• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.77-85
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• 2005

Background : According to the 2002 consensus report of the American Thoracic Society/European Respiratory Society (ATS/ERS), idiopathic pulmonary fibrosis (IPF) was classified as biopsy proven or probable IPF. Probable IPF is defined as those with distinctive features that allow for a confident diagnosis of IPF/usual interstitial pneumonia (UIP) within an appropriate clinical setting. The determination of the clinical course of probable IPF, as diagnosed by the ATS/ERS criteria, was studied. Methods : Between March 1995 and August 2002, 36 patients with probable IPF, from two tertiary referral hospitals, were enrolled in this study. The clinical characteristics, prognostic factors and treatment efficacy of these patients were retrospectively evaluated. Results : The mean age of the subjects was $65{\pm}6$ years. The one and 3 year survival rates were 82.4 and 50.3%, respectively, and a median survival period of 42.0 months. The total cell count of bronchoalveolar lavage was higher in the death than the survival group (p<0.05). No survival benefits were found in the cytoxan and steroid treatment groups compared with other treatment groups. Conclusion : These results suggest that the clinical course of probable IPF may be similar to that of biopsy-proven UIP. However, atypical patients must undergo an open lung biopsy for confirmation of the diagnosis.

• The Journal of Korean Academy of Sensory Integration
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• v.6 no.1
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• pp.1-12
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• 2008

Objective : The purpose of this study is to provide reference to functional level of sensory integration of in the low-grads school age, based on the Clinical Observation of Motor and Postural Skills (COMPS) and to examine correlation between the function of sensory integration and academic achievement. Method : Two schools ("J" and "S") have been selected indiscriminately among 56 elementary schools located in Gimhae-si, GyeongNam and then one class from each school was voluntarily chosen among all second-grade classes of the schools. The total number of students in those two classes was 69 (34 boys and 35 girls). Subjects had no developmental problem and no history of referral regarding neurological conditions. Three skilled researchers administrated the COMPS together, and each researcher executed two sub-items of the COMPS. As result of the academic achievement, score data of midterm- and final-exam in the spring semester were collected. The scores of 'Korean language' and 'Math', common examination subjects in both schools, were utilized for data analysis in this study. Results : Statically, there was no significant correlation between the COMPS Weighted Scores and any academic achievements. In a dispersion graphic analysis, however, the total achievement showed significant negative-correlation with the area of 'Rapid Forearm Rotation' and significant positive-correlation with the area of 'Supine Flexion'. In terms of the Math achievement, there are significant negative-correlation with rapid forearm rotation and asymmetrical tonic neck reflex, and significant positive-correlation with the area of 'Supine Flexion'. Students with higher score of the Korean language showed a tendency to get higher Weighted Score and Minus Adjustment Score, and those with lower score of the Math showed a tendency to get higher COMPS scores in all area except the area of 'Supine Flexion'. There was a statically significant difference in the COMPS scores depend on the age among general characteristics. As student older, all COMPS scores, except those in the area of 'Slow Motion' and 'Supine Flexion, were higher. Conclusions : There is somehow reliable correlation between sensory integration function and academic achievement although no statistical significance found in this study. The information from this study may contribute to initiate developing a normative-reference to screen earlier and more alertly sensory integration dysfunctions for school-age children. Further study is recommended trying to find out more reliable matter regarding low grade- schooler's academic achievement.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.459-473
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• 2004

Recently, many children have been treated under sedation in the department of pediatric dentistry of the dental hospital of Kangnung National University, and sedation cases are increasing gradually. So, in this study. the author analyzed and studied about the characteristics of sedated pediatric dental patients and their parents with patient chart and questionnaire at first visit, from 1999 to 2002 for the purpose of making pediatric dental treatment plan more effective and the improvement of behavior management for better pediatric dentistry. The results were follows : 1. The number of total pediatric and sedative patients increased from 1999 to 2002. 2. The sedated pediatric dental patients were younger than total pediatric dental patients(p<0.001). 3. In visit frequency per month, the sedated patients showed higher percentage on March, July, November contrast to non-sedated patients(p<0.001). 4. In parental occupation, there was a significant difference between sedated patients and non-sedated patients(p<0.001). 5. Caries treatment rather than preventive care or orthodontic treatment, was primarily composed of chief complaint of sedated patients(p<0.001). 6. The sedated patients showed worse response to previous treatment than non-sedated patients, and their parents also expected worse response contrast to non-sedated patients (p>0.001). 7. The patients who were introduced, occupied 31.2% of sedated pediatric dental patients and referral by the dentist were composed of the highest percentage(58.3%). 8. In case of uncooperative child at conventional behavior management, the parents of sedated pediatric dental patients prefered to sedation(50.9%). while the parents of non-sedated patients prefered to physical restraint(54.6%) (p<0.001).

