• Health Policy and Management
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• v.21 no.1
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• pp.23-43
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• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.261-268
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• 2013

Purpose: To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT). Methods: This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT). Results: Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth. Conclusion: Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.

• Asian Oncology Nursing
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• v.4 no.1
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• pp.26-37
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• 2004

The purpose of this study was to determine and test treatment-seeking behavior type and decisional factors of the cancer patients after first detecting symptoms. This study used the methodological triangulation. In the first, treatment-seeking behavior type and decisional factor were described based on qualitative data collected from in-depth interviews with 29 cancer patients. Next, they were tested using quantitative data collected from a structured questionnaire involving 165 cancer patients with statistical method. As a result, treatment-seeking behavior from detecting symptoms to visiting a doctor categorized into immediate visit and delayed visit. The decisional factors on time interval between detecting symptoms and visiting a doctor was influenced by the perceived seriousness of symptoms, the experiences of visiting a doctor previously with similar symptoms, social-group influences on visiting a doctor, barriers to visiting a doctor, and health concerns. There were significant relationship between treatment-seeking time and these factors, however, there was no statistically significant relationship between treatment-seeking time and the demographic characteristics. It is expected that results of this study can be used for nursing education data of cancer patients for early diagnosis after detecting symptoms

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.700-708
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• 2008

The aim of this study was to recognize guardians' desire and awareness on sedation, and to guide guardians' satisfaction and cooperation. Followings are the conclusion : 1. Information supply about conscious sedation were restrictive and insufficient. 2. Both first-visit guardians and guardians of sedated patients were interested in decrease of dental fear. 3. Both first-visit guardians and guardians of sedated patients were satisfied with psychological improvement better than behavior improvement. Therefore, decrease of patients'ear and anxiety was essential. 4. Both first-visit guardians and guardians of sedated patients didn't recognize accurate safety of conscious sedation.

• Journal of Oral Medicine and Pain
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• v.47 no.4
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• pp.198-205
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• 2022

Purpose: The first-line treatment of temporomandibular joint disorders (TMDs) should include self-management and education. Self-management techniques include moist heat application, stretching, diet control, and mandibular rest position adjustment. Although the effectiveness of video educational resources has been studied in multiple sectors, their application in TMD management has not yet been explored. This study seeks to assess how effective media education was at motivating TMD patients to self-management and improve symptoms. Methods: Data were obtained from the hospital records of TMD patients who visited the Department of Oral Medicine, Yonsei University Dental Hospital, between May 2020 and December 2021. First, without any differences between groups, a significance analysis was conducted between the degree of self-management and symptom improvement over time. At the second visit, one group received media education (n=31) linked to TMD management, while the other received written-oriented education (n=45). At the third visit, the number of precautions taken by the patients was determined and contrasted to that recorded in the previous visit between the groups. Generalized estimated equation multivariate models were applied for statistical analysis. Results: In the media education group, the frequency of stretching and the number of patients on pain-free diets increased substantially. Taking precautions improved daily pain intensity, maximum mouth opening, and pain intensity during the maximum unassisted opening. Conclusions: Media education could be beneficial for TMD patients because it allows them to take self-management precautions. The symptoms of the media education group improved, with no considerable distinction between both groups.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.165-178
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• 2009

