• Journal of Trauma and Injury
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• v.28 no.4
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• pp.241-247
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• 2015

Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.190-203
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• 2003

Background: Dental hygienists are at risk of acquiring infections through exposure to infectious agents. This study explores the frequency of exposure to infectious agents and infection control practices among dental hygienists. Methods: We undertook a cross-sectional survey to examine the exposure to infectious agents and infection control practices among dental hygienists through questionnaire. Data were obtained from 124 dental hygienists attending educational conferences. A multiple logistic regression analysis was conducted to determine the factors that effect infection control practices in relation to age, completion of infection control education, recognition of their own serum hepatitis Ag/Ab status, the number of one day patients, location of clinics, type of clinics, and career years. Result: Of the 124 dental hygienists, 91.7% were exposed to at least one accident such as needle stick injuries during their practices periods. The health screening coverage rate in dental hygienists was 16.5%. The number of one day patients and career years were important in relation to infection control practices among dental hygienists. The adjusted odds ratio estimates for career years were 5.049 times greater(95% Cl 1.238-20.597) for groups with over 4 career years than under 2 career years. That for the number of one day patients were 0.261(95% Cl 0.071-0.955) lower for through 20 up to 30 patients, 0.531(95% Cl 0.102-2.78) lower for through 30 up to 40 patients and 0.498(95% Cl 0.123-2.017) lower for more than 40 patients than under 20 patients. Conclusion: From these results, prevalence of infection control practices among dental hygienists is related to the number of one day patients and career years. Prevention of cross infection and reduction of future transmission should be a priority to dental hygienists for promotion of infection control and further efforts to educate newcomers on infection prevention should be made.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.137-145
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• 2016

Objective: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ${\geq}40years$. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.511-519
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• 2018

Objectives: The purpose of this clinical trial was to examine the efficacy and safety of electroacupuncture on liver cirrhosis patients suffering from muscle cramps. Methods: Fourteen patients with liver cirrhosis who experienced muscle cramps at least once a week, regardless of cramp location, were enrolled and randomly allocated to an experimental group (n=12) or a control group (n=12). The experimental patients were treated with electroacupuncture at an electrical stimulation frequency of 100 Hz three times a week for four weeks (12 times in total). Muscle cramps were evaluated by a questionnaire that probed subjective symptoms. We analyzed the frequency of muscle cramps 3 times (at screening, 14 th visit, 15 th visit) during 8 weeks. Results: The number of patients with cramps occurring 'more than once a week' was reduced and the proportion of patients decreased in response to electroacupuncture. The number of patients with cramps occurring 'less than once every two weeks' increased and the proportion of patients also increased in response to eletroacupunture. Conclusions: The results of this study suggest that electroacupuncture treatment will be beneficial for improving muscle cramps in patients with liver cirrhosis. Electroacupuncture is considered a safe and efficacious treatment for patients with liver cirrhosis who complain of muscle cramps.

• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.357-368
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• 2009

The purpose of this study was to examine the state of dental treatment among disabled patients by the type of disability. After the medical records of 531 disabled patients who received treatment at the pediatric dentistry in K university hospital, the following findings were given: 1. As for age distribution by year, the rate of patients aged 10 or down rose to 42.5 from 5.1 percent, and the 16-20 age group increased from 16.7 to 24.8 percent. But the rates of patients aged between 11 and 15 and aged 21 and up were on the rise(p<.05). 2. Concerning the type of disability by year, there was an increase in the number of patients with brain lesions, mental retardation, developmental disorder and Down's syndrome(p<.05). As to the number of dental caries by the type of disability, the patients with heart diseases had the most dental caries that numbered 8.49, followed by Down's syndrome, metal retardation, brain lesions, the other disabilities and developmental disorder. 3. In relation to dental treatment experiences by the type of disability, the patients with developmental disorder(57.5%) received the most dental treatment, followed by mental retardation, the other disabilities, brain lesions, Down's syndrome and heart diseases(p<.05). 4. Regarding general anesthesia experience by the type of disability, the patients with mental retardation(31.6%) were put under general anesthesia the most, followed by developmental disorder, brain lesions, the other disabilities, heart diseases and Down's syndrome(p<.05). In conclusion, nationwide efforts to nurture separate dental personnels responsible for the disabled, to expand relevant facilities and to improve the health care insurance are required to promote the oral health of disabled children.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.73-83
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• 2024

Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.84-93
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• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.393-397
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• 2015

Background: The management of contralateral bullae incidentally found in radiological studies is controversial, largely due to the unpredictability of the natural course of incidentally found contralateral bullae. This study aimed to identify the factors associated with the contralateral occurrence of primary spontaneous pneumothorax (PSP), and to characterize the outcomes of contralateral bullae incidentally found in radiological studies. Methods: From January 2005 to December 2008, 285 patients were admitted to our institution for PSP, and the patients underwent follow-up until August 2012. The relationships between the following variables and contralateral pneumothorax occurrence were evaluated: age, sex, smoking history, body mass index, ipsilateral recurrence, ipsilateral bullae size, the number of ipsilateral bullae, contralateral bullae size, and the number of contralateral bullae. Results: The study group consisted of 233 males and 29 females. The mean age and mean body index of the patients were $23.85{\pm}9.50years$ and $19.63{\pm}2.50kg/m^2$. Contralateral PSP occurred in 26 patients. The five-year contralateral PSP occurrence-free survival rate was 64.3% in patients in whom contralateral bullae were found. Conclusion: The occurrence of contralateral PSP was associated with younger age, ipsilateral recurrence, and the presence of contralateral bullae. Contralateral PSP occurrence was more common in young patients and patients with recurrent PSP. Single-stage bilateral surgery should be considered if an operation is needed in young patients, patients with recurrent pneumothorax, and patients with contralateral bullae.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.416-422
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• 2023

Background: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA). Methods: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants. Results: A total of 53 patients (62%) responded "yes" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30). Conclusions: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.1-9
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• 2013

This study intends to identify the characteristics of cancer in-patients and those of cancer patients who defected to other medical institutions based on the summary of hospital discharge information of a university hospital for the purpose of improving work efficiency and maximizing the number of patients. The study used data on cancer patients registered in the database of C University Hospital in Gyeonggi Province for a period of one year between January 1 and December 31. The analysis results suggest that the commonalities of the cancer patients who defected to other medical institutions include no specific job, old age, and hospitalization through emergency room. In conclusion, hospitals need to identify the characteristics of cancer patients classified as patients who are prone to defect and the defection factors through this prediction model.