• The Korean Journal of Health Service Management
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• v.2 no.1
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• pp.137-154
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• 2008

The increase of the supply of medical service and the increase of hospitals have intensified the competition of hospitals, and the advancement towards internationalization in the opening of medical industry has triggered the infinite competition of medical profession. In addition, the high expectation of customers and quality improvement in the medical care in accordance with the improvement of overall income, and the change of active role of medical consumers according to the popularization and the improvement of rights awareness reflect the customer needs and choice in the medical service. Customers wanted to receive the kind and pleasant service under the up-to-date medical service. Therefore, as a solution, hospital coordinators were emerged for the purpose of smooth treatment and customer satisfaction by generalizing all service of hospital. Accordingly, this thesis attempted to investigate the effect of hospital coordinator education curriculum on the education satisfaction and the quality of medical service. In order to solve the purpose of this study, I, author reviewed the existing literatures, established hypothesis, and verified hypothesis by using the variety of statistics techniques such as reliability, validity, frequency analysis, and regression analysis. The verification of hypothesis is as followings: First, among education training factors of hospital coordinators, the quality of instructor significantly affects the satisfaction of hospital coordinator education training. Second, among training factors of hospital coordinator, the attitude of trainee significantly affects the training satisfaction of hospital coordinator. Third, among education training factors of hospital coordinator, education course significantly affects the training satisfaction of hospital coordinator education. As the qualities of instructor are better equipped, the satisfaction of education becomes higher. It indicates that the education method of instructors is important as an index to represent the qualities of instructor such as the appropriateness of education method, preparation, passion, visual materials, the adequacy of education procession, and specialized knowledge, and it has important effect on the satisfaction of education. In order to enhance the satisfaction of hospital coordinator education, the creation of education environment, making trainee concentrate on the education, is required by appropriately allocating programs, arousing interest in education, based on the attitude of trainee, discussion, and preliminary programs, preparation, ahead of enforcement of education. Fourth, the satisfaction of hospital coordinator education training significantly affects the reliability among the qualities of medical service. Fifth, satisfaction of hospital coordinator education training significantly affects hospitality I kindness among the qualities of medical service. If the education satisfaction of trainee is high, it is effective in the practical application such as dealing with complaints, the duty performance for the patients, and so on in offering the medical service, related to reliability and furthermore, we can find the positive change in the attitude change of medical professions related to the reliability of hospital coordinator. In addition, in the process of offering medical services such as the kind explanation on the duty, rapid response to the customers inquiry, and tidy uniform, practical effect was verified. Sixth, the education training factor of hospital coordinator significantly affects the reliability among the quality of medical service. Seventh, the education training factors of hospital coordinator significantly affect hospitality/kindness. In the education of hospital coordinator, the methods to attract the interest of trainee by emphasizing reliability should be sought and for gaining the practical effect of hospital coordinator education, the sufficient preparation and investigation on the education curriculum should be prerequisite and under this condition, intensified discussion on the instructor and education course is needed. In the design of education course, more education hours and subjects should be allocated in the part of hospitality in order to improve the practical application of hospitality. Therefore, it is meaningful in a sense that this study newly approached the components of hospital coordinator education and the need to modify the quality components of medical service in accordance with the study subjects was raised. This study also finds its meaning in that it provides basic materials for the study of future hospital coordinator education by suggesting the system development model of hospital coordinator education through preliminary study of education training. In addition, this study is meaningful in the aspect that it suggested the direction of education training by showing how the hospital coordinator education training would applied to the hospital coordinator course of the Continuing Education Center at Pusan and Kyungnam National University to some extent. Since all investigation of this study was approached from the side of hospital coordinator, the thoughts of patients who are beneficiaries of medical service, and care givers cannot be identified. Therefore, the satisfaction of patients and care givers through the experience of medical service, which is the essential prerequisite of medical service, should be importantly considered and investigated. Accordingly, The study of comparing and analyzing the views of both patients and care givers should be carried out in the future.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.205-213
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• 2004

