• Journal of radiological science and technology
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• v.37 no.2
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• pp.109-116
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• 2014

Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irrespective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age $62.44{\pm}9.8$year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%), 2(6.3%), 1(3.1%), 1(3.1%) and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death during a follow-up period of $32.9{\pm}12.4$ months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.25-37
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• 2005

Objective : To estimate the magnitude of psychosocial distress and examine eligible factors associated with the development of psychosocial distress in Korean employees, using a nationwide sample. Methods : A total of 6,977 workers were recruited from 245 companies. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, social support at work, personality traits (locus of control, type A behavior pattern), self-esteem, and psychosocial distress. Results : The results showed that 23 % of workers were categorized as high stress, 73% as moderate, and 5% as normal. Hierarchical multiple regression analysis showed that psychosocial distress was more common in younger workers, both male and female. Regular exercise was negatively associated with increase of psychosocial distress. In job characteristics, as expected, low decision latitude, high job insecurity, and low social support at work were related to high psychosocial distress. Personality traits such as locus of control and type A behavior pattern, and self-esteem were more powerful predictors of psychosocial distress than general characteristics, health-related behavior, and job characteristics. There were some gender differences. While men who are less educated and single (unmarried, divorced, and separated) experienced higher levels of psychosocial distress than those who are educated and married, women who feel high job demand experienced higher levels of psychosocial distress than those who feel low job demand. Conclusions : The proportion of the high stress group was higher than expected, and psychosocial factors like social support and personality characteristics (e. g. locus of control, type A behavior pattern and self-esteem) were more significant factors for psychosocial distress than other variables. This finding suggests that some psychosocial factors, especially inadequate social support, low self-esteem and lack of internal locus of control for the development of psychosocial distress, will also operate as an intervention strategy in the worksite stress reduction program. It is strongly required that worksite stress reduction programs should be established in at both occupational and level as well as in individual levels.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.134-141
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• 2010

Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Journal of Music and Human Behavior
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• v.2 no.2
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• pp.15-31
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• 2005

Terminal pediatric patient include congenital metabolic abnormalities, chromosome aberrations, congenital anomalies, neuromuscular diseases and other incurable conditions as well as malignant tumors. One third of these diseases are cancers, and two thirds of cancers are lymphadenoma and leukemia. Terminal pediatric patient may feel fear, anger and frustration against treatment process in hospitals, lose control of themselves and stay in helplessness due to restrictions within controlled hospital environment. This study examined the relationship between hospitalized childrens behavior and music using Contextual Support Model of Music Therapya theory stating therapeutic music environments possess three elements of Structure, Autonomy support and Involvement, and increase childrens active engagement. Focused on these three therapeutic elements, this study analyzed music therapy cases of terminally ill children to examine the relationship between childrens behavior and music as environmental supportive medium in the environment. This study is on a single case case subject, a 10-year-old girl with acute lymphocytic leukemia. Nine sessions of music therapy activities were conducted and analyzed using qualitative method. Focusing on three therapeutic elements of Contextual Support Model, analysis of sessions was made on the basis of activities specifically designed for this study. Main music therapy activities included singing while playing musical instruments, singing while listening to music through CD player, making up songs, and searching for song lines. The findings of this study are as follows: a) in terms of Structure, music therapy suggested a direction for effective musical activities for terminally ill children by providing environments where child can sing, play musical instruments and make up songs; b) in terms of Autonomy support, music therapy encouraged childs voluntary participation by giving her chances to make choice while singing or playing musical instruments; c) in terms of Involvement, child could gain positive approval of the therapist and conduct musical activities in cooperation with the therapist. Music therapy serves as supportive medium in the environment, develops spontaneity and self-reliance in emotionally depressed children, and promotes voluntary attitudes in the restricted hospital environment. Based on the positive effects of music therapy, more studies need to be conducted with an approach to more various terminal pediatric patients.

• Journal of Music and Human Behavior
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• v.2 no.2
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• pp.33-56
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• 2005

