• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.191-199
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• 2016

Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.88-100
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• 1992

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.1-14
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• 2004

Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

• Research in Community and Public Health Nursing
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• v.13 no.1
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• pp.182-196
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• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.166-173
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• 2002

Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.79-96
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• 2001

In order to ascertain the utilization patterns and Perception and attitudes of Primary Health Post(PHP) by rural residents in farm areas, a survey was conducted of 753 households(1,803 persons) in 24 PHPs in Sangju-si, Gyeongsangbuk- do, from December 10, 2000 to January 15, 2001. The morbidly rate of acute illnesses for last two weeks for all households was 29.6%, and the rate of use of medical facilities to treat acute illness was 98.3%. The morbidly rate was highest between the ages of 60 and 69, with a rate of 35.4%. The higher their ages and the lower their educational levels were, the higher the morbidly rate was. The morbidly rate of chronic illnesses for one year for all households was 19.2%, and the rate of use of medical facilities to treat chronic illness was 92.8%. The elderly over 70 years old had the highest morbidly rate of 37.2%. The higher their ages and the lower their educational levels were, the higher the chronic illnesses rate was. For the rate of use of medical facilities to treat acute diseases, the use of PHPs was 89.5%, accounting for the majority of the time. However, for chronic diseases, hospitals and clinics were used more often, with a rate of 48.9%, compared to the use of PHPs, 40.2%. Their previous experiences on the use of PHPs one year before the survey showed that 94.8% used PHPs, 72.2% just visited them, not for the purpose of getting any medical assistance, and 73.3% received health education from PHPs. 98.5% remembered the locations of PHPs, 98.6% thought that PHPs were helpful for their health management, and 84.3% said that PHPs were playing great roles in development of their communities. 97.4% said that they found PHPs necessary. They understood the main job of PHPs as in the order of disease treatment, vaccination and health counseling. The work that they mostly wanted PHPs to do was health counseling and health management, which 31.6% answered. 88.9% said the examination fee was not expensive, 98.4% said CHPs were kind, and 97.0% said they were satisfied with the services at PHPs. Complaints about PHPs included a lack of a variety of medications, said by 42.9%, and poor facilities, by 15.8%. According to the above results, it is concluded that local residents on survey were frequently using PHPs due to their geographical and economical conditions. Also, the residents appeared to be satisfied with the services at PHPs, and they had a high demand for public health service as well as disease treatment. Considering the complaints about medications and medical facilities and equipment, active supports are required to manage PHPs in a way it can provide desirable services to the residents in remote villages through the readjustment of PHPs' functions, reinforcement of facilities and equipment and enhancement of CHPs ' training.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.257-262
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• 2004

Purpose: We reported our preliminary result in 2001. At that time, the follow-up period was too short to evaluate the survival benefit of adjuvant chemotherapy in gastric cancer without serosal invasion. Therefore, we followed those patients for 66 months to determine the long-term effects of adjuvant chemotherapy. Materials and Methods: We analyzed the recurrence pattern, the survival rate, and the disease-specific survival of 135 patients by reviewing their medical records and calling the patients or their relatives. All enrolled patients were included in the intention-to-treat analysis of efficacy. Results: The follow-up rate was $89.6\%$ (121/135), and the median follow-up duration was 66 months. Among the 135 patients, 4 relapsed in group 1 (5-FU+cisplatin), 7 in group 2 (mitomycin C+oral 5-FU), and 6 in group 3 (oral 5-FU only). The overall survival rate was $89\%$ in group 1, $84\%$ in group 2, and $82\%$ in group 3. There were no differences in the overall survival rates and the disease-specific survival rates among the three groups. Conclusion: Oral chemotherapeutic agents have an acceptable effect for adjuvant chemotherapy compared with intravenous agent. However, a large-scale, prospective, randomized study, including a control group, is needed for an exact evaluation.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.267-273
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• 1993

