• Health Policy and Management
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• v.10 no.2
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• pp.22-40
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• 2000

The purpose of the study was to discuss amrketing strategy for oriental hospital, by making a comparative analysis of how hospital user satifaction was affected by hospi시 choice motivation between oriental hospital users and western hospital. The data usel in this study was the Korea Isititute of oriental medicine(1999)'s study on utilization of oriental medical care. And and interview was hold with outpatients who visited around march to April, 1999, at each an oriental hospital and a westen hospital in Seoul and in Wonju city, Kongwon province. The collected data were analyzed by SPSS program. The factor analysis of hospital choice motivation was made by figuring out facor's mean value, and T-test and ANOVA were employed to find out what difference was made by sociodmographic charcteristics to the factors. Also, the multiple regression analysis was carried out to examine what gave an impact on hospital user satisfaction. The findings of this study were as follows; First as a result of making a factor analysis against hospital choice motivation to find out what kind of differenc there was between oriental hospital user motivation and western hospital and person factors. Among them, the hospital charcteristics, preception, personal and person factors. Among them, the hospital charcteristics appered to have the biggest effect of hospital choice motivation. Second, as a result of making comparison between oriental oriental hospital user satisfaction and werterm hospital user satisfaction, there was a singificant between their satisfaction at treatment time, kindness and relative kiness aginst the pther hospital. The oriental level combining 6 items. The geneal satisfaction level combining 6itmes tured out to have reliability of chronbach $\alpha$=0.7126. As a result of examining how mech the general satifaction level depended on sociodemographic characteristics, ther was found be significantly affected by age, marital status, educational background or hospital type. Those who a spouse or a lower educational background or the oriental hospital users got better score. Third, the multiple regression analysis was made to find out what factors affected western and oriental hospital user satisfaction, As a result, the waiting time, experience of other medical facilities and hospital characteristic variable were identified as a key factor on which westerm hospital user satisfaction depended. In conclusion, the oriental hhspital user expressed more staisfaction than the weshren hospital users. Then the characteristic factor played a singificant role in user satisfaction, which included hospital facilities, kindness of herb doctor and employees, or hospital reputation of credibility. in order to raise hospital user datisfaction, it seemed necessary to pay more attention to hospital characteristic factor rather than to perception factor.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.113-121
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• 2014

The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.4
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• pp.243-250
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• 2015

A bone marrow biopsy that has undergone decalcification with 10% nitric acid could not be used for various pathological tests and had extremely limited reproducibility. The fixing solution of each experimental group was differentiated in usage, one solution including acid and the other not. The use of the decalcification solution was separated into either acidic or alkaline (EDTA), and further experiments were conducted with differing time phases. When using a fixing solution and decalcification solution which included acid, the specimens were faulty to the extent that all pathological tests were impossible. However specimens that were processed with an EDTA type decalcification solution did not display a non-specific reaction in EBV ISH and were even able to produce results that were at a level suited to various studies or a pathological diagnosis in the FISH, DNA, RNA tests. By improving the fixing and decalcification of bone marrow biopsy, the study was able to make possible ISH, FISH, DNA tests as well as RNA study, and secured the sensitivity, specificity, and reproducibility of various test methods. The stabilization of various test methods that use bone marrow biopsy contributes to the diagnosis, prognosis, prediction, treatment of the patient and provide guidelines for decision-making.

• Fire Science and Engineering
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• v.29 no.5
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• pp.96-103
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• 2015

This study investigates the socio-economic and clinical characteristics associated with emergency medical transport use by the elderly based on 2008~2011 Korea Health Panel data. A model of emergency medical transport use was analyzed, and the results indicate that use of 119 ambulances and private ambulances by the elderly accounted for 46.8% of all users, and 35.1% of their emergency room visits. Statistically significant factors associated with emergency medical transport use were gender (OR = 2.19, 95% CI = 1.51-3.17), relationship to household (OR = 2.19, 95% CI = 1.45-3.32), insurance type (OR = 1.41, 95% CI = 1.10-1.82), handicap (OR = 1.44, 95% CI = 1.14-1.83), reason for emergency department visits (OR = 1.53, 95% CI = 1.20-1.97), and treatment after emergency medical service completed (OR = 3.45, 95% CI = 2.80-4.25). The increased elderly population in an aging society will lead to a surge in demand for emergency patient transport services, and emergency medical services that are tailored to the elderly need to be developed accordingly.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.509-519
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• 2013

