• Health Policy and Management
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• v.32 no.1
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• pp.94-106
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• 2022

Background: The efforts to build more "people centered," "patient centered" health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called "Medical Service Experience Survey (MSES)." There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: "doctor experience," "nurse experience," "outpatient service experience," and "patient satisfaction." It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as "experiences on medical staffs considering physical exposure" or "experiences related to personal information exposure," were answered in conjunction with items of "nurse experience." Besides, patients responded that administrative elements of medical services, such as "experiences of comfort in medical institutions" and "experiences of satisfactory administrative services," were related to the items of "nurse experience." The answers of patients who visited traditional medical hospitals and clinics about "doctor experience" and "nurse experience" were not discerned statistically, and the answers to "doctor experience," "nurse experience," and "medical institution experience" were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.

• Progress in Medical Physics
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• v.26 no.3
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• pp.160-167
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• 2015

Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

• Journal of the Korean Chemical Society
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• v.56 no.6
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• pp.751-758
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• 2012

In this study, we analyzed career paths and college life plans of department of chemistry education students in teacher's college examined by their roadmaps. We let students make their roadmaps and analyzed them using the PASW 18 program. There were significant differences on gender in their career paths, learning English, traveling and volunteer activity. Female students for passing the MEET(Medical Education Eligibility Test) or DEET(Dental Education Eligibility Test) were more interested in learning English and traveling than male students. In addition, female students were more interested in volunteer activity. And the lower year students, the more interested in medical paths, learning English, traveling, getting good grades, exchange student program and scholarship. On the other hand the higher year students, the more interested in group study or E-learning. Then significant differences were in learning English, traveling and getting good grades by students's career paths. Students who wish to pass the MEET or DEET were more interested in learning English and getting good grades. Those two factors were essential in passing the MEET or DEET. Students who did not specified their career paths had more traveling plans than other students for setting their directions of careers. These results show that freshman and female students don't recognize the identity of teacher's college correctly. Because of reduction in the number of teacher recruitment according to decrease of students by birth rate drop, students in teacher's college are expected to continue like this trend that students look for other paths. Therefore, it is required career counseling and guidance for students who give priority practical path choices and college life plans over original characteristics of teacher's college. And it should be reconsidered the direction of chemistry education prepared the identity of teacher's college reflected in this actuality.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.429-455
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• 2002

There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.408-415
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• 1999

When a zinc-oxide eugenol type sealer was placed in root canals treated previously with calcium hydroxide, acceleration of its setting and the yellowish discoloration were observed clinically. The purpose of this study was to evaluate the properties of calcium hydroxide-eugenol compound. Some physical properties of calcium hydroxide-eugenol compound were compared with a manufactured zinc-oxide eugenol based root canal sealer, Tubli-seal$^{(R)}$ in terms of water solubility, water sorption, film thickness and microleakage. Solubility and water sorption were determined by the use of the method described in American Dental Association Specification(ADAS) no. 57. Ten samples of each material were prepared into disks 20mm in diameter and 1.5mm in thickness. The samples were immersed in 50ml of distilled water at $37{\pm}1^{\circ}C$ for 7 days. The samples were then removed and placed in a desiccator. The values for solubility and water sorption were calculated using differences between the weights of same sample. Film thickness was determined by the use of the method described in ADAS no. 57 too. A small quantity of mixed cement was placed between two glass plates of which thickness was measured previously. 15Kg loading was applied and total thickness of the glass plates and the cement film was measured. The thickness difference was recorded as the material's film thickness. Microleakage was determined with a dye penetration method. Experimental materials were placed between the dentin surface of bovine tooth and the acrylic rod. These units were immersed in Pelican ink (W-Germany) for three days. Dye-penetrated dentin surfaces of bovine tooth were measured using the NIB Image 1.60 Macintosh program. The results are as follows: 1. Water solubility value of calcium hydroxide-eugenol compound (20.98${\pm}$2.94%) was statistically higher than those of Tubli-seal$^{(R)}$(2.52${\pm}$0.49%)(p<0.05). 2. Water sorption value of calcium hydroxide-eugenol compound (59.72${\pm}$17.75%) was statistically higher than those of Tubli-seal$^{(R)}$(3.15${\pm}$0.76%)(p<0.05). 3. Film thickness value of calcium hydroxide-eugenol compound (0.36${\pm}$0.03mm) was statistically higher than those of Tubli-seal$^{(R)}$(0.12${\pm}$0.1mm)(p<0.05). 4. Dye penetration value after 3 days-immersion of calcium hydroxide-eugenol compound(57.63${\pm}$25.85%) was statistically higher than those of Tubli-seal$^{(R)}$(28.05${\pm}$23.46%)(p<0.05).

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.581-588
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• 2019

MRI is superior when contrasted to help the organization generate artifacts resolution, but also affect the diagnosis and create a image that can not be read. Metal is inserted into the tooth, it is necessary to often be inhibited in imaging by causing the geometric distortion due to the majority and if the difference between the magnetic susceptibility of a ferromagnetic material or paramagnetic reducing them. The purpose of this study is to conduct a metal artefact in accordance with the analysis using a diamagnetic material. The magnetic material include a wire for the orthodontic bracket and a stainless steel was used as a diamagnetic material was used copper, zinc, bismuth. Testing equipment is sequenced using 1.5T, 3T was used was measured using a SE, TSE, GE, EPI. A self-produced phantom material was used for agarose gel (10%) to a uniform signal artifacts causing materials are stainless steel were tested by placing in the center of the phantom and cover inspection of the positive cube diamagnetic material of 10mm each length.After a measurement artefact artifact zone settings area was calculated using the Wand tool After setting the Low Threshold value of 10 in the image obtained by subtracting images, including magnetic material from a pure tool phantom images using Image J. Metal artifacts occur in stainless steel metal artifact reduction was greatest in the image with the bismuth diamagnetic materials of copper and zinc is slightly reduced, but the difference in degree will not greater. The reason for this is thought to be due to hayeotgi offset most of the susceptibility in bismuth diamagnetic susceptibility of most small ferromagnetic. Most came with less artifacts in image of bismuth in both 1.5T and 3T. Sequence-specific artifact reduction was most reduced artifacts from the TSE 1.5T 3T was reduced in the most artifacts from SE. Signal-to-noise ratio was the lowest SNR is low, appears in the implant, the 1.5T was the Implant + Bi Cu and Zn showed similar results to each other. Therefore, the results of artifacts variation of diamagnetic material, magnetic susceptibility (${\chi}$) is the most this shows the reduced aspect lower than the implant artificial metal artifacts criteria in the video using low bismuth susceptibility to low material the more metal artifacts It was found that the decrease. Therefore, based on the study on the increase, the metal artifacts reduction for the whole, as well as dental prosthesis future orthodontic materials in a way that can even reduce the artifact does not appear which has been pointed out as a disadvantage of the solutions of conventional metal artifact It is considered to be material.