Background: Panting method for airway resistance measurement has the disadvantages of departing from the normal breathing pattern and of difficult for some patients to perform. We can measure airway resistance during quiet breathing under more physiologic conditions. Airway resistance is often measured during panting but attempts have been made to facilitate resistance measurements during quiet breathing. This study was designed to compare airway resistance measurements during panting with those during quiet breathing. Method: The 24 normal persons and 29 pulmonary disease patients were included in this study. Spirometry was performed and airway resistance measurement was also done during panting and quiet breathing concomittently. Results: The results were as follows; 1) High correlations were found between airway resistance measurements during panting and quiet breathing. 2) Resistance fell during panting, 21.2% in Raw tot, and 22.1% in Raw 0.5. 3) In normal persons, airway resistance fell more during panting when comparing to those in pulmonary disease patients. 4) This was largely independent of thoracic gas volume differences, because the specific airway conductance rose significantly during panting 5) The patients in whom resistance didn't fell during panting was supposed to the patients who couldn't perform panting successively because of high resistance. Conclusions: Although airway resistance can be measured during panting or quiet breathing according to the patient's performance, we must consider resistance fell during panting, by a mean 20%. It may be concluded that quiet breathing is more likely than panting to provide a relevant measurement of airway resistance.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.31-40
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• 2003

Background : A CT scan is a useful modality for the diagnosis and evaluation of disease activity in patients with pulmonary tuberculosis. However, the CT diagnosis of pulmonary tuberculosis is sometimes difficult in patients with an atypical CT pattern, especially with lobar consolidation mimicking pneumonia. The aim of this study was to evaluate the clinical and CT features of pulmonary tuberculosis, simulating pneumonia, from a CT scan. Materials and Methods : The clinical and CT features in 21 patients, where the CT diagnosis was pneumonia, or the CT differential diagnosis included pneumonia, were retrospectively analyzed. Results : Of the 21 patients, 6 were immunocompromised, 15 presented with fever or leukocytosis and 15 showed positive sputum smear test for acid fast bacilli. Also, 17 of the 21 patients showed a positive sputum culture test. On the CT scan, consolidation was noted in all patients (100%), volume loss of the involved lobe or segment in 12 (57%), bronchogenic spread in 15 (71%), a cavity in 7 (33%) and bronchial wall thickening also in 7 (33%). The location of the consolidation revealed a relatively even distribution, with no specific predilection site. The other associated pulmonary diseases included ARDS, bronchiectasis, severe pulmonary emphysema, idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis. Conclusion : In the immunocompromised patients, or patients with an underlying pulmonary disease, whose CT scans showed pulmonary consolidation, especially in association with findings of bronchogenic spread, a cavity or bronchial wall thickening, meticulous examination for pulmonary tuberculosis is recommended.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.283-294
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• 2003

Introduction : Rapidly growing nontuberculous mycobacteria (RGM) can produce numerous types of manifestations including a pulmonary infection. Managing a pulmonary infection due to RGM is unusually difficult to treat because the organism is invariably resistant to traditional antituberculous drugs and has a varying susceptibility to other antibiotics. The experiences of treatments for a RGM pulmonary infection with various antibiotics are also limited. This study evaluated the clinical manifestations, treatment, and the therapeutic outcomes of a RGM pulmonary infection. Subjects and method : Fifty-four cases with RGM from respiratory specimens were identified between November of 1996 and September of 2002 in the Asan medical center. The medical records and radiographic findings in 20 patients who fulfilled the diagnostic criteria of nontuberculous mycobacteria (NTM) pulmonary disease by ATS guidelines. The clinical, laboratory, and radiological parameters between subgroups. Results : Of the 20 patients, 15 were female. The mean age was 57.7 yrs (${\pm}7.5$), and all of the patients had a history of pulmonary tuberculosis. Most (90%) had an underlying lung disease. The majority of the isolates (80%) were M. abscessus. Chest radiography showed bilateral involvement in 80% of the patients. Bronchiectasis and multiple nodules were the main findings. Cavitation was present in 35% of the patients. Even though 70 % of the patients received antituberculous drugs prior to the correct diagnosis, all of the patients eventually received antibiotics. A mean of 3.5 antibiotics were given for an average of 439 days(${\pm}168$). After completing treatment, nine patients showed improvement after a mean 591(${\pm}311$) days of treatment, whereas the antibiotic treatment was unsuccessful in 2 patients. Conclusion : Many patients with a RGM pulmonary infection show an atypical pattern of radiological findings (bronchiectasis and multiple centrilobular nodules). It is very important to differentiate between M. tuberculosis and NTM and to identify the causative organisms among the NTM because a misdiagnosis can lead to an inappropriate and prolonged treatment. Combined antibiotic treatment yielded promising results, and is recommended for treating patients with a RGM pulmonary infection.