Through the study on judgment of Body form and settle Energy flow(立形定氣) before diagnose the patients, the results are as follows. The observation of the body form is to determine prosperity and deficiency of each internal organ. It is necessary to distinguish Body form loss(形脫) and Body form fullness(形充). Fat man(肥人), Thin man(瘦人), Creamy man(膏人), Muscular man(肉人), Small Fat man(脂人) are discriminated by fat distribution, fat content, and muscle mass. The observation of the body form means the observation of structure disorder, color change, develop part at body, head and face. The observation of the body form that is to determine prosperity and deficiency of each internal organ is from the limited knowledge of the anatomy. The observation of face color is considered by blood perfusion, blood oxygenation and accumulation of carotinoid, bilirubin and change of melanin in the facial skin. The prosperity and the deficiency of energy flow is considered by symptom combined with growth (<40 years) and aging (>40 years). The prosperity of energy flow includes the anger, anxious emotion and the deficiency of energy flow includes the fear, depressive emotion. The breathing type is expiratory exhalation like asthma patients in the prosperity of energy flow. The deficiency of energy flow is weakness to overcome the disease. The prosperity and the deficiency of energy flow are considered by body metabolic ratios (Basal metabolic Rate: BMR, Resting metabolic rate: RMR, Physical activity ratios: PASs). Development of subcutaneous fat is good in the person of prosperous energy flow. The person of prosperous energy flow is hard to overcome to heat weather than cold weather. The person of deficiency of energy flow has tendencies of low blood pressure, insufficiency of blood flow in the peripheral and being shocked. The person of deficiency of energy flow has tendencies of chronic fatigue syndrome or automatic nerve disorder. If the patient who has deficiency of energy flow has severe weight loss should be checked for the presence of disease. The observation of small and large of bone is to check the development and disorder of bone growth and aging. The observation of thickness and weakness of muscle is to check the development of muscle, particularly biceps, gastrocnemius, and rectus abdominal muscle. The observation of thickness and weakness of skin is to check the ability of regulating body temperature by sweating.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.3
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• pp.280-288
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• 2013

Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.695-698
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• 2010

Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.44-51
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• 2003

Objectives: Antidepressants are frequently associated with sexual dysfunction. Especially, there were few report of sexual dysfunction related with venlafaxine and mirtazapine in Korea. The purpose of this survey was to evaluate the frequency and nature of sexual dysfunction related with selective serotonin reuptake inhibitors(SSRIs), venlafaxine and mirtazapine by the use of specific questionaires. Methods: In one hundred twenty two patients, sexual dysfunction was investigated cross-sectionally by using The questionaires for sexual dysfunction, which includes questions about decreased libido, delayed orgasm or ejaculation, premature ejaculation or orgasm, absence of orgasm or ejaculation, erectile dysfunction in men/vaginal lubrication dysfunction in women, sexual pain and patient's tolerance of the sexual dysfunction. BDI was also measured. Sexual dysfunction was analyzed in association with the duration and the dose of medications and the severity of depression. Results: The incidence of sexual dysfunction during antidepressants use in our survey was 37.7%. There were no difference of incidence in sexes(p=.746). In comparison of paroxetine, venlafaxine and mirtazapine, there were no significant differences of the incidence(p=.065) and the severity of any type of sexual dysfunction. Conclusion: Although there were no significant differences of sexual dysfunction in our survey, sexual dysfunction may be closely associated with antidepressants. Further prospective study of sexual dysfunction should be needed.

• Journal of Korean Academy of Nursing
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• v.23 no.1
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• pp.68-89
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• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3336-3340
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• 2010

This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.