• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.546-550
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• 2011

The aim of this study was to evaluate oriental medicine pattern identification in patients with stroke on the basis of plasma fibrinogen levels and platelet counts. 555 patients diagnosed with stroke between November 2006 and February 2010 were divided in several ways according to the plasma fibrinogen levels and platelet counts on admission. And comparative analysis of the distribution ratio of oriental medicine pattern identification was done between the groups. The mean value of the plasma fibrinogen levels of whole population was 449.18 mg/dL, and it was higher than normal range. The mean value of the platelet counts of whole population was 244.29 /mL, and it was lower but in normal range. Oriental medicine pattern identifications were not characteristic between groups divided according to the serum levels of fibrinogen and platelet counts. In this study, there was not significant correlation between Oriental medicine pattern identifications and the thrombotic factor like plasma fibrinogen levels and platelet counts. This study could be the steppingstone for the next study to develope the objective indicator for the Oriental medicine pattern identifications.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.55-59
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• 2005

The proper management of the pediatric facial bone fracture is critical in the facial bone development. This study characterizes the surgically treated patient population suffering from facial bone fractures by the use of current data from a large series consisting of 201 cases. The data was gathered through a retrospective chart review of patients surgically treated for facial bone fractures at the department of plastic and reconstructive surgery, Sanggye Paik hospital, Inje university medical center, collected over 10-years period from January, 1993 to December, 2002. Data regarding patient demographics(age, sex), seasonal distribution, location of fractures, and the causes of injury with admission periods, were collected. In total, there were 201cases of pediatric facial bone fractures. Male patients outnumbered female patients by a 5.48: 1 ratio and were found to engage in a wider range of behaviors that resulted in facial bone fractures. Physical violence was the leading cause of pediatric facial bone fractures(27.9%), followed by sports-related mechanisms (22.9%) and falling down(17.9%). The most prevalent age group was 11-15 years-old(71.1%) and there was a 14.3% prevalence in March. Among the location of fractures, the nasal bone was the most prevalent, accounting for 82.3% of injuries, followed by the orbit(9.95%), and the mandible fractures(7.5%). Most patients(59.7%) were treated within 6-9 days after trauma and the mean hospitalization period was 8-11 days. We should follow up the surgically treated patients, and they will be further evaluated about postoperative sequele and effect on the facial bone development. These studies demonstrate differences in the demographics and clinical presentation that, if applied to patients, will enable a more accurate diagnosis and proper management.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.421-428
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• 1986

From January 1981 through December 1985, 481 thoracic civilian injuries were reviewed in the Department of Thoracic Surgery, Paik Hospital in Seoul. Sixty two percent of the injuries were caused by traffic accident, 18% fall down, 15% blunt trauma, 2% crushing injury, 2% stab wound, and 0.4% gunshot wound. Peak incidence of the trauma victim was fourth and fifth decades revealing 22% and 27% respectively. Sex ratio was 3.5:1 with male predominance. Elapsed time before admission was less than one hour in 36% and one to six hour in 30%. The types of the injuries were as follows: Non-penetrating injuries were the most part of the wounded, 97.6%. Rib fracture was the most common lesion occupying 292 patient out of 481 [61%]. Of these 292 patients, 72% was multiple rib fracture. The incidence of hemothorax or hemopneumothorax was 19% [102 patients] [Table 4]. Most common associated condition was head injuries, 98 patients [14%]. Thoracoabdominal injuries were seen in 31 patients [0.6%]. Tube thoracostomy was the definitive measures in the 20% of the wounded. Open thoractomy was performed in 5%. Additional procedures for the associated condition were done in the 16% of the cases, for example, reduction of long bone fracture and trephination for the head injury. Among 481 wounded, fatal complication occurred in 13 patients [2.7%]. This paper has also compared two series of patients according to period; one from 1970 to 1980 and the present series [Table 8]. Conclusively, the fatal complications or trauma death may be reduced by the effort 1] rapid transport of the victim, 2] initial correction or resuscitative measures of the circulatory and ventilatory deficit 3] early decision of definitive thoracostomy or thoracotomy and 4] proper prioritizing for the care of the multiple critically injured patient.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.6 no.6
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• pp.1522-1545
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• 2012

