<0.001) and the average weight loss rate was 8.06±2.70%(p<0.001). After the 12-week program, the body fat rate was significantly decreased(3.76±2.20%)(p<0.001) and the skeletal muscle ratio was significantly increased(2.07±1.24%)(p<0.001). There were no significant differences in weight loss, skeletal muscle ratio change and body fat rate change depending on the number of hospital visits. Insomnia was frequently reported throughout the period, and no serious adverse events were reported. Conclusions: This study showed the potential that weight management treatment with Gamitaeeumjowee-tang could be a good way to lose weight of post-menopausal obese women without serious adverse events. Continuous well designed clinical studies are needed.
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