• 한국임상약학회지
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• 제20권2호
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• pp.145-150
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• 2010

In order to investigate the antibiotic prescription pattern for upper respiratory infections (URI), the prescription sheets for outpatients from July 2008 to June 2009 were collected from 7 community pharmacies in Ulsan City, and the prescription pattern of Pediatric and ENT physicians was analyzed. The antibiotic prescription rates of Pediatric and ENT physicians were 63.8% and 61.7%, respectively. It was also observed that the oral antibiotic prescription was 95.6% in Pediatrics and 97.6% in ENT. The most favorable antibiotics by Pediatric physicians were penicillins (21.5%) penicillin-clavulanate (36.4%) and cephalosporins (16.5%), macrolides (11.6%), quinolones (3.5%), and nifuroxazide (3.5%). In case of ENT, the commonly prescribed antibiotics were also penicillin-clavulanate (47.6%), cephalosporins (31.6%), macrolides (11.9%) and sulfonamide (1.3%). The antibiotic combination rate was 7.6% in Peditrics and 1.9% in ENT, among antibiotic prescriptions. The combination of more than two oral antibiotics was examined as 66.8% in Pediatrics and 44.2% in ENT. The common oral antibiotic combination in Pediatrics was prescriptions of two ${\beta}$-lactam antibiotics (54.3%). Among them 83% was the combination of amoxicillin-clavulanate (7:1) and amoxicillin, which could be judged as antibiotic overuse. The next highly prescribed oral antibiotic combination was ${\beta}$-lactam/macrolide antibiotic combination probably for URI (11.3%) and ${\beta}$-lactam/nifuroxazide combination (10.0%) presumably for acute diarrhea. Comparatively the oral antibiotic combination prescribed by ENT physicians was negligible except one physician. In conclusion, the antibiotic over-prescription rate by antibiotic combination was much higher in Pediatrics than ENT, even though both clinical departments showed nealy the similar antibiotic prescription rates.

• 한국임상약학회지
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• 제20권3호
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• pp.205-212
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• 2010

The prescription sheets for outpatients from July 2008 to June 2009 from 7 community pharmacies in Ulsan City were surveyed for the anti-inflammatory drug (AID) prescription pattern. The AID prescription rate of pediatricians and ENT physicians were 30.0% and 34.8%, respectively. The oral steroidal anti-inflammatory drugs (SAIDs) were prescribed as much as 3.9% by pediatricians and 10.3% by ENT physicians. The chiefly prescribed oral SAID was prednisolone in pediatric clinics and methylprednisolone in ENT clinics. Meanwhile the prescription rate of oral non-steroidal anti-inflammatory drug (NSAID) was 22.5% by pediatricians and 21.4% in ENT physicians. The most favorable NSAIDs were propionate derivatives in both clinics. In case of externally-applied SAIDs, the prescription rate of pediatricians was 3.6% and that of ENT physicians was 2.8%. Among them, nasal spray, inhalant and gargle formulations for upper respiratory infection (URI) treatment occupied 35.8% of externally-applied SAIDs in pediatric clinics and 59.7% in ENT clinics. Further, it was observed that ENT physicians favored much stronger SAIDs in Group III of ATC classification (75.4% of externally-applied SAIDs) than pediatricians (49.2%). In the survey of AID combination rate, pediatric clinics showed much lower rate (1.4% of total AID prescriptions) than ENT clinics (7.5%). Among them, the combination rate of oral SAID and oral NSAID by ENT physicians (52.2% of total AID combinations) was much higher than pediatricians (36.6%), which might be over-prescription of AID agents. In conclusion, the AID prescription rate as well as AID combination rate, especially in SAID prescriptions, was much higher in ENT than pediatric clinics, which implies the higher confidency on AID drugs of ENT physicians even though the severity of patient's symptom could be considered.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.35-39
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• 2016

Background and Objectives : Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. Materials and Methods : First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. Results : Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. Conclusion : Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.

