• Korean Journal of Psychosomatic Medicine
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• v.31 no.1
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• pp.10-18
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• 2023

Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

• Archives of Plastic Surgery
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• v.41 no.2
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• pp.116-121
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• 2014

Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

• Journal of Acupuncture Research
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• v.33 no.2
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• pp.151-164
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• 2016

Objectives : The purpose of this study is to review clinical studies about the efficacy of fire needling for the treatment of acne vulgaris. Methods and Results : In this review, Oasis, NDSL, CNKI, PubMed, Cochrane, J STAGE and CINII were used as the main databases for searching for medical journals, using the keywords "acne and fire needling"," acne and fire needle"," acne and fire acupuncture", and" acne and red hot needle". The initial search range included only randomized controlled trials (RCTs), and papers not matching inclusion criteria were excluded. Initially a total of 108 studies were found, with ten being excluded during title and abstract screening. After scanning 98 papers, a total of 31 RCTs were selected and analyzed. In the 31 RCTs, patients with acne were randomized into groups for treatment and control. Specifically, the treatment group received fire needling, while the control group were concurrently given other treatments. The results of the completed studies have shown that the treatment group receiving fire needling demonstrated significant improvement compared to the control group. Conclusion : During our study, it was verified that the efficacy of fire needling for the treatment of acne vulgaris was both significant and meaningful. Therefore, fire needling can be a safe and effective alternative treatment for acne. However, to confirm this result, further investigation in a traditional clinic is required, accompanied by high quality studies including randomized, placebo-controlled double-blind trials.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.43-49
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• 2009

Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the $SKMVTT^{(R)}$ (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and $SKMVTT^{(R)}$ is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.

• Health Policy and Management
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• v.12 no.1
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.1
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• pp.141-159
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• 2004

Purpose: The purpose of this study was to investigate the degree of information technology application, and to identify the effect of information technology application en knowledge management process in clinical nurses. Method: Participants were 629 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Thee structured instruments were used to collect the data: Information Technology Application scale, Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), and one for general characteristics. The data were analyzed using reliability analysis, descriptive analysis, one-way ANOVA, $Scheff{\acute{e}$ test, correlation analysis, partial correlation analysis, and multiple regression analysis with the SPSS for Windows 10,0 program. Result: 1) The HIS application degree, IT application ability, and IT application frequency were significantly correlated with the degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization(p=.000). 2) The 3 variables, HIS application degree, IT application ability, and IT application frequency explained 47.2% of the total variance of the degree of knowledge management process activation, and 352% of me total variance of Knowledge Storage. And 2 variables, HIS application degree and IT application frequency explained 17.6% of the total variance of Knowledge Creation, 39.9% of the total variance of Knowledge sharing, and 33.8% of the total variance of Knowledge utilization(p=.000). 3) As a result of multiple regression analysis, the key determinant of the degree of knowledge management process activation for nurses was HIS application degree The HIS application degree, IT application frequency, position, IT application ability, and continuous total numbers of years working at the present hospital explained 51.1% of the total variance of the degree of knowledge management process activation(p=.000). Conclusions: These results suggest that the information technology application positively affects the nurses' knowledge management process. From the above findings, information technology application is empirically verified as a useful and effective method to activate knowledge management process, and knowledge management.

• International Journal of Fuzzy Logic and Intelligent Systems
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• v.15 no.2
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• pp.102-110
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• 2015

The main source of noise in computed tomography (CT) images is a quantum noise, which results from statistical fluctuations of X-ray quanta reaching the detector. This paper proposes a neural network (NN) based hybrid filter for removing quantum noise. The proposed filter consists of bