• Journal of agricultural medicine and community health
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• v.11 no.1
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• pp.44-54
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• 1986

This study was aimed at investigating the health seeking behaviors of patients; For the purpose of analyzing the research theme we classified the study into two phase. First, the types of patients' health seeking behavior were categorized into a scheme according to what medical care resources were utilized in patients' coping process. Second, from patients' first visits to third visits to medical resources, we analyzed variations of factors which noted as crucial elements in constituting the patients' sickness career. To grasp the generalized characteristics from complicated empirical data, we limited the scope of our analysis to third stage of health seeking. A total of 121 persons who had beer suffering from chronic diseases more than 3 months was sampled among the residents of Banwol-Eup, the target Area of Korea University Health Project. The findings are as follows ; 1) In the course of visiting medical care resources, 34 different types of health seeking Behavior were found. From this result we inferred the idea that patients in Banwol-Eup had not any stable norms to cope with their pains. Clinics, hospital, pharmacy, Herb-doctors', folkways (self-treatment) were accessed by patients in orders. But more than half of patients who had utilized clinics or hospitals from their first to third visits, changed medical care resources to others, for example herb doctors or folkways, which had fundamentally different treatment models. Upon these two facts, the diversified types and capricious patterns in the health seeking behavior of Banwol patients, we observed a typical Shopping-Around phenomenon. 2) Factors which influenced patients' to their sickness career were changed along the courses of health seeking, from first to third visits as follows ; $\cdot$ Perceived seriousness of diseases were tended to decrease. $\cdot$ Professional medical personnel tended to be influencial in the patients' sickness career, (5.0%, 25.0% and 65.7%). The influence of the primary interaction groups such as parents, friends, neighbours, tended to decrease ; (90.9%, 71.2% and 30.0%). $\cdot$ The subjective reasons why to choose such a medical care resource were related to economic affordability and disease-itself as main motives. Credibility of health resources tended to increase 14.9%, 24.0% and 31.4 sequently. $\cdot$ Geographic accessibility factors did not change significantly. Most of patients had utilized health resources in Banwol and Anyang area. 3) Cultural inclination in the shopping-around phenomenon has shown difference among age groups. The age group' over 50 years' preferred traditional health resources to modern health resources. 4) Consistency of health seeking behavior on the shopping around phenomenon has shown difference according to the degrees of patients' economic affordability and those of psychological satisfaction toward modern health services. However, there were some restrictions in this thesis ; a) the study was limited to the 3rd health seeking career so it did not allow us to collect more informations after that, b) the study was not able to carry out causal analysis on patients health behavior determinated by explanatory model of health resources, and c) the study was not able to take into consideration of factors connected with social structural circumstances. Despite of restrictions described above, we are sure that this thesis would promote health providers' understanding toward patients' inclinations, through which they could provide efficient and accurate medical service.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.752-758
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• 2007

Background: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. Material and Method: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). Result: For group 1, 41.9% experienced no sweating and 48.4% re-plied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions, 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. Conclusion: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.315-329
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• 1999

Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

• Journal of dental hygiene science
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• v.7 no.2
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• pp.65-72
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• 2007

The purpose of this study was to examine the job stress and job stressors of dental hygienists. The subjects in the study were 220 dental hygienists who worked in north Jeolla province. After a mail survey was conducted from July 24 through September 24, 2006, the responses from 180 dental hygienists(response rate 81.8%) were gathered, and 156 answer sheets were analyzed except 24 incomplete ones that couldn't be analyzable. The findings of the study were as follows: 1. As for the correlation of overall job stress to turnover intention, their entire stress was under the influence of unreasonable treatment (r = 0.382), conflicts as a professional(r = 0.285), tough working environments(r = 0.303), conflicts with colleagues(r = 0.233), and heavy workload (r = 0.262). Those who were more stressed were more willing to change their occupation, and their stress level made a statistically significant difference to that(p < 0.01). 2. A multiple regression analysis was carried out by selecting the job stressors and turnover intention as independent and dependent variables respectively to see how each of the stressors affected job stress. And unreasonable treatment(p < 0.001) was identified as what had the biggest impact on that, followed by conflicts as a professional(p < 0.05), and tough working environments (p < 0.05). The stressors made a 22.2% prediction of turnover intention.