• 약학회지
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• 제54권4호
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• pp.258-269
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• 2010

As people are easy to access the National Health Insurance, medical health service has been increased. It contributed to extend human's average life expectancy and to get better health care. But also increased unnecessary health service or inappropriate drug use. Therefore, DUR (Drug Use Review) is needed to induce appropriate drug use. The purpose of this study is to evaluate outpatient prescriptions by General Practitioner (GP) and Specialized Practitioner, especially indication for ENT referral including common cold which is the frequent indications that have patient see doctor. This study was reviewed retrospectively prescriptions for ENT referral collected at the A pharmacy for ENT Clinic in Cheong-Ju, B pharmacy for GP Clinic in BoEun from Feb 2nd, 2009 to Feb 28th, 2009. Each pharmacy located closed to the each enrolled clinic. The numbers of collected prescriptions were each A pharmacy (n=2501), B pharmacy (n=1343). This study was classified Drug Related Problems (DRPs) those prescriptions had as total 6 groups according to following 6 categories; 1) Unnecessary Drug, 2) Wrong Drug, 3) Low Dose, 4) Overdose, 5) Wrong Instruction, 6) Wrong Combination. In results, Specialized Practitioner's prescriptions had more DRPs than General Practitioner's prescriptions (ENT 155.34% vs GP 130.01%). In detail, Specialized Practitioner's prescriptions had more DRPs in Low Dose (ENT 16.95% vs GP 4.77%), Overdose (ENT 6.72% vs G.P 5.51%), Wrong Instruction (ENT 7.91% vs GP 5.81%), Wrong Combination (ENT 29.31% vs GP 25.09%). These DRPs would be caused from lack of consideration for dosage and drug interaction. General Practitioner's prescriptions had more DRPs in Unnecessary Drug (ENT 70.37% vs GP 78.85%), Wrong drug (ENT 4.12% vs GP 9.98%). These DRPs would be associated with drug selection. This study was assumed that Specialized Practitioner is better prescriber than General Practitioner because Specialized Practitioner complete additional intern and residency training. But, Specialized Practitioner is not always better prescriber than General Practitioner. Furthermore, prescriptions of both Specialized Practitioner and General Practitioner had many problems. In conclusion, It could be cut down the excessive medical expense and expected more efficient medical care by reducing DRPs, thus contributing to the improvement of national health. In order to pharmacist must have good professional ability of pharmacotherapy to help the physician for the drug selection.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.5.1-5
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• 1982

식도 및 기도이물은 순간적인 부주의로 우리 생활주변에서 흔히 볼 수 있으며 대부분의 경우를 제거하게 된다. 그러나 보호자의 무지, 환자가 연소자인 경우, 그리고 치료자의 적극적인 진단이 결여된 경우에 이물의 존재를 파악하지 못한채 장기간 체내에 체류하게 되며 그 결과로 생긴 합병증을 주소로 타과에서 치료를 받던 중 뒤늦게 이물을 발견하고 이비인후과로 전원되는 경우가 간혹 있다. 저자들은 체내에 장기간 체류한 식도이물 1 례와 기관지이물 1 례를 각각 경험하였기에 그 문헌적 고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.59.1-59.10
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• 2019

Background: Primary rhinoplasty outcomes may not meet individual expectations. Consequently, reoperation may be advocated to improve results. This study examines the prevalence of individuals considering revision rhinoplasty, while identifying the main cosmetic and functional complaints and factors associated. Methodology: This is a cross-sectional study conducted in Saudi Arabia using a self-reported online questionnaire distributed through social media channels. The sample included 1370 participants who were all Saudi nationals over the age of 16 who had undergone primary rhinoplasty at least 1 year prior. Results: The prevalence of individuals considering revision rhinoplasty was 44.7%. The primary reason for considering it was the desire for further esthetic improvement in an already acceptable result (50.16%). The most common cosmetic complaints subjectively reported were poorly defined nasal tip (32.35%). The most prevalent nasal function symptom was nasal obstruction (56.9%). Significant factors associated with considering revision rhinoplasty included the physician not understanding the patient's complaints, short consultation time, low monthly income, inadequate information about the expected results, not using computer imaging to predict outcomes, lack of rapport with the surgeon, and inadequate information about the risks and complications. Conclusions: A thorough understanding of patient concerns and expectations, as well as thoughtful consideration of risk factors, may help surgeons achieve more successful outcomes and potentially reduce the incidence of revision rhinoplasties. Level of evidence: III.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.65-89
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• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• 한국지역지리학회지
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• 제3권2호
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• pp.163-193
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• 1997