Purpose: To evaluate the clinical manifestations of various glomerular diseases in children, a clinicopathological study was performed in 52 children who had renal biopsy. The type and relative incidence of the glomerular pathologies were analyzed, and the clinical predictability and usefulness of renal biopsy in glomerular diseases were assessed. Methods: Medical records of fifty two children with renal disease who had undergone percutaneous renal biopsy under ultrasonic guidance at Chungnam University Hospital from October 1995 to August 2003 were reviewed. In addition, we compared the clinical findings before renal biopsy with the pathological diagnosis. Results: The male to female ratio was 1.6:1 and they were $9.8\pm2.6$ years old on average. The chief complaints for biopsy were hematuria in 22 cases which was the most common (42.3%), proteinuria in 16 cases(30.8%), and hematuria & proteinuria(26.9%). Among the 22 cases of hematuria, there were 15 cases of gross hematuria(68.2%) and 7 cases of microscopic hematuria(31.8%). In terms of histopathologic diagnosis, most of them were primary glomerular diseases(84.6%), which included IgA nephropathy(28.8%), thin glomerular basement membrane disease(25.0%), focal segmental glomerulosclerosis(FSGS)(11.5%), membranous proliferative glomerulonephritis(7.7%), minimal change lesion(3.8%), acute poststreptococcal glomerulonephritis(3.8%) and membranous glomerulonephritis(3.8%). The clinical manifestations and pathologic diagnosis were not correlated. Conclusion: The clinical manifestations could not predict the pathological diagnosis. Therefore, renal biopsy would be inevitable in diagnosis of glomerular diseases for effective management and assessment of prognosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.1-9
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• 2009

Purpose: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC. Methods: We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up. Results: The mean age of the patients was 12.5${\pm}$14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients. Conclusion: LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.179-186
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• 1997

The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.69-76
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• 2003

Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.317-326
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• 2012

Objectives : This study aims to examine satisfaction of dental treatment and revisit and intention of recommendation to dental patients and to supply as a basic resource for dental management improvement. Methods : 645 dental patients to dental hospitals in G City were subjects of this study. 27 dental hospitals were randomly chosen per 5 or 6 in 5 Districts. The intention of the survey was explained to 645 patients and it was agreed to have questionnaire survey. Questionnaire survey was carried out for 2 weeks in April 2011. Total 593 were used for the analysis except for insufficient answer sheets. The analysis was executed by using SPSS 18.0 and the results are as follows. Results : 1. The highest figures are as follows: female was 53.29% in sex, 20-29 age group was 44.52%, graduates of university were 38.62%, students were 28.50%, monthly family income with 300-399 million won was 31.70%. As to the treatment, dental caries were highest with 46.21% followed by scaling with 40.81%. As to the number of visit, 39.80% were over 5 times, and as to the opportunity to use, 29.34% answered it because it is close to home. 2. As to satisfaction, male was 4.15, over 60years old was 4.58, self-employed was 4.33, friendship with dentist as opportunity to use was 4.37. And as to revisit intention, over 60 years old was 4.60, over postgraduate in education level was 4.38, self-employed was 4.43, over 5 times visit was 4.32, and fame as opportunity to use was 4.39 which were the highest. As to the intention of recommendation to others, female was 4.24, over 60 years old was 4.65, self-employed was 4.36, friendship with dentist as opportunity was 4.43 which were the highest and showed significant differences (p<0.05). 3. As to patient satisfaction, there were strong relevance between revisit intention and intention of recommendation with 0.769 and 0.744 respectively. And, as to revisit intention, it had significant relation with revisit intention with 0.791. 4. The explanatory power of the regression analysis on the factors affecting revisit intention was 61.20%. The revisit intention was high when the satisfaction of dental hospital was high (${\beta}$=0.767, p<0.001), the number of visit (${\beta}$=0.026, p<0.01), reason for a visit (${\beta}$=0.070, p<0.01), education level (${\beta}$=-0.063, p<0.05) and occupation (${\beta}$=0.078, p<0.05). 5. The explanatory power of the regression analysis on the factors affecting intention of recommendation was 59.9%. The intention was taken patients satisfaction(${\beta}$=0.601, p<0.001), dental hygienist's kindness (${\beta}$=0.218, p<0.001), female (${\beta}$=0.079, p<0.05), reason for a visit(${\beta}$=-0.059, p<0.05), dissatisfaction treat(${\beta}$=0.084, p<0.05), dentist's kindness (${\beta}$=-0.080, p<0.05), age (${\beta}$=0.054, p<0.05). Conclusions : To improve revisit rate of patients, the refurbishing hospital facility, treatment and kindness of dental hygienists and satisfaction of treatment must be improved. And it also needs to accept complaint from female patients in a positive manner, and understand and correct complaints actively from the perspective of patients.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.73-85
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• 2017