The purpose of this study was to provide basic information for improving oral health and dental hygiene through comprehensive dental hygiene care. The subjects in this study were 54 patients who had been treated for 4 weeks in clinic of the Dental Hygiene Department of G University under comprehensive dental hygiene control and care and measured their oral condition, intensity of oral malodor, Simplified Oral Hygiene Index (S-OHI), and Modified Personal Hygiene Performance Index (PHP-M), and surveyed their oral health behavior and oral health consciousness. The results of the study were as follows: 1. The intensity of malodor decreased by 16.49ppb from 75.33ppb on the first visit to 50.84ppb on the last visit when the comprehensive dental hygiene care had been finished. 2. As to change in S-OHI according to gender between the first visit and the last visit for comprehensive dental hygiene care, S-OHI decreased from 2.89 on the first visit to 1.16 on the last visit, and the difference was statistically highly significant. 3. As to change in PHP-M index by tooth according to gender and age between the first visit and the last visit, PHP-M index of the first 6 teeth decreased very significantly from 0.50 on the first visit to 0.34 on the last visit. 4. As a whole, significant improvement was observed in every tooth. According to gender and age, PHP-M index for Tooth No. 26, 36 and 32 decreased significantly in men and women, and those aged under 30 and those aged 30 or over, but for Tooth No. 13 and 15 and 44 it decreased significantly only in men and those aged 30 or over, and for Tooth No. 44 only in men. As presented above, the oral health behavior and oral health consciousness of the visitors to the oral prophylaxis practice room are very important, and it is necessary to enhance their interest in and knowledge of how to improve oral health. Furthermore, comprehensive dental hygiene care required for improving the visitors' oral health.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.596-603
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• 2021

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.1
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• pp.11-18
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• 2018

Objectives The purpose of this study is to analyze the clinical data of atopic dermatitis patients and to report the therapeutic effect of Jageum-Jung. Methods We conducted a retrospective study on the effects of treatment on atopic dermatitis patients who took Jageum-Jung from August 1, 2017 to December 20, 2017. The patients visited three times during the treatment period. The SCORAD Index score was measured and analyzed. Results Atopic dermatitis patients were 2 adults and 5 children. Both 2 adults were male (100%). Among the children, 1 child was a male (20%) and 4 children were females (80%). For adults, average age was 29.5 years, average weight was 72.75 kg, average height was 1.76 m and average BMI was $23.49kg/m^2$. For children, average age was 6.2 years, average weight was 23.92 kg, average height was 1.2 m and average BMI was $16.08kg/m^2$. The atopic dermatitis patients' average SCORAD Index score was 18.04 at first visit, 11.46 at second visit, and 7.64 at third visit. The scores lowered significantly after every visit. Conclusions The SCORAD Index in atopic dermatitis patients who took Jageum-Jung significantly decreased and it is expected that Jageum-Jung will be clinically effective in the treatment of atopic dermatitis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.27 no.2
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• pp.64-74
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• 2014

Objective : The purpose of this study is to report the effectiveness of a Korean Medicine Treatment on 45 facial atopic dermatitis patients. Methods : Total 45 facial atopic dermatitis patients, who has visited korean medical clinic in year 2011 were analyzed by Objective SCORAD Index(OSI) and Investigator's Global Assessment(IGA). Subanalysis of OSI and IGA were done according to topical ointment user/non-user, treatment period and change in IGA distribution. Results : 1. Male and female percent was 20%:80%. 17.8% were teens, 55.6% were twenties, 13.3% were thirties, 13.3% were above age forty. 64.4% were on topical ointment treatment of corticosteroid or calcineurin inhibitor, and 35.6% were not at the initial visit. Patients with family history were 44.4% and 62.2% had atopic dermatitis past history. 2. OSI and IGA were significantly lower after 1~3, 3~6, 6~9 month of treatment. Average post-treatment score was lower in longer-treated group. 3. IGA distribution has changed from average 3.42 at the first visit to 1.76 at final visit. 91.1% of total patients reported decrease in IGA at the final visit. 4. OSI and IGA improvement rate were significantly higher in non-topical ointment user than the user. Age, treatment period, initial OSI and IGA score difference were not significantly different. Conclusion : A significant percent of 45 facial atopic dermatitis patients who were treated with Korean Medicine Treatment reported decrease in OSI and IGA. The difference increased with the treatment period. Non-topical ointment users' improvement was significantly higher than topical ointment user.

• Journal of Audiology & Otology
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• v.25 no.4
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• pp.209-216
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• 2021

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.