• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.6.4-7
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• 1983

Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.

• Journal of Food Hygiene and Safety
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• v.36 no.1
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• pp.68-76
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• 2021

Foodborne outbreaks frequently occur worldwide and result in huge economic losses. It is the therefore important to estimate the costs associated with foodborne diseases to minimize the economic damage. At the same time, it is difficult to accurately estimate the economic loss from foodborne disease due to a wide variety of cost components. In Korea, there are a limited number of analytical studies attempting to estimate such costs. In this study we investigated the components of economic cost used in foreign countries to better estimate the cost of foodborne disease in Korea. Seven recent studies investigated the cost components used to estimate the cost of foodborne disease in humans. This study categorized the economic loss into four types of cost: direct costs, indirect costs, food business costs, and government administration costs. The healthcare costs most often included were medical (outpatient) and hospital costs (inpatient). However, these cost components should be selected according to the systems and budgets of medical services by country. For non-healthcare costs, several other studies considered transportation costs to the hospital as an exception to the cost of inpatient care. So, further discussion is needed on whether to consider inpatient care costs. Among the indirect costs, premature mortality, lost productivity, lost leisure time, and lost quality of life/pain, grief and suffering costs were considered, but the opportunity costs for hospital visits were not considered in any of the above studies. As with healthcare costs, government administration costs should also be considered appropriate cost components due to the difference in government budget systems, for example. Our findings will provide fundamental information for economic analysis associated with foodborne diseases to improve food safety policy in Korea.

• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.55-61
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• 2007

Purpose : Fever, the most common presenting symptom in pediatric clinics, has been believed to be a dangerous symptom by many parents. Proper recognition about fever will relieve unnecessary anxiety of parents and help them understand the course of the disease. Our objectives of this study were to investigate current parental recognition about fever and to compare these results with those described in 1992. Methods : Between May and July 2006, we questioned caregivers who visited the pediatric outpatient clinic in St.Paul hospital. The questionnaire consisted of 19 items asking about recognition, attitude and management of fever. Results : A total of 136 caregivers were interviewed. Compared with 10 years ago, there were no significant improvements in misconception about fever. Many caregivers (61%) had wrong information about a definition and the way to measure body temperature. There were still high concerns about febrile convulsion and brain damage from fever. Caregivers started treatment at the body temperature which actually needed no therapy. Conclusion : Parents were not aware that fever is just one of physiologic responses and has benefits, which led to unnecessary anxiety and treatment. This misconception has not been changed over the years. Pediatrician should inform parents that fever itself is not harmful and only rational reason for use of antipyretics is to relieve a discomfort of a febrile child. An educational interventions offered by pediatricians will be helpful for parents to have right attitude and understandings toward fever.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.681-695
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• 1995

It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle In addition to a series of other carcinogens increases various neoplasmic diseases. Therefore the importance of lifestyle that minimizes such impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is re-lated to the Korean lifestyle and as there's a possibility of its recurrence, people with stomach cancer need to lead a healthy lifestyle. The purpose of this study is to provide a basis for nursing intervention strategies to promote health promoting behaviors that are constructive to a healthy lifestyle. A multivariate model was constructed based on the fender's health promotion model and Booker's health belief model by including influential factors such as hope. The sample was composed of 164 patients with stomach cancer who visited outpatient clinics of a university hospital in Seoul. The following instruments were used in the study after some adaptation : Wallston and others' multidimensional health locus of control scale Laffrey's health conception scale, Lawston and others' health self- rating scale, Walker and others' health promotion lifestyle profile and Rogenberg's self esteem scale. In addition Moon's health belief scale was used with some modification. For self efficacy, the present author constructed a self-efficacy scale based on previous research. The above mentioned instruments were tested in a pilot study with 24 patients with stomach cancer. The reliabilities of instruments were tested with Cronbach's alpha(0.574∼0.949). Data were analyzed using a SAS program (or Pearson correlation coefficients, descriptive correlational statistics and stepwise multiple regression. The results are as follows : 1. The scores on the health promoting behavior scale ranged from 55 to 145 with a mean of 107.91 (S. D : 16.50). The mean scores(range 1-4) on the different dimensions were nutrition 3.14, exercise 2.48, stress management 2.69, health responsibility 2.65, interpersonal relationship 2.878E self actualization 2.85. 2. There were significant correlations among all the predictive variables & the health promoting behavior (r=.20-.55, p〈.01) 3. Stepwise multiple regression analysis showed that : 1) Hope was the main predictor and accounted for 29.8％ of the total variance. 2) Self efficacy, perceived barriers & self esteem accounted for an additional 14.6% of the total variance. 3) Hope, self efficacy, perceived barriers & self esteem altogether accounted for 44.3％ of the total variance. In conclusion, hope, self efficacy, perceived barriers & self esteem were identified as important variables that contributed to promote health promoting behavior.