• Tuberculosis and Respiratory Diseases
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• v.66 no.5
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• pp.358-364
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• 2009

Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.331-340
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• 1987

To determine the incidence rate of school accidents and its associated factors, a cohort observation was carried out in a boys' high school of a total of 2,324 students for an academic year from March 1986 to February 1987. Data for accidents were collected by the author (school nurse) as students came to the school health station for treatment of accidental injury. Data for school activities were obtained from the diary of academic affairs. A total of 603 students made 1,126 visits to the station for accidental injury during the study period that gave an average 1.9 accidents per student. The average number of visits for accidental injury per day was 5.1 and the incidence rate of accidental injury was 2.2 per 1,000 student days. Each class had about 30 accidents on the average in a year. However there were two classes that had exceptionally high incidence rate of accidents; 54 accidents in one class where 10 athletes were assigned and 58 accidents in the other class where the teacher in charge was On vacation for two months. The highest incidence rate of accident was observed in June (3.4 per 1,000 student days) and the lowest rates were in December and February (1.5 and 0.7 per 1,000 student days, respectively) and there were no appreciable difference by day of week. Accidents were caused by mischief or carelessness of students in 62.2% and by the inappropriate tools and facilities of school in 18.6% . The accidents caused by tools and facilities were mainly due to the antiquated chairs and tables. Referral rate to hospital for severe injury was three times higher in cloudy days and five times higher in rainy days than in clear days. There was almost no accident during the examination period but increased after the examination. Based on these findings, following measures are recommended to prevent school accident: disperse the athletes throughout the classes: should the teacher in charge leave the class for a long period, replace with another teacher who is familiar with the class to keep order; replace or repair the inappropriate tools and facilities; and warn the students for the risk of accident or broadcast music or let the students have light physical exercise to relieve the tension in cloudy or rainy day and after examination.

• Research in Community and Public Health Nursing
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• v.4 no.1
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• pp.67-76
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• 1993

The purpose of this study was to find the status of health examination and health management of industrial companies located in Taegu and Kyung book areas. It will provide basic information for the provision of effective health management of industrial workers. 49 companies were selected as a study sample group, and data was collected by using a structured Questionnaire which was developed by the members of the Community Health Nursing Academy of Korean Nursing. The health managers of the companies filled out the Questionnaire. The data was gathered from Dec 20, 1992 to Jan 20. The results of the study was as follows : 1. The Study sample showed 85.7% manufacturing companies having 300 or more workers. 2. All the companies had health managers, and companies which had 1,000 or more workers had industrial physicians and nurses. Only 12.2% of the industrial physicians were full time employees, and almost all industrial nurses were full time employees. Except for industrial physicians and nurses, the proportion of hygienists (6.1%), nurses aids (4.1%), and environmental engineers (22.4%) with full time employment statuss was very low. The mean age of industrial physicians was 49.2 while that of industrial nurses was 27.2. The length of work experiences currently ranges for 1 to 3 years for all health workers: physicians, nurses, hygienists, and environmental engineers. 3. Health examination and follow up care 94.31% took general health examinations. Of those, the proportion of the workers, who were determined as C grade(in need of close examination) was 43.86%. The proportion of the workers who were determined as D grade was 22.19%. 13.28% of the workers evaluated at the D grade were taken as a gauge for temporary leave from work. While 8.7% and .09% of them were taken as gauge for a change in job, and or shortening work hours respectively. The proportion of workers who must have taken special examination was 65.04% and of those the proportion of the workers who actually took, the examination was 98.55%. 75% of the workers who were recommended for follow up care were given follow up care. The special examinations were done the most frequently to detect the effects of physical agents (59.2%). Direct notice to individual workers was used the most frequently as a method of notification after a special examination (61.2%). The length of time taken to receive the result of a special examination was less than 1 month (38.9%) and 36.7% had taken up to two months (36.7%.). Most results of special examination were obtained within 2 months. The referral rate of consulting special examination by health managers was estimated at 95.9%. 4. 89.8% of the companies had. their own company dispensaries and 75.5% of those. had separate dispensaries. 32.7% of the companies designated local clinics for health management of workers. Industrial nurses performed health examination the most frequently(1.4 points). Health appraisal for work places were. done the least(0.83 points).

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.155-169
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• 2003

Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.73-81
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• 1995

Objective : Patients with sleep apnea should be diagnosed with polysomnography(PSG). However, it is not easy to recommend PSG for all patients suspected with sleep apnea in practice. Therefore, we tried to develop the screening test for referral of PSG. Method : 140 patients with snoring and sleep apnea syndrome were studied by the PSG. Sleep apnea questionnaire. Zung's scale for depression. Stanford Sleepiness Scale(SSS), insomnia scale and neuropsychological test were administered. Also, blood pressure, height, weight and neck circumference were measured and some histories were taken. Correlations between respiratory disturbance index(RDI) and various parameters mentioned above and discriminant coefficients of the parameters to RDI were computed. And, we investigated sensitivities of screening tests for selection of the patients with RDI above 20. Results : Using six parameters(neck circumference, systolic blood pressure before sleep, degree of alcohol drinking, frequency of breath-holding during sleep, degree of dry mouth during sleep, sleep apnea score), the patients with RDI above 20 could be discriminated in 92.8% sensitivity. In case of more than two among six parameters(neck circumference of above 40cm, systolic blood pressure of above 125mmHg, frequent alcohol drinking, frequent breath-holding during sleep, frequent dry mouth during sleep, sleep apnea score of above 35), same patients could be discriminated in 87.6% sensitivity. And, in case of more than one among four parameters(neck circumference of above 40cm. systolic blood pressure of above 125mmHg, frequent alcohol drinking, body weight of above 80kg), discrimination sensitivity was 83.5%. Conclusions : Patients with RDI above 20 could be discriminated by above parameters with high sensitivity. Therefore, the screening test using above parameters can be applied in selection of the patients with sleep apnea for PSG in practice.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.130-137
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• 2019

Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.