• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.206-233
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• 1994

The Medical Research Council has for some years encouraged collaborative clinical trials in leukaemia and other cancers, reporting the results in the medical literature. One unreported result which deserves such publication is the development of the expertise to design and analyse such trials. This report was prepared by a group of British and American statisticians, but it is intended for people without any statistical expertise. Part!, which appears in this issue, discusses the design of such trials; Part II, which will appear separately in the January 1977 issue of the Journal, gives full instructions for the statistical analysis of such trials by means of life tables and the logrank test, including a worked example, and discusses the interpretation of trial results, including brief reports of particular trials. Both parts of this report are relevant to all clinical trials which study time to death, and would be equally relevant to clinical trials which study time to other particular classes of untoward event: first stroke, perhaps, or first relapse, metastasis, disease recurrence, thrombosis, transplant rejection, or death from a particular cause. Part I, in this issue, collects together ideas that have mostly already appeared in the medical literature, but Part II, next month, is the first simple account yet published for non-statistical physicians of how to analyse efficiently data from clinical trials of survival duration. Such trials include the majority of all clinical trials of cancer therapy; in cancer trials, however, it may be preferable to use these statistical methods to study time to local recurrence of tumour, or to study time to detectable metastatic spread, in addition to studying total survival. Solid tumours can be staged at diagnosis; if this, or any other available information in some other disease is an important determinant of outcome, it can be used to make the overall logrank test for the whole heterogeneous trial population more sensitive, and more intuitively satisfactory, for it will then only be necessary to compare like with like, and not, by chance, Stage I with Stage III.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.8 no.6
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• pp.1604-1612
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• 2007

For the latest 10 years, many companies have introduced the ERP system competitively. There have been many evaluations of the system, but most of them have made general evaluation and few of them studied output creation. The output of the introduction of the ERP system cannot be uniform, and the stages of output creation also vary. Accordingly, the present study purposed to examine when the management output of the ERP system is created in Korean companies that adopted the ERP system in order to predict the management output of such companies and to provide opportunities to change ERP operation methodology. Balanced scorecard was used as an indicator to measure the outcome of ERP. In addition, we conducted correlation analysis for determining the correlation between ERP system activation factors and management output, and performed frequency analysis to examine the stages of management output creation according to the stage of ERP system.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.1-8
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• 2016

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft $f{\ddot{u}}r$ osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.236-243
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• 2017

Purpose: Studies on the efficacy of infliximab (IFX) in a large population of pediatric patients with Crohn's disease (CD) are limited, and prognostic factors are not well-known. The aim of this study was to evaluate outcomes of IFX in pediatric patients with CD and to identify factors associated with poor prognosis. Methods: We retrospectively analyzed medical data of 594 pediatric patients with CD between 1987 and 2013 in a tertiary center. Of these, 156 children treated with IFX were enrolled and were followed up for at least a year with intact data. Outcomes of induction and maintenance, classified as failure or clinical response, were evaluated on the tenth and 54th week of IFX therapy. Results: We treated 156 pediatric patients with CD with IFX, and the median duration of IFX therapy was 47 months. For IFX induction therapy, 134 (85.9%) patients experienced clinical response on the 10th week. Among the 134 patients who showed response to induction, 111 (82.8%) patients maintained the clinical response on the 54th week. In multivariate analysis, low hematocrit (p=0.046) at the time of IFX initiation was associated with the failure of IFX induction. For IFX maintenance therapy, longer duration from the initial diagnosis to IFX therapy (p=0.017) was associated with maintenance failure on the 54th week. Conclusion: We have shown the acceptable outcomes of IFX in a large cohort of pediatric CD patients in Korea. Hematocrit and early introduction of IFX may be prognostic factors for the outcomes of IFX.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.485-497
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• 2017

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

• Journal of Sasang Constitutional Medicine
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• v.33 no.3
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• pp.146-160
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• 2021

Introduction This study is the first to report a significant improvement of Soyangin patients with persistent night sweats through herbal medicine treatment. Methods We reviewed the total of 6 Soyangin patients with moderate to severe persistent night sweats who visited the outpatient clinic. The patients received herbal medicine treatment alone for 4 to 9 weeks. We evaluated the treatment outcome using Night Sweats Degree criteria, developed by Lea and Aber(1985), every other 2 to 4 weeks. In addition, we recorded the treatment period from the first visit to symptom alleviation. Results Persistent night sweats improved significantly in all 6 Soyangin patients, and 4 out of 6 patients had better sleep quality after the treatment. It took 1 to 3 weeks until the symptom alleviated from moderate or severe to mild, and 3 to 7 weeks until the patients have no sign of night sweating. The progression of persistent night sweats and treatment period until no sign of symptom varied according to the Soyangin External and Internal disease diagnosis. Discussion The Soyangin patients having persistent night sweats treated with herbal medicines showed a significant improvement in their symptoms. This result proposes the possibility of using herbal medicine in primary care patients experiencing persistent night sweats.