복지사회를 지향하는 오늘날, 건강 중진에 직접 관계되는 의료시설의 접근성 문제는 주요 과제이다. 특히 삶의 질이라는 측면에서 질병의 치료 외에 건강진단, 예방과 회복, 요양 및 응급서비스의 비중이 커지고, 인구의 노령화 현상이 진전되면서 의료시설의 효율적인 입지가 주 관심사로 대두되고 있다. 의료시설은 주민의 생존과 직접 관계되는 기본적이고도 필수적인 중심시설로, 지역 주민은 균등한 혜택을 받을 수 있어야 한다. 이를 실현시키기 위해서는 기본적으로는 효율성과 평등성을 기반으로 1차 진료기관이 균등 분포해야 한다. 이에 본 연구에서는, 광주시를 사례지역으로 선정하여 의료시설의 입지와 그에 대한 주민의 효율적 이용에 관하여 분석하였다. 분석에 있어서는 통계자료와 기존의 연구 성과 외에 설문 및 현지조사 자료를 기반으로 시설 측면과 이용자 측면을 동시에 고찰하였다. 우선 의료 환경의 변화 및 의료시설의 변화 과정을 고찰하고, 이어서 의료시설의 유형별 입지 특성과 주민의 분포 특성을 고려한 지역별 의료수준을 분석하였다. 그리고 유형별 의료시설의 이용행태와 그 요인을 구명한 후, 마지막으로 장래 이용 유형의 예측과 문제지역의 추출, 나아가서는 시설의 합리적인 입지와 경영 방향을 제시하였다. 본 연구 결과는, 앞으로 신설될 의료시설의 적정 입지에 관한 기본 자료로서는 물론 지역 주민의 불평등성 해소라는 응용적 측면에서 의의를 지닌다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.12.2-13
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• 1983

화학 독극물의 오염 및 음독으로 인한 부식성 식도염의 처치 및 치료법은 지금까지도 논란이 심한 부분이며 아직도 뚜렷한 치료법이 정립되어 있지 않는 실정이다. 그러나 1960년대 부터 소위 “적극적 진단 방법 (VDA)”으로 집약되는 조기 식도경술 혹은 응급 식도경술의 개념이 이 질환의 진단에 도입되면서 여러 치료방법의 선택에 선행하여 식도 부식의 유무 확진 및 부식 정도를 분류하는 중요성이 강조되어 왔다. [Kaplan(1961), Hanckel (1951), Davis(1956), Alford(1959), Daly(1968), Welsh(1978)] 조기 식도경 술의 장점은 \circled1 병변부위 및 화상 정도의 정확한 진단. \circled2 치료방법의 선택. \circled3 입원기간단축. \circled4 병의 예후판정 등을 들 수 있다. 이 질환에 관한 많은 연구자들은 실제로 조기 식도경술을 시행한 결과 약 25 %~45 %에서만 식도병변이 존재 하였을 뿐 많은 경우에서 병변이 없거나 경미한 예가 많았다는 보고들이 있어 [Waggonor (1958), Kaplan(1961), Yarington (1964), Hawkins(1980)] 이 질환의 치료방법의 선택은 조기 식도경술로 병변부위 를 확진하지 않고 치료하는 것이 얼마나 중대한 오류를 범하는지에 대한 좋은 설명이라 생각된다. 특히 식도협착의 예방을 위한 Steroid투여는 아직도 학자간에 찬반의 논란이 많고, 더욱 다량의 출혈 및 천공의 위험성의 증대가 예견되는 Steroid 치료는 적용 예가 아닌 경우에도 투여함으로서 불필요한 합병증의 위험만 초래하는 경우가 많았던 것으로 판단된다. 저자들은 1980년 1월 부터 1982년 12월 까지 원주기독병원에 입원하였던 부식성 식도염 환자 41명을 식도경 검사를 실시하여 식도ㆍ병변의 정도에 따라 분류하고 이에 대한 각각의 치료를 시도함으로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실시한 결과 Steroid를 투여한 27명중 5명(18.5 %)에서 식도염이 계속 존재하는 음영을 나타냈으며 Steroid를 투여하지 않은 9명은 1명 (11.1 %) 만 식도염의 음영이 보였다. 9) 3개월후 추적검사는 Steroid 투여군에서 4명 (14 .8 %), 비투여군에서 3명(33.3 %)의 식도 협착을 보여 Steroid 비투여군에서 다소 식도 협착의 빈도가 증가하는 양상을 나타내나 통계학적 의의는 없었다. 10) 평균 입원 기간은 식도경 검사에서 Normal로 나온 경우가 평균 4.2 일, Grade I은 13.8일, II는 25 6 일, III는 30.9일 이었다.