• Korean Journal of Clinical Pharmacy
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• v.22 no.1
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• pp.30-40
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• 2012

In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially, neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60% of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist, analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.27-33
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• 1990

In the past decades there has been a growth of interest in the use of stellate ganglion block (SGB) as part of the diagnosis and therapy for the disease of the head, neck and upper extremities. For the evaluation of changes in hemodynamics and temperature of the affected extremity after the SGB, unilateral SGB (either right or left) was performed by local injection of 10 ml of 1% lidocaine without epinephrine in 45 patients (right side SGB: 25, left side SGB: 20) with various diseases. Systolic and diastolic blood pressure, pulse rate and skin temperature of the ipsilateral hand were studied before and 1, 2, 3, 4, 5, 10, 15, 30 and 60 minutes after the block. The results were as follows: 1) Changes of blood pressure: Systolic and distolic blood pressure after either right or left side SGB showed no statistically significant change. 2) Changes of pulse rate: While the left side SGB showed a mild decrease without statistical significance, the right side SGB showed a statistically significant decrease at 30 and 60 minutes after the block (p<0.05). 3) Changes of skin temperature of the blocked hand: Either side SGB produced a gradual increase in temperature with time and showed statistical significance from 10 minutes in the left side block (p<0.01), and a from 10 minutes after the block in the right side (p<0.01). Both sides SGB showed a maximal increase at 30 minutes after the block and a small decrease at 60 minutes after the block compared to the 30 minutes value. 4) Despite the successful SGB. 4 of 45 patients failed to produce a significant increase in skin temperature on the affected upper extremity. In conclusion, unilateral SGB with 1% lidocaine at the 6th cervical vertebral level is a safe method for use on an outpatient basis, and an increase in skin temperature in the affected upper extremity is necessary to confirm the successful therapeutic effect on disease of the upper extremity.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.167-179
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• 2009

Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.184-190
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• 2011

Scrotal involvement has been reported from 2% to 38% of males with Henoch-Sch$\ddot{o}$nlein purpura (HSP). It may present before the rash occurs or even long time after it has disappeared. Scrotal involvement of HSP usually results in pain, tenderness, swelling or discoloration of scrotum. Scrotal pain sometimes mimics testicular torsion to various degrees, which can be followed by unnecessary operation. In our 2 cases, one was a 5-year and 11-month-old boy who came to our emergency department due to scrotal pain before the diagnosis of HSP, and the other was a 5-year and 1-month-old boy who came to the outpatient clinic due to scrotal pain after the resolution of HSP about 1 month before the visit. We performed Doppler ultrasonography (USG) to evaluate the acute scrotal pain in the two boys. On Doppler USG, epididymis showed increased blood flow, and testis showed normal blood flow. These findings enabled the diagnosis of acute epididymitis and excluded testicular torsion. Epididymitis was improved by conservative management including shortterm steroid therapy within 5 days. It is important to perform adequate evaluation with tools such as Doppler USG in the early course of acute scrotum of HSP, to avoid unnecessary scrotal exploration.