• Journal of Technologic Dentistry
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• v.24 no.1
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• pp.51-63
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• 2002

The purpose of this study was to be of use for getting rid of job stress from dental technicians, by examining how much they were stressed out at work place as one of the professional medical personnels. The subjects in this study were 255 selected dental technicians who were working in the region of Taegu. The one-on-one interview was conducted from March 1 to 30, 2001, with structured questionnaire. The questionnaire sued in this study included 19 question items about the general characteristics and 29 items regarding job stress. The job stress was categorized into seven subareas based on earlier studies and considering the job situations of dental technicians: heavy workload, job conflicts, improper treatment, role and job knowledge, human relations, physical environment and personal matters. The job stress extent was measured on five-point Likert scale that is widely used in social science: one point for no stress, two for little stress, three for so-so, four for a little stress, and five for severe stress. Therefore, a higher point means a severer job stress. The reliability of the questionnaire turned out very good with Cronbach a = 0.9272. The findings of this study were as follows: 1. The general characteristics of the dental technicians investigated could be described as below: (1) By gender, 80.4% of the dental technicians were male, and 50.2%, the largest percentage, were in their 20s, followed by those in their 30s, those in their 40s, and those in their 50s in the order named. (2) The most common work place was dental technician shop(92.5%), followed by dental technology room in dental hospital or clinic and in general hospital in the order named. The primary duties were coating materials work(30.6%), followed by sculpture, grinding, partial and full denture and orthodontics in the order named. 2. The most larges (1) The most largest motivation to be a dental technician was its being a professional(33.7%), followed by the advice from others, their own aptitude, and good economic treatment in the order named. 3. Their job stress could be explained as below: (1) Their collective job stress average was 3.96$^{\circ}{\ae}$0.50 on the basis of 5 point, which showed that they were exposed to a fairly severe job stress. (2) By area, they were most stressed out from heavy workload (4.12), and they also were severely stressed from role and job knowledge(4.02) and personal matters(4.00). (3) By situation, they were most stressed when the disagreement of prosthesis that results from a specific error is unconditionally attributed to them(4.43). And they were also stressed a lot when their workload increases due to the rework(4.38), when a dentist asks something difficult for them to resolve(4.20), when heavy workload makes their working hours irregular and it's impossible to lead a personal life or have leisure time(4.16), and when they are o work for an excessively short time(4.16). This fact indicated that most of the dental technicians were exposed to a lot of stress in conjunction with job performance. 4. The main duties they took charge of didn't make any significant difference to their job stress, but yielded a significant difference to the extent of job stress in individual areas and the order of the most stressful one. Those who were engaged in grinding were most stressed from their own matters, whereas heavy workload was most stressful for those who were engaged in the other types of works. 5. As a result of seeing if their personal characteristics yielded any differences to job stress, the personal characteristics that made their job stress vary significantly were working hours, motivation of being a dental technician, job satisfaction and willingness to continue doing dental technology works. There was a tendency that longer working hours led to severer job stress, and those who chose to be a dental technician according to their own aptitude were less stressed than the others who became a dental technician because of economic reason or advices from others. And the people who were satisfied with their job were exposed to less job stress than the others who weren't, and those who had an intention to keep that job as much as possible were less stressed, compared to the others who hadn't.

