• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.69-73
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• 2008

To curb a rapid increase in expenditures for pharmaceuticals, the Korean government introduced a positive list system and a negotiation process for drug prices at the end of 2006. Economic evaluation of pharmaceuticals has begun to have a pivotal role in the listing and pricing of drugs for the Korean National Health Insurance. There are some points to discuss regarding the use of economic evaluation in the listing and pricing in the context of the Korean system. First, the listing and pricing processes have been fragmented, evoking complaints from pharmaceutical companies and delaying the access of new drugs to patients. Second, there is a concern that the positive list system may limit the range and availability of drugs for patients to choose for treatment. Third, the time schedule for de-listing of existing drugs may not be realistic. Fourth, it is not always easy to provide reliable evidence of cost-effectiveness due to a lack of materials. Fifth, there is no consensus on the range of the ICER (incremental cost-effectiveness ratio) acceptable to the Korean society. In conclusion, in the near future, it will be necessary to evaluate the achievements that the economic evaluation has provided to the Korean society.

• 대한한의학회지
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• 제23권4호
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• pp.73-90
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• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

• 대한물리치료과학회지
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• 제1권1호
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• pp.129-134
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• 1994

The purpose of this study is to conduct a retrospective chart audit of initial physical therapy evaluation to determine the incidence of sitting imbalance and its relationship to the side of weakness in hemiparetic patients. A review of the records of 36 patients revealed that the left side was predominantly affected in 17 patients and the right side in 19 patients. Ages, time since onset, and proportion of men and women did not difer between the left and right hemiparetic patients. About half patients(52.8%) could sit independently, but 64.7% of those with left-sided weak-ness and 31.6% of those with right-sided weakness could not. A chi-sequare analysis revealed a significant relationship between the side of weakness and independent sitting balance(p<0.1). Patients with left hemiplegia are more likely to have difficulty with independent sitting balance(p<0.1). Patient with left hemiplegia are more likely to have difficulty with independent sitting than patients with right hemiplegia, which may affect their progress in rehabilitation.

• International Journal of Contents
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• 제3권3호
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• pp.32-37
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• 2007

Up to now, several tools to evaluate visual perception tests have been introduced for different purposes. However, they were mostly manual tools, paper books in which the therapists would turn the pages while working together with patients. This paper discusses a potential plan to develop motor-free visual perception test software for Korean patients with brain injury, and to construct a centralized database for their evaluated data in a client/server environment. Through its development, we eventually hope to achieve effective management of the data for better understanding of patients' visual perceptual skills and the standardization of the evaluation for Korean patients. With the help of the computerized environment, we also expect some advantages such as acquisition of reliable results from patients with brain injury, automation for storing and accessing patients' data, construction of the patients' database and the management of a vast amount of the data within it and the provision of a foundation to promote further development of various perceptual-cognitive rehabilitation programs.

• Journal of Chest Surgery
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• 제27권8호
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• pp.683-688
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• 1994

The most common cause of spontaneous pneumothorax is a ruptured bleb, which occurs mostly in young patients and they are usually treated by tube thoracostomy. Recurrence frequently occurs and these patients require some form of surgical intervention. From March 1990 to February 1994, we have experienced 19 cases of recurrent pneumothorax in 16 patients among 347 patients who underwent 423 surgical interventions. The name of first operation after thoracotomy were bullectomy in 4 cases, bullectomy and pleurodesis in 3 cases, bullectomy, pleurodesis in addition to application of tissue sealant in 1 case. Thoracoscopic operations were performed as follows: bullectomy in 2 cases,electroablation plus tissue sealant in 4 cases, electroablation, tissue sealant and pleurodesis in 1 case,and in 4 cases, only tissue sealant was applied. The average age of patients are 21.5 years, and bilaterally operated patients and patients. who received tissue sealant or tissue sealant plus electrocauterization only had higher incidence of recurrence. The patients who needed chest tube insertion longer than 5 days after the first operation were 52.6 %, and 82.3 % recurred within one month of the first operation.

• Journal of Chest Surgery
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• 제27권6호
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• pp.444-450
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• 1994

From June 1984 to February 1994, cardiac valve replacement was performed in 108 patients. The distribution of patients was ranged from 13 to 64 year-old age[mean 39.48 1.24] and 51 patients were male, 57 patients were female [male:female=1:1.1]. 64 patients had mitral valve replacement, 27 patients underwent aortic valve replacement and 17 patients were performed double[mitral & aortic] valve replacement. Total 125 artificial cardiac valves were used, mechanical valves were 51 valves and tissue valves were 74 valves. The duration of follow-up was 473.41 patient-year[mean 4.79 3.29 patient-year] and the information of follow-up was available for 99 patients[92%]. The actuarial survival rates including the operative mortality was 89.5% & 88.3 at postoperative fourth & ninth year. The probability of freedom from overall valve failure, thromboembolism and bacterial endocarditis were 77.5%, 89.2% and 95.6% at ninth year after cardiac valve replacement.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.124-128
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• 2016

Purpose: Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of trauma patients; however, the risk factors for contrast-induced nephropathy (CIN) in these patients remain unclear. This study determined the rate of CIN in trauma patients at a regional trauma center in Korea and identified the risk factors for developing CIN. Methods: We retrospectively reviewed the medical records of 138 patients for the patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast. Results: Of the patients, 7.2% developed CIN during their admission after receiving IV contrast for CT. In the multivariate analysis, only the creatinine level at presentation (Adjusted odds ratio [aOR], 5.944; 95% confidence interval [CI], 1.486-23.733; p=0.012) and an injury severity score (ISS) greater than 22 (aOR, 1.096; 95% CI, 1.021-1.176; p=0.011) were independently associated with the risk of CIN. Conclusion: CIN is uncommon in trauma patients following CT with IV contrast. The creatinine level at presentation and ISS were independent risk factors for developing CIN in trauma patients.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.196-202
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• 2000

Objective : This study was designed to evaluate the relationship between the initial neurosurgical or psychosocial factors and the psychosocial outcome. Patients and Methods : We analyzed 123 head-injured patients who were referred to the department of psychiatry for the evaluation of psychosocial function. We analyzed initial neurosurgical variables such as Glasgow Coma scale(GCS) score, skull fracture, CT finding, and psychosocial outcomes with regards to psychosis, personality change, depression, anxiety and IQ on Intelligence Scale. Results : Patients with mild head injury(GCS score 13-15, N＝94, 76.4%) had better recovery rate on Glasgow Outcome Scale(GOS), less personality change than those with moderate or severe head injury. However, depression, anxiety and intelligence were not significantly different between two groups. The skull fracture(N＝37, 30.1%) did not influence on the psychosocial outcome with reference to personality change, depression, anxiety and intelligence. The patients with abnormal CT findings(N＝64, 52%) had lower recovery rate on GOS, more frequent tendency in psychosis, personality change and severe depression, less frequent in anxiety and mild depression, than patients with normal CT finding. However, levels of intelligence were not different between two groups. The patients with industrial accidents(IA) had lower educational level, milder head injury, more delay for the psychiatric evaluation (longer treatment period) than those with motor vehicular accidents(MVA). The psychosocial outcome with reference to personality change, depression, anxiety, intelligence were not different between two groups. Conclusion : These findings indicate that the more severe initial trauma, the poorer psychosocial outcome. However, it was frequently observed that patients with mild head injury suffered from mild anxiety and depression. Therefore mild head injury appeared to be more complicated by psychosocial stressors. The patients with IA, despite the fact that initial head injury was mild, required longer treatment period than MVA.

• 대한한방내과학회지
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• 제35권2호
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• pp.145-156
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• 2014

Objectives : The aim of this study was to compare Tianwangbuxin-dan to Fluoxetine for antidepressive efficacy and safety in poststroke depression (PSD). Methods : A randomized, double blinded, non-inferiority trial was conducted. 113 PSD patients were recruited from a stroke center. Except for the 25 excluded patients, 88 PSD patients were randomly given either Tianwangbuxin-dan 1100 mg or Fluoxetine 20 mg per a day for 16 weeks. PSD was evaluated using Beck's depression inventory (BDI) and Hamilton depression rating scale (HDRS) and followed every fourth week. Repeated measure analysis of variance (ANOVA) was used to compare and contrast the depression scores of the two groups and to compare them among the evaluation times, at the beginning, $4^{th}$, $8^{th}$, $12^{th}$ and $16^{th}$ weeks. In addition, independent t-tests were used to find the difference between two groups at every evaluation time. Results : Finally, 88 PSD patients were included in the study, 63 PSD patients completed the procedure and 25 PSD patients were dropped out by the incompliance or withdrawal of consent. Tianwangbuxin-dan (or Fluoxetine) improved the depression of stroke patients and the efficacy of Tianwangbuxin-dan was not inferior to that of Fluoxetine. In addition, there was no significant side effect in two groups. Conclusions : This study showed that antidepressive efficacy and safety of Tianwangbuxin-dan in PSD patients.

• 대한영양사협회학술지
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• 제13권2호
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• pp.101-113
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• 2007

The purpose of this study was to measure hospitalized patients' satisfactions with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out questionnaires by 382 hospitalized patients into 7 hospitals in Deagu, Busan, Changwon. The subjects were 50.5% male and 49.5% female. Sixty-two percent of the subjects were over 40age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7-14 days. The result of evaluation for hospital foodservice during the length of hospitalization are as follows : Taste, seasoning, temperature, apperance of foods were higher in the short hospitalized patients than in the long hospitalized patients, especially kind and combinazation of food were significantly higher(p<0.001). The result of the foodservice with appetite status was significantly higher score(3.33) in the good appetite patients than in the bad appetite patients score(2.00)(p<0.001). As the hospitalization rooms were the significantly difference in the taste(p<0.05), seasoning(p<0.001), apperance(p<0.01) of the foods, amount of service(p<0.01), variety of menu(p<0.05), combinazation of foods(p<0.01) and opinion of patients(p<0.05).