• Journal of Oriental Neuropsychiatry
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• v.30 no.2
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• pp.59-69
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• 2019

Objectives: Case report is a description of medical experience that contains a patient's information and treatments. It has been used to determine the effectiveness and side effect of the treatments. Case report can be used for medical, scientific, or educational purposes. The objective of this study was to evaluate the quality of case reports published in Journal of Oriental Neuropsychiatry from 2013 to 2017 using CARE and CARES guideline. Methods: Case reports were selected from Journal of Oriental Neuropsychiatry and their quality assessed using CARE guideline and CARES guideline. The items of CARE and CARES guideline were assessed as 'Sufficient', 'Not sufficient', 'Not reported', 'Not applicable'. The outcome was analyzed using case reports and items. Results: 26 case reports were selected. For CARE guideline, 'Sufficient' percentage was min at 22.2%, max at 46.4% with a median of 39.3%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 59.3%, max at 85.7% with a median of 75.0%. Items 'Timeline', 'Diagnostic assessment', 'Follow up and outcomes', 'Informed consent' were not reported in more than 50% of all case reports. Items 'Keywords', 'Abstract', 'Introduction', 'patient information', 'Diagnostic assessment', 'Therapeutic interventions', 'Follow up and outcomes' were not sufficiently reported in more than 50% of all case reports. For CARES guideline, 'Sufficient' percentage was min at 0%, max at 50% with a median of 0%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 33.3%, max at 100% with a median of 92.9%. Items of herbal prescription 'herb', 'decoction', 'use', items of acupuncture treatment 'materials', 'techniques', items of moxibustion treatment 'materials', 'techniques' were not sufficiently reported in more than 50% of all case reports. Conclusions: The reporting rate of items was good. But the quality of reporting was low. Also, particular items were not reported frequently. Therefore, there is a need to improve the quality of case reports in Journal of Oriental Neuropsychiatry.

• Journal of the Korean Society of Food Culture
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• v.34 no.1
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• pp.34-43
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• 2019

The aim of this study was to develop and evaluate a nutrition education program that was designed to increase the knowledge, attitudes, and skills of Korean adults regarding nutrition labeling. The education program was 45 minutes of short-term training, which was conducted in the form of lectures and exercises. The contents of the program were as follows: in the introduction stage, talking about status and reasons for checking nutrition labels; in the development stage, explanation of nutrition labeling and their content, reading, and identifying sample nutrition labels, as well as comparing nutrition labels and selecting better foods; in the closing stage, summary of nutrition labeling and a pledge to check nutrition labels when purchasing processed food. A total of 53 adults (88.5% female) aged 30 years and over participated in this study. The nutrition labeling awareness of the subjects was increased significantly from 55.8 to 96.2% after the education. After the education, the correct recognition rate of a nutrition label was increased significantly from 26.9 to 78.8% for the amount of food, from 25.0 to 73.1% for the calorie content, from 36.5 to 69.2% for the nutrient contents, and from 30.8 to 82.7% for the percent daily value. The self-efficacy of checking nutrition labels was also increased significantly compared to that before the education. The overall satisfaction score of the nutrition education program was 4.2 out of 5. The outcome showed that the nutrition education program of nutrition labeling improved the participants' awareness and self-efficacy towards checking nutrition labels.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.2
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• pp.18-28
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• 2019

Objectives: The research is aimed at identifying the necessity of the support project of Korean medical treatment in infertility by analyzing the outcome of those subject and providing data for Korean medical treatment in infertility by analyzing the medical treatment of Korean medical doctors involved in the project. Methods: 98 patients who participated in the support project of Korean medical treatment in infertility in Jeollanamdo and 57 Korean medical doctors who participated as therapists were surveyed. Patients were given four months of treatment at local Korean medical clinics. After the treatment was completed, we analyzed the characteristics of the patients' group. And we sent questionnaires to doctors to answer the message. The content of the questionnaire consisted of infertility treatments, a wish for support project. These data were analyzed by frequency and t-test. Results: Analysis of the answer to the questionnaire obtained data on Korean medical treatment in infertility. The most desired thing for future support program was the introduction of husband and wife care. Conclusions: This survey by Korean medical doctors gave us reference data for Korean medical treatment in infertility and the direction in which therapy business should proceed.