• Journal of Technologic Dentistry
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• v.28 no.1
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• pp.177-198
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• 2006

This study purposed to offer basic data for safety education of the dental laboratory technology after the investigation of how much the students in the dept. of dental laboratory technology are aware of the danger of each instrument, equipment or laboratory procedure that they use during laboratory and how much they demand safety education for this. The objects for this study were 423 students who were in the dept. of dental laboratory technology. In this regard, four colleges which have the dept. of dental laboratory technology were randomly selected to do a questionnaire survey. SPSS 12.0 was used to analyze the collected data. The results were as follows: As for satisfaction with their major, the respondents answered Satisfied (59.1%), Average (35.5%) and Dissatisfied (5.4%). In terms of the production process of a partial denture, they considered casting, polishing the casting body, polishing denture and burn out were most dangerous in order. As for the production process of a full denture, what they regarded as the most dangerous in order was polishing denture, deflasking and wax wash. Regarding the laboratory procedures of porcelain material, casting, trimming casting body, polishing porcelain material and burn out were the most dangerous procedures that they perceived. With regard to materials for use, alcohol, polishing, metal and wire were the most dangerous ones they thought. As for the handling characteristics of each material, small towns showed a higher demand for safety of the handling characteristics of alcohol. In terms of school year and sex, juniors and girls had higher scores in the demand for safety of the handling characteristics of acid. Regarding the handling characteristics of each equipment and instrument, all of small towns, juniors and girls showed the highest demand for safety of the handling characteristics of alcohol lamps. With regard to scores in the demand for safety of other characteristics, all of small towns, juniors and girls had the highest demand for safety of emergency treatment. Concerning the demand for safety education by the completion of safety education, in terms of each material, highest was the demand for safety of acid from the group which completed safety education. In regard to equipments and instruments, when it came to the demand for safety of the handling characteristics of casting machine, the educated group's demand for safety of acid was higher. Regarding other characteristics, the group which was not educated gained higher scores in the demand for safety of emergency treatment. 11. In all areas(materials, machines and others), small towns, girls and juniors showed higher scores in the demand for safety. Based on the above results, it was found that when students conduct the laboratory of dental technology, they would think that many materials, instruments or equipments for use are very dangerous. However, safety education was not fully given to them. Regarding the scores in the damned for safety education, the highest was 4.16 and the lowest was 3.43, which suggests that the scores were generally very high. In this regard, it is necessary to continue delivering a systematic safety education of materials, equipments or instruments used during the laboratory of dental technology. Therefore, through the analysis of each material, instruments or facility used in every laboratory and each process, safety accident types and accident risk factors should be investigated to develop educational materials for this. Moreover, it is required to open safety education as a single course of study or insert safety contents of all materials and machines into the class of dental laboratory instrument or dental materials for the purpose of a systematic and thorough safety education to prevent a safety accident during laboratory.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.134-139
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• 2012

Purpose: To report the treatment results of arthroscopic osteochondroplasty in osteochondral lesion of the talus. Materials and Methods: This study included 32 patients who had osteochondral lesion of the talus treated with arthroscopic osteochondroplasty and were able to be followed up over 3 years from 1999 to 2007. The mean follow up period was 48 (38-108) months, and 22 male patients and 10 female patients with a mean age of 34 (20-56) years were included. Locations of lesion were evaluated with simple X-ray and magnetic resonance imaging (MRI), and severities of lesions were classified by Berndt and Harty classification. All cases were treated by arthroscopic debridement or microfracture. The treatment results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and subjective and functional score of Kailkkonen. The group treated by arthroscopic microfracture was compared with the group treated by arthroscopic debridement. Results: The mean AOFAS ankle-hindfoot scale was significantly improved 53 (${\pm}7$) points preoperatively to 84 (${\pm}8$) points postoperatively (P<0.001). The mean subjective and functional score was also improved 55 (${\pm}8$) points preoperatively to 88 (${\pm}8$) points postoperatively with statistical significant (P<0.001). There were no relations between the severity of lesions and the postoperative functional score of ankle (P>0.05). There were no significant differences in the clinical results between the group treated with arthroscopic microfracture and the group treated with arthroscopic debridement (P>0.05). Conclusion: Arthroscopic osteochondroplasty of osteochondral lesion of the talus shows excellent result in terms of patients' satisfaction. There were no significant differences in the clinical results between arthroscopic microfracture group and debridement group.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.124-131
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• 2004

Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1152-1159
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• 2018

Purpose: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). Methods: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. Results: The mean patient age was $72.46{\pm}7.16years$. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was $0.13{\pm}0.14logMAR$ and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. Conclusions: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.