Call admission control (CAC) plays an important role in mobile cellular network to guarantee the quality of service (QoS). In this paper, a dynamic hybrid CAC scheme with integrated cutoff priority and handoff queue for mobile cellular network is proposed and some performance metrics are derived. The unique characteristic of the proposed CAC scheme is that it can support any number of service types and that the cutoff thresholds for handoff calls are dynamically adjusted according to the number of service types and service priority index. Moreover, timeouts of handoff calls in queues are also considered in our scheme. By modeling the proposed CAC scheme with a one-dimensional Markov chain (1DMC), some performance metrics are derived, which include new call blocking probability ($P_{nb}$), forced termination probability (PF), average queue length, average waiting time in queue, offered traffic utilization, wireless channel utilization and system performance which is defined as the ratio of channel utilization to Grade of Service (GoS) cost function. In order to validate the correctness of the derived analytical performance metrics, simulation is performed. It is shown that simulation results match closely with the derived analytic results in terms of $P_{nb}$ and PF. And then, to show the advantage of 1DMC modeling for the performance analysis of our proposed CAC scheme, the computing complexity of multi-dimensional Markov chain (MDMC) modeling in performance analysis is analyzed in detail. It is indicated that state-space cardinality, which reflects the computing complexity of MDMC, increases exponentially with the number of service types and total channels in a cell. However, the state-space cardinality of our 1DMC model for performance analysis is unrelated to the number of service types and is determined by total number of channels and queue capacity of the highest priority service in a cell. At last, the performance comparison between our CAC scheme and Mahmoud ASH's scheme is carried out. The results show that our CAC scheme performs well to some extend.

• Proceedings of the Safety Management and Science Conference
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• 2009.11a
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• pp.51-60
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• 2009

To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.210-214
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• 2009

Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.68-82
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• 2020

Running title: Adequacy of dentist supply Objectives: The proper provision of dentists is very important for delivering the dental care that people need. The purpose of this study is to evaluate the adequacy of dentist supply and to predict the proper supply of dentists in Korea for the next 10 years. Methods and materials: Using the data from 2004 to 2017 in the Statictics Korea, the dental needs were measured as days of admission and the annual total dental care hours in 2020, 2023, 2026 and 2030 were predticted using regression analysis. The dental care productivity (average in-office hours) of dentists was analyzed using regression analysis including age, gender, education level and region as a confounder. The annual care hours were predicted according to seven scenarios based on the percentage of women among dentists, post-dentist education levels, the percentage of dentists in the metropolitan area, aging and retirement age. Results: The needed dentist based on the data in the Statictics Korea will be 27, 288 ~ 27, 311 in 2020, 28,104 ~ 28,1785 in 2023, 28,977 ~ 29,124 in 2026, and 30,174 ~ 30,413 in 2030. On the other hand, the number of dentists in Korea will be 26,945 in 2020, 28,813 in 2023, 30,682 in 2026 and 33,173 in 2030. The adequacy index of dentist supply will be -0.01 in 2020 to +0.10 in 2030. Conclusions: Our data showed that dentists will be adequately supplied in Korea for the next 10 years. Overall, the ratio between dentist versus 1,000 Koreans will be increased from 0.5 in 2019 to 0.7 in 2020, which will meet the mean of OECD countries.

• Korean Journal of Biological Psychiatry
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• v.13 no.1
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• pp.32-37
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• 2006

Background : Several studies have suggested that alterations of cytokine level could be related to the pathophysiology of bipolar disorder. In this study, we measured plasma level of Interleukin-12(IL-12), a pro-inflammatory cytokine and transforming growth factor-${\beta}$1(TGF-${\beta}$1), an anti-inflammatory cytokine before and after treatment in acute manic patients. Methods : The plasma concentrations of IL-12 and TGF-${\beta}$1 were measured using quantitative ELISA in 18 bipolar disorder patients and 25 normal controls at admission and 6 weeks later. The psychopathology was measured by Brief Psychiatric Rating Scale(BPRS) and Young Mania Rating Scale(YMRS). Results : IL-12 levels were significantly higher in bipolar manic patients than in controls before treatment. Following the 6-week treatment, the IL-12 level was decreased than before treatment, but sustained still higher level than normal control. TGF-${\beta}$1 level was not significant different between manic patients and normal controls before treatment, but was increased after treatment comparing with before treatment in bipolar patients. The ratio of IL-12 and TGF-${\beta}$1 was significantly decreased after treatment. Conclusion : Cytokine abnormalities in bipolar disorder might be involved in the pathophysiology of the illness. It is possible that TGF-${\beta}$1 plays an important role in the regulation of immunological imbalance in bipolar disorder.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.175-181
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• 2010

Objectives : The purpose of this study is to investigate interaction and safety in administering herb-medicine with warfarin. Methods : For this study, we selected 19 patients who have been taking warfarin, from the ones that have been transferred from western hospital to oriental hospital. During their stay in the oriental hospital, we gave herb-medicine in addition to warfarin. Then we gathered informations and data on sex, age, main indications, and International Normalized Ratio(INR) values of selected patients through Electronic Medical Records(EMR) of Dong-Guk university hospital. Accordingly, we compiled all of the above data for a period of 10 days prior and 10 days post admission(western hospital period and oriental hospital period, respectively). Results and Conclusions : The statistical analysis of the data have revealed that there was no significant change of INR values after giving herb-medicine with warfarin(p=0.586). The result shows that administration of herb-medicine with warfarin is safe and has little drug interaction. However, this study was carried out on small sample size and the interaction with other drugs and various kinds of herb-medicine was not considered. Although we attained a restrictive result from this study, we are able to suggest the safety about co-administration of herb-medicine and warfarin.