Objectives : In this study I made investigations how 'strange hunger' and 'compulsive overeating' threatening the ego could be resolved and healed. And I aim to present a healing model of psychotherapy and analysis as one of methods of treatment for 'eating disorder'. Methods : The analysands of this study were outpatients who visited the department of psychiatry of Yong-In Mental Hospital from March 2008 to February 2017 with 'hunger' and 'compulsive overeating' as their chief complaints. This study is based on the detailed records of the process of analysis including dreams and visions. Results : 1) Throughout the process of analysis that explore both consciousness and unconsciousness(dream, vision), hunger and compulsive overeating is improved and healed in all analysands. 2) The Imago of 'Snake' appeared in dreams and visions of all analysands. 3) By suffering impulse rather than acting it out, impulse transformes itself into 'Imago'. As impulse transforms into 'Imago' and reveals the 'meaning' of it, ego-threatening power of impulse weakens and mood is calmed. And as a result, synthesis of consciousness and unconsciousness and creative transformation of personality can be possible. Conclusions : In some people, 'hunger' and 'compulsive overeating' are 'creative impulses' that aim 'Self-realization' which can be fruited as creative transformation of personality and as creative transformation in the relation with the world. 'Creative impulses', which often can be experienced as instinctive impulse or emotional suffering unless ego realizes the meaning, reveal the meaning in dreams or visions through 'Imago' and 'Symbol'.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.731-736
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• 2005

Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.176-184
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• 1997

Abnormal illness behavior in patients with somatoform disorders were known formed by their traditional disease concepts and somatization-prone socio-cultural factors. The authors evaluated the characteristics of abnormal illness behavior in patients with somatoform disorders(who had somatization) by using abnormal illness behavior questionnaire. Methods : 29 somatoform disorders(SD) and 57 disease controls were compared by clinical characteristics, severity of pain, state anxiety(by Spielberger's State & Trait Anxiety Inventory), depression(by Beck's Depression Inventory) and level of psychosocial stess(by DSM-III-R). The illness behavior was measured by illness Behavior Questionnaire(IBQ). Results SD group had longer period of somatic symptoms with less severity in pain. The degree of anxiety and depression were higher in SB compared with controls. However, the degree of psychosocial stress was almost same between both groups. In IBQ, SD showed higher scores in general hypochondriasis, disease conviction, and affective disturbance subscales compared to control group. Conclusion: High disease conviction and hypochondriacal nature revealed by IBQ seemed to be a role in making somatization by way of somatic focusing and hypervigilance. And those tended to lead patients visit hospital frequently and report various somatic complaints. Evaluating abnormal illness behavior in somatoform disorders would be not only helpful in understanding the natures of somatoform disorders but also useful differentiating SD with other psychiatric conditions.

• Journal of Distribution Science
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• v.10 no.3
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• pp.15-30
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• 2012

It has been 10 years since the facility modernization projects of traditional markets was rigorously undertaken. Although more than 835 traditional Korean markets nationwide have already completed these projects, there does not exist a specific set of standards of installation, future maintenance, and management. As a result, the complaints made by civil stakeholders in accordance of the actual facility installation caused problems and delays of related projects. In addition, while some local governments secured and implemented their own differing standards, others have not yet established their own separate standards for maintenance and management. Specifically, 694 traditional markets nationwide were supported for the cost of installing arcades by 2010. For the short period of time after the arcade-supported projects were deployed, the number of the traditional markets had been rapidly growing as a prime example of the facility modernization projects. The arcade facilities are being planned and installed merely for screening the rain or the sun. Without fundamental data for the newly landscaped environments or information on the actual conditions of usage and assessment, there is a lack of comprehensive approaches that could possibly organize the public environments. Furthermore, the amount of support needed for repairs, maintenance, and management from the central and local governments is gradually increasing. Thus, it becomes both crucial and necessary to complement the current set of standards. The purpose of this study is to examine the actual conditions of usage, maintenance, and management among those traditional market facilities that were installed with the supports of the facility-modernization projects, especially for arcades. This will be carried out through investigating the local problems, issues, and considering international case studies. The results of this study will provide measures for effective and efficient installation and management of traditional market arcades. Improvements in the use of public resources could be directed towards transforming public business, as well as public enhancement and functional maintenance and reinforcement. Under this condition, the arcade is not a simple area to avoid rain or sunlight; it becomes a public space. It is highlighted that the arcade should establish its public business not only to activate markets but also to refine street environments and revitalize local communities. A more specific way to improve is introduced through systematic supplementation. This is needed to attract effective participation from local residents and is done so by conducting a fair procedure from the first stage of business and by providing guidelines for establishing arcades as public facilities. The study points out to the problem of merchants-centered plans and street use. It presents the need to expand to involve residents and customers. Given that the arcade is a public facility and merchants' ability to maintain it is limited, manuals and systems for its maintenance needs to be introduced through multi-party agreement of merchants, government, residents and customers.