• 보건의료산업학회지
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• 제5권1호
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• pp.147-158
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• 2011

This study compares the degree of satisfaction and the causes of selecting facilities for stroke patients in the senior specialized hospitals and other senior care facilities. The research results are followed. First, The patients who held the level of senior long-term care used senior specialized hospitals, while the patients who had the level of 2 or 3 degree used senior care facilities. The patients helped by cooperative care service used senior care facilities, and the patients helped by private service or family service used senior specialized hospitals. Second, The patients in senior specialized hospitals had affirmative attitude for their service system, while the patients in senior care facilities preferred their various service systems. In the satisfaction of the facilities, the patients in senior care facilities felt more satisfaction to staff, environment, service, and other factors than the patients in hospitals did. Third, in the result of logistic analysis, the patients had an affirmative attitude in case that they had spouse, experience of senior specialized hospitals or senior care facilities, without senior long-term care insurance. They also valued the service standard and the staff quality. As this study points out, the overall preference is higher in the senior care facilities. So, the stroke patients recognized the new role between the hospitals and the facilities after the establishment of long-term senior medicare system. This research had some limitation for the research areas and numbers. So the data analysis for the types of facility and the responses may not be generalized. However, the standard of choosing facility and satisfaction will be a guideline for establishing a new future role between hospitals and facilities. This result will be used as a basic data for the renovation of long-term senior medicare insurance.

• Advances in pediatric surgery
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• 제14권2호
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• pp.134-143
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• 2008

Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.54-62
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• 2005

The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.

• 한국임상약학회지
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• 제28권2호
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• pp.107-116
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• 2018

Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.

• 대한간호학회지
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• 제26권3호
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• pp.697-708
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• 1996

Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adherence to tuberculosis treatment regimens. A random assignment, two-group(experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitoring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows : 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0.01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03) 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, p=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

• 재활간호학회지
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• 제4권1호
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• pp.105-118
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• 2001

The purpose of study was to compare body image between diabetes mellitus patients who used insulin pump therapy and didn't use insulin pump therapy. The study design was comparative survey study the subjects were 60 diabetes mellitus patients who used insulin pump therapy and 60 diabetes mellitus patients who didn't use insulin pump therapy at B hospital in Busan The data were collected from 15th April to 20th August, 1998. The instrument used for this study were Osgood's body image scale. The collected data were analyzed frequency, percentage, $X^2$-test, mean, standard deviation, t-test, ANOVA, Scheffe test. The results were as follows 1. Demographical characteristics between diabetes mellitus patients who used insulin pump therapy and didn't use insulin pump therapy were no significant difference. 2. Characteristics related disease between diabetes mellitus patients who used insulin pump therapy and didn't use insulin pump therapy were significant difference in paticipation of D.M. meeting, no of paticipation of D.M. meeting. 3. Body inmage score of diabetes mellitus patients was $69.08{\pm}18.13$. In body image, diabetes mellitus patients who used insulin pump therapy were higher than that didn't use insulin pump therapy(t=1.964, P<.05) 4. In body image's each item, common-strange item, noble-humble item, competent-incompetent item, light-heavy item, diabetes mellitus patients who used insulin pump therapy were higher than diabetes mellitus patients who didn't use insulin pump therapy(P<.05) 5. In body image according to economic status, marital status, occupational status were significantly difference. 6. In body image according to causes of regular hospital visiting, paticipation of diabetes mellitus class were significantly difference. In conclusion, diabetes mellitus patients who used insulin pump therapy were more positive than diabetes mellitus patients who didn't use insulin pump therapy.

• 음성과학
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• 제8권4호
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• pp.139-156
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• 2001

Speech intelligibility in patients with complete dentures is an important clinical problem depending on the material used. The objective of this study was to investigate the speech of two edentulous subjects fitted with a complete maxillary prosthesis made of two different palatal materials: chrome-cobalt alloy and acrylic resin. Three patients with complete dentures in the experiment group and ten people in the controls groups participated in the experiment. CSL, Visi-Pitch were used to measure speech characteristics. The test words consisted of a simple vowel /e/, meaningless three syllabic words containing fricative, affricated and stops sounds, and sustained fricative sounds /s/ and /$\int$/. The analysis speech parameters were vowel and lateral formants, VOT, sound durations, sound pressure level and fricative frequency. Data analysis was conducted by a series of paired T-test. The findings like the following: (1) Vowel formant one of patients with complete denture is higher than that of the control group (p<0.05), while lateral formant three of patients with complete denture is lower than that of the control group (p<0.0l). (2) Patients with complete denture produced lower speech intelligibility with low fricative frequency (/$\int$/) than control group (p<0.0). The speech intelligibility of patients with metal prosthesis was higher than that of those with resin prosthesis (p<0.05). (3) Fricative, lateral and stop sound durations of patients with complete denture were longer than those of the control group (p<0.01 and p<0.05), respectively. Total sound durations of patients with metal prosthesis were similar to that of the control group (p<0.05), while those with resin prosthesis had a shorter duration (p<0.01). This implied that those with metal prosthesis had higher speech intelligibility than those with resin prosthesis. (4) Patients with complete denture had higher sound pressure levels /t/ and /c/ than the control group (p<0.01). However, sound pressure levels for /c/ of patients with metal prosthesis or resin prosthesis was similar to the control group (p<0.05). (5) Patients with complete denture had higher fundamental frequency than the control group (p<0.01).

• Tuberculosis and Respiratory Diseases
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• 제83권3호
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.35-40
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• 2015

Purpose: This study aims to assess the psychological characteristics of patients with iatrogenic damage of the trigeminal nerve using Symptom Checklist-90-Revised (SCL-90-R). Methods: A total of 22 patients who visited the clinic of Department of Oral Medicine, School of Dentistry, Chosun University were evaluated in the months from December 2012 to December 2014. Patients were included in the study if they presented with reported sensory changes due to iatrogenic trigeminal nerve injury. A total of 37 control group who has no symptoms of pain and sensory change were included in the study. All participants filled out the SCL-90-R instrument to assess psychosocial symptoms. Results: The T-scores of most of the SCL-90-R symptom dimensions were within normal range (less than 55) in the patients and the control group. The patients group showed higher T-scores of SCL-90-R than those of the control group, with statistically significance of somatization, anxiety, psychoticism, and positive symptoms distress. Female patients group had higher Tscores of SCL-90-R than those of male patients group, but there was no statistical difference, except for the positive symptom global index. The chronic patients group showed higher Tscores of SCL-90-R than those of the acute patients group, but there was no statistical difference, except for the Positive symptom global index. Conclusions: According to the psychological assessment of iatrogenic trigeminal nerve injury patients using SCL-90-R, the patients group, as compared to the control group shows a significantly higher score for somatization, anxiety, and psychoticism. Therefore, assessment of psychological state would be considered to treat patients with iatrogenic trigeminal nerve injury.

• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.48-53
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• 2016

Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.