• Journal of Chest Surgery
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• v.50 no.6
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• pp.424-429
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• 2017

Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

• Journal of Chest Surgery
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• v.52 no.6
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• pp.409-415
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• 2019

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.934-939
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• 2012

To investigate and characterize basic patterns of prehypertension. Participants were divided into three groups; ideal blood pressure(n=40), prehypertension(n=62), and stage 1 hypertension groups(n=68) according to the JNC 7 standards. They answered questionnaire asking various symptoms and received clinical examination. Data were collected and analyzed in the focus of three Zheng patterns, cold-heat, deficiency-excess and four major hypertension types. Analysis of variance was used to find differences among groups. In addition, relationship between the cold-heat trends and risk factors of hypertension were analyzed using Pearson's correlation analysis. Three risk factors; age, body mass index (BMI), and fasting blood sugar (FBS) showed intergroup differences. Statistical significances were revealed in the cold-heat pattern and two hypertension subtypes. The cold scores decreased from $4.8{\pm}1.84$ to $3.9{\pm}1.88$ and $3.7{\pm}1.27$ (p=0.022), while the heat increased from $1.9{\pm}1.32$ to $2.8{\pm}1.72$ and $2.8{\pm}1.48$ (p=0.009). Additionally two hypertension subtypes, the excessive liver fire, and the yin-yang deficiency showed significant differences. Cold had negative correlations with blood pressure (both systolic and diastolic), BMI, triglyceride, and FBS. Heat had positive correlations with systolic blood pressure, BMI, triglyceride, and FBS. Prehypertension could be characterized by using the cold-heat patterns. The cold-heat are correlated with Blood pressure, BMI, blood lipids and sugar.

• Korea Journal of Hospital Management
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• v.3 no.1
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• pp.219-237
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• 1998

Economists have identified informed consumer choice as one element of a better-functioning health care market, and thus increased attention is directed to the role of information in the health care system. In this country, however, little work has been done for understanding consumers' search behavior in health care market. Based upon this observation, expectant mothers' information search for the choice of delivery care institution was investigated. In doing so, two hypotheses were proposed: 1) Those women who were more active in the search for information would make choice of a delivery care institution with more confidence and would feel greater subsequent satisfaction. 2) The activeness of expectant mothers in information search would depend upon their various personal characteristics, such as socio-economic status, obstetric conditions, and knowledge and attitudes in relation to delivery and health care. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using prepared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with 319. The results of analysis were generally consistent with the proposed hypotheses. Apparently, information increased expectant mothers' confidence in selecting a delivery care institution and subsequent satisfaction with the institution. Indication is that policy efforts should be strengthened to produce and disseminate relevant, comprehensible and credible information that can aid patient decision making. Also, attention should be directed to motivate patients to actively engage in information search from adequate sources.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.26 no.2
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• pp.198-209
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• 2016

Objectives: This study aimed to provide basic data for the improvement of the guidance services for the management of the workplace environment of the specialized health management institution, by making inquiries on the perception and extent of practice by health managers and workers in the workplace. Methods: Workplaces with officially noted environmental hazards of noise, organic compounds and/or dust-metals were selected in a South Korean metropolitan city in 2015. The workplace health managers(hereinafter referred to as 'manager') and workers at 97 workplace were interviewed. Managers are those who are in charge of health management at the corresponding workplace and the workers were subjected to in-depth interviews by sampling one worker for each of the workplace. Results: The majority of the managers acknowledged the guidance services of the specialized health management institution affirmatively. Regarding the extent of practice in accordance with the guidance on engineering improvement, only 23 managers(37.1%) responded. With respect to education, 40 managers(41.2%) responded that it was implemented along with 35 workers(36.1%) who responded that they received education, showing no significant difference between manager and worker. Regarding the actual wearing of the protective equipment, however, 83 of the manager(85.6%) insisted that workers wore the protective devices while only 44 workers(49.5%) responded that they actually wore the devices, thereby illustrating a significant difference between managers and workers. Conclusions: These results suggest the urgent necessity of improvement in the mechanism of guidance services of the specialized health management institution for the workplace environment management.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.264-272
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• 2010

Objectives : This study was carried out to measure perceptions about Traditional Korean Medicine hospitals and provide data for improvement of TKM hospital management. Methods : We surveyed the general population from 1st to 17th December, 2008, and patients visiting a TKM hospital from 1st June to 9th December, 2008. Results : Result as follows. 1. The response ratio for the generally preferred medical institution was in the order of western medical clinic, pharmacy, general hospital, TKM clinic, TKM hospital. 2. The response ratio for the preferred medical institution for herbal medicine treatment was in the order of TKM clinic, herbal medicine store, TKM hospital, pharmacy. The preferred medical institution for acupuncture treatment was in the order of TKM clinic, TKM hospital, acupuncture clinic, public health center. 3. The most common response to reason for receiving traditional Korean medical care was "traditional Korean medical care is more effective than western medical care." 4. The proportion of first treatment and second treatment of patients visiting at TKM hospital was about 1:1. 5. 72.3% of patients had been to another medical institution. 6. The response ratio for the first visited medical institution for the same disease was in the order of general hospital, western medical hospital, western medical clinic, TKM clinic. 7. The response ratio for the concern about TKM treatment was in the order of expensive charge for TKM treatment, uncertainty of TKM treatment effect. Conclusions : Through this research, we can understand the perception about TKM hospital treatment of the general population and patients visiting TKM hospitals.

• Journal of Korean society of Dental Hygiene
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• v.10 no.5
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• pp.897-904
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• 2010

Objectives : The aim is to examine what a selective factor of dental institution in the elderly is, which can be used as a strategy for vitalizing hospital management, and which difference there is in selection of dental institution according to health-promotion lifestyle. Methods : Questionnaire survey of individual interview was carried out targeting 177 old people in over 65 years old of Jeonju, Iksan, and Gunsan in Jeollabuk-do Province by convenience sampling from August 16, 2010 to August 27. The analysis was performed by using SPSS WIN 12.0 program. Results : 1. The average mark of health-promotion lifestyle in the elderly was 2.69 points. The health responsibility was the highest with 2.91 points. 2. The mark of health-promotion lifestyle was higher in the higher educational level of the elderly(p<0.01), when monthly income is more than 2 million won(p<0.01), and in the better subjective awareness of oral condition(p<0.01). 3. The group with high mark of health-promotion lifestyle regarded reliability(p<0.001), economic efficiency(p<0.01), and facilities & cleanliness(p<0.01) as important factors when selecting dental institution. Conclusions : The development and expansion in health-promotion program targeting the elderly are seen to be necessary that reflect difference by sphere in health-promotion lifestyle. There will be necessity for pursuing even a strategy for the elderly in the group who have relatively low characteristic in the practice level of health-promotion lifestyle. Also, given understanding characteristics on the elderly and focusing on management proper for the needs of medical consumers, the successful medical management is thought to be likely possible.

• Korea Journal of Hospital Management
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• v.22 no.2
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• pp.58-69
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• 2017

Recently, with the increase in the number of private health insurance subscribers, interest in overuse of the medical service is increasing. This study analyzed the impacts of private health insurance (PHI) on medical institution selection in outpatient service utilization among persons with arthritis. In order to control patients' health status, we extracted outpatient episodes with the same disease (KCD6, M13) from Korea Health Panel. The unit of analysis was an outpatient visit with arthritis in 2014 (n=23,363). In the light of insurance coverage, we redefined three type of private health insurance (ex, indemnity, fixed benefit, and non-insured) as a test variable and two type of medical institution (ex, hospital and physician visit) as a dependent variable. We conducted a probit regression analysis to identify the impacts of PHI on medical institution selection controlling for heteroscedasticity. The results of this study showed that the insured with indemnity were more likely to choose hospital departments than clinics (marginal effect=0.0475, p=0.000). The impact of participation of fixed benefit PHI was not as clear as that of indemnity type (marginal effect=0.0162, p=0.047). In conclusion, this study confirmed that PHI, particularly indemnity type has a significant impact on the selection of medical institutions. Healthcare policy makers should consider that PHI not only affects the overall quantitative increase in healthcare utilization, but also influences the selection of medical institutions.

• Journal of the Korean Society of Food Science and Nutrition
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• v.27 no.4
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• pp.756-764
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• 1998

The purpose of this study is to compare food habits of four institution(public boarding home, public mursing home, private boarding home, meal service in welfare center) in Pusan, Korea. Data were collected from 119 of were more than 65 years in the above institutions. Chi-square test was the main data analysis method. More than a quarter of the respondents(27%) showed fairly good level of activity, while a half of them(52.9%) answered the middle level. More than 80 percent of the respondents reported that their food attitude was "Good". There were more elderly women than elderly men among the four institutions. Although the four institutions have served snacks on the regular basis, they did not provide the residents with nutritious food. Most of the residents want to have snacks between meals, but they did not perfer candy. All the subjects didn't point out any particular problem of institution. They were accustomed with their old food served by their institution. As food perferences, almost all of the respondents preferred cooked rice and cooked rice with cereals. Only the residents of private boaring home liked cooked rice with red bean. In case of soup, all of residents liked any kind of soup. The most preferred most menu was beef. But only residents of private boarding home did not like pork. All residents like any all kind of kimchi except kimchi made by radish. In preference of cooking method of a side dish, seasoned food and vegetables were the most favorable menu by the respondents. Compared to the private home, the institutions give residents effective plan to prepare meals. Even though this study tried to find differences in attitudes of dietary life among the institutions, it could not find any meaningful difference among them. Korean elders in the institutions seem to have no proper that they do not have any proper sense of evaluating their dietary life.

• Korean Journal of Acupuncture
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• v.27 no.3
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• pp.79-95
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• 2010

Objective : In this study, we try to identify the herbal formulated by Heo Im from Kyeongheombang(經驗方), and investigate its medical property. Method : Those articles referenced from Heo Im's herbal formulas in "Sauikyeongheombang(四醫經驗方)" were extracted and results were quantitatively analyzed. From extracted empirical formulas, those categorized as externally applicable formulas were grouped by several standards and their medical significance was analyzed. Results and Conclusions : 85 and 66 articles were designated to be referred from Heo(許) in "Sauikyeongheombang" and "Uibanghapbu(醫方合部)" in each category, and 263 and 155 were identified to be Heo Im formulas, respectively. Externally applicable formulas in Heo Im's empirical recipes have following characteristics. First, various methods were used by Heo Im. Second, Heo Im's empirical formulas suggest useful clinical information maximizing therapeutic effect, which is of much value, originated from his practical experiences as a clinician. Third, Heo Im's therapy favorably succeeds the tradition of Hyangyak-medicine and Empirical -medicine. From this information, Heo Im is thought to have had rich insight and experience, not only in acupuncture but also in the prescription of herbal formulas at those days.