The purpose of this study is to measure the effect of musical activities on children's aggressiveness using percussion playing through case studies and to present the therapeutic programs. Musical activities using percussion playing were organized for three aggressive children. Twenty-one small group sessions were conducted over seven weeks with 30 minutes given each session. Fourth-grade children involved in using Aggressiveness Measuring Tool for Teachers-revised by Gwak Geum-Joo(1992) was selected for case studies. Children's impulsiveness was also tested through self-test measuring tool for impulsiveness-revision of 16 questions used by Cho Hae Yeon (2001) and Lee Joo Shik (2003). As quantitative method, comparative analysis was made between the pre and post test results using measuring tools for aggressiveness and impulsiveness of children as well as between aggressive behaviors occurring in the initial stage of the first three sessions and in the latter stage of the last three sessions. Qualitative method was used at the same time to examine the effect of percussion playing on children. After the musical activities, child A showed reduced Aggressive Measuring Tool scores from 19 to 18, with child B from 23 to 19 and child C from 21 to 18. The results show that occurrence of aggressive behaviors were lowered in the post test. Impulsiveness Measuring Tool scores in the post test were decreased as well in all three children. During the music therapy programs, it was also observed that the frequency of the target behaviors in all three children has reduced more in the latter stage than the initial stage of music therapy. The qualitative findings indicate that the children experienced releasing stress through self-expression after percussion playing. These findings indicate therapeutic effectiveness of music therapy using on percussion playing in reducing aggressiveness of children as well as the effectiveness of percussion as a therapeutic intervention for aggressive children. These results can be adapted and reapplied by teachers in primary schools to approach children with behavior problems, and can present a useful therapeutic approach to therapists practicing in clinical environments.

• Journal of agricultural medicine and community health
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• v.42 no.3
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• pp.119-131
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• 2017

Objectives: The purpose of this study was to compare the diabetic management indicators between agriculture, forestry, and fishery workers (AFF) and other occupational adults (non-AFF) in community-dwelling diabetes. Methods: The study population consisted of 22,127 diabetic population ${\geq}19years$ who participated in the 2015 Community Health Survey. Chi-square test and logistic regression analysis was used to compare the diabetic management indicators between AFF and non-AFF. Socioeconomic characteristics such as age, gender, education level, monthly household income, National Basic Livelihood Security status, and marital status was sequentially adjusted. Results: Among total diabetic population, 3,712 people (16.8%) was AFF and 18,415 people (83.2%) was non-AFF. The fully-adjusted odds ratio [OR] (95% confidence interval [CI]) of current non-medical treatment (0.72, 0.66-0.79), measurement of hemoglobin A1c (0.61, 0.55-0.67), screening for diabetic retinopathy (0.76, 0.70-0.83), screening for diabetic nephropathy (0.75, 0.70-0.81), non-alcoholic or moderate drinking (0.70, 0.64-0.78), nutrition label reading (0.83, 0.71-0.98), low salt preference (0.85, 0.78-0.93), dental examination (0.60, 0.54-0.66), scaling experience (0.84, 0.77-0.93), regular toothbrushing (0.66, 0.58-0.76), and diabetes management education (0.84, 0.77-0.92) was significantly lower in AFF compared to non-AFF. In contrast, the fully-adjusted OR (95% CI) of AFF's low stress level (1.39, 1.26-1.52) and adequate sleep duration (1.22, 1.13-1.32) was significantly higher than non-AFF, which are better indicators of diabetic management in AFF. Conclusions: Overall, the level of diabetes management of AFF was not as good as that of non-AFF. In order to improve the level of diabetes management of AFF, a delicate diabetes intervention strategy considering the occupational characteristics of AFF will be needed.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.323-330
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• 1996

Objective : Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis. Methods : Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995. Results: The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 eases and remained in 28 eases. In the cases of closed cavity, it was happened within $10.6{\pm}4.72$ months after they took treatment, the size of cavity was $35.5{\pm}17.1$ in long diameter, $27.0{\pm}12.2$ in short diameter and $4.6{\pm}2.1\;mm$ in wall thickness. In the cases of remained cavity, the size of cavity was $31.9{\pm}12.3$ in long diameter, $21.0{\pm}9.8$ in short diameter and $5.04{\pm}2.0\;mm$ in wall thickness. In terms of negative conversion, it took $3.8{\pm}2.17$ months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions. Conclusion : In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.

• Journal of dental hygiene science
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• v.16 no.1
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• pp.26-36
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• 2016

The purpose of this study was to examine how oral health literacy of mothers affect the oral health status of their preschool children. The subjects were 233 mothers and their preschool children who are between 5 and 6 years old. They were selected according to the convenience sampling method. The individual self-administered questionnaire was used for the mother's survey while the children were interviewed using structured questionnaire to examine their oral health status and behavior. According to study results, the number of decayed primary teeth and the number of decayed and filled primary teeth had a statistically significant negative correlation with the oral health literacy of the mother, the children's oral health knowledge, attitude and behavior (COHKAB), and the mother's oral health management behavior. Hierarchical multiple regression analysis was performed after including general characteristics variables, the COHKAB and the mother's oral health management behavior. Meanwhile, mother's oral health literacy had a statistically influence on children's oral health status. The higher the mother's oral health literacy level, the lower the number of decayed and filled primary teeth were. The findings suggest that efforts to improve the oral health status of preschool children should consider mother's oral health literacy as an important factor. Therefore, the effective intervention and education programs are necessary to enhance mother's oral health literacy.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.238-250
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• 2011

Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.