• Journal of Korean society of Dental Hygiene
• /
• v.11 no.2
• /
• pp.293-301
• /
• 2011

Objectives : The aim of the trial was to study the effect of plaque control(tooth brushing instruction) for oral health improvement on periodontitis patients. Methods : 30 patients(35~65 years) with advanced periodontal disease were subjected to a baseline examination including assessment of oral hygiene status(O'leary index), gingival condition(bleeding). the assessment were repeated after 2, 4, 6 weeks. cognitive, behavioral and clinical outcomes were assessed in the primary care setting by questionnaire and clinical oral examination. Results : The oral hygiene status expressed as the individual mean percentage of tooth surfaces with plaque 59.3% at baseline and 21.2% after 6 weeks(p<0.001). The gingival bleeding status expressed as the individual mean point of interdental papilla 3.8 at baseline and 1.9 after 6 weeks(p<0.001). Also, the patients self-assessment about correct tooth brushing behavior was 3.9(5-point likert scales), satisfaction of plan practices 4.1(5-point likert scales), efficacy of tooth brushing instruction 8.7(10-point likert scales). Patients wanted to continuous participation. Conclusions : A verification of effect after individualized oral health instruction and repeated dental plaque control represented to significance on plaque control score, oral care practice and oral health recognition. The important oral care step against periodontal disease is to establish good oral health habits. Also, oral health behavior recognition is more important for the practice of oral health. Therefore professional plaque control and tooth brushing instruction absolutely need in improving oral health.

• Quality Improvement in Health Care
• /
• v.8 no.2
• /
• pp.146-159
• /
• 2001

Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.4
• /
• pp.377-384
• /
• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1123-1127
• /
• 2016

Chemotherapy is the primary treatment for advanced and recurrent cervical cancer. To evaluate the survival outcomes of chemotherapy and the prognostic factors in this setting, we conducted a retrospective study by reviewing the medical records of advanced and recurrent cervical cancer patients treated with systemic chemotherapy at our institute between January, 2008 and December, 2014. One hundred and seventy-three patients met the criteria with a mean age of 50.9 years. 4.1% of them were HIV positive. The most common initial stage was stage IVB (30.1%) and the most common histology was squamous cell carcinoma (68.6%). Ninety-two (53.2%) patients were previously treated with concurrent chemoradiation with 53% developing combined sites of recurrence. The median recurrence free interval was 16.7 months. Cisplatin + 5 fluorouracil (5FU) (53.2%) was the most frequent first line chemotherapy followed by carboplatin + paclitaxel (20.2%) with an objective response of 39.3%. Seventy-two patients received subsequent chemotherapy. The median overall survival of all studied patients was 13.2 months. Only a recurrence free interval of less than 12 months was an independent prognostic factor for survival outcome. In conclusion, chemotherapy treatment for advanced and recurrent cervical cancer patients showed modest efficacy with a shorter recurrence free survival less than 12 months as a significant poor prognosis factor.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.7
• /
• pp.3357-3360
• /
• 2012

Objective: This study was to present the survival of advanced cancer patients and explore the influence of various factors on survival time as well as survival rate. The results provide guidelines for clinical practice of cancer treatment. Methods: Follow-up of 674 advanced cancer patients was performed in a hospice. The median survival time and survival rate were calculated, and survival analysis was carried out. Results: The median survival time of all patients dying from cancer was 12.0 months and the average survival time was 25.1 months. The 1-year cumulative survival rate was $0.518{\pm}0.020$ and the 5-year cumulative survival rate was $0.088{\pm}0.012$. The following factors showed significant impacts on survival rate: gender, age, primary diagnosis, surgery and the time when pain appeared. Conclusions: The survival time of patients with advanced cancer was relatively short. Major approaches to extend the survival time include early detection, early diagnosis, effective surgical treatment, pain control, reasonable supply of nutrients and multiple interventions.

• Korean Medical Education Review
• /
• v.18 no.3
• /
• pp.156-166
• /
• 2016

Medical school students learn a lot about medical knowledge and clinical experience in the classroom. Teaching is a main focus in medical schools; therefore, it is necessary to identify the characteristics of good teaching. The aim of this study is to analyze the characteristics of high-quality education in medical schools. In this study, in-depth interviews were conducted over two weeks on twelve fourth-year medical students. Participants were asked to define high-quality education, list the general ways in which high-quality classes are delivered, mention cases where they have experienced high-quality teaching, and describe the attitude required of students to make high-quality education possible. The results showed that students want to be taught in an interactive way on the core content needed in an actual clinical setting for the goal of cultivating primary care physicians. They want their education to include not only medical knowledge, but also liberal art subjects such as politics, economics, sociology, culture and ethics education to help instill a sound value system. In particular, students stressed the importance of instructors delivering appropriate post-evaluation feedback, and they also emphasized that learner mindset and attitude is important in supporting high-quality teaching in class. This paper also summarizes the elements of high-quality teaching in terms of educational goals, content, and method, and examines cases of instructors who have delivered high-quality classes.

• The Journal of Pediatrics of Korean Medicine
• /
• v.32 no.2
• /
• pp.64-71
• /
• 2018

Objectives The purpose of this study is to examine the correlation of antibiotics administration duration and antimicrobial resistance by reviewing domestic and foreign literatures. Methods We searched literatures dated up to 23 February, 2018 in PubMed and Cochrane Library using terms of "Anti-Bacterial Agents", "Carrier State", "Nasopharynx", "Drug Administration Schedule", and also searched via RISS (Research Information Service System), KISS (Koreanstudies Information Service System), DBpia (DataBase Periodical Information Academic) using terms of antibiotics, resistance, and dose. Results In comparison with shortened and standard antibiotic course, longer treatment duration is associated with greater antimicrobial resistance or non-significant difference, but we cannot find literature that shortened antibiotic course increases antimicrobial resistance on human nasopharyngeal flora. Conclusions Currently, there is no evidence that completing the standard antibiotic course reduces antimicrobial resistance. It can be a strategy for reducing antibiotic use to apply Korean medicine treatment, as well as short-course antibiotic therapy or delayed antibiotic prescription. Additional well-designed trials should be conducted in domestic and foreign settings about the appropriate duration of antibiotic therapy.

• Journal of the Korean Society of Physical Medicine
• /
• v.2 no.2
• /
• pp.135-142
• /
• 2007

Purpose : To investigate the effectiveness of local vibration and interferential therapy for patient with acute low back pain. Methods : A randomized trial designed to compare interferential therapy and local vibration therapy for acute low back pain in primary care setting Results : A total of 60 patients were recruited. The two treatment groups had similar demographic and clinical baseline characteristics. The mean VAS scores before treatment was 8.290 for interferental therapy group and 8.572 for local vibration therapy groups. After treatment, this VAS score had dropped to 4.812(interferental therapy group, at 7 days), and 4.945(local vibration group, at 7 days). Conclusion : This study shows a progressive fall in visual analog scale scores in patients with acute low back pain treated with either interferential therapy and local vibration therapy. There was some difference in the improvement between the two groups at 1 to 4 days, VAS score of vibration therapy groups was low better than interferential therapy groups.

• Korean Journal of Radiology
• /
• v.22 no.10
• /
• pp.1650-1657
• /
• 2021

Metastatic mature teratoma is a common radiologic and histopathologic finding after chemotherapy for metastatic non-seminomatous germ cell tumors. The leading theory for these residual tumors is the selective chemotherapy resistance of teratomas versus the high chemotherapy sensitivity of the embryonal components. Growing teratoma syndrome is a relatively rare phenomenon defined as an enlarging residual mass histologically proven to be a mature teratoma in the setting of normal serum tumor markers. Metastatic mature teratomas should be resected because of their malignant potential and occasional progression to growing teratoma syndrome with the invasion of the surrounding structures. CT is the preferred imaging modality for post-chemotherapy surveillance and should cover all sites of potential metastatic disease. This article reviews the clinical, pathologic, and multimodality imaging features of metastatic mature teratomas in patients with primary testicular non-seminomatous germ cell tumors.

• Health Policy and Management
• /
• v.7 no.1
• /
• pp.73-99
• /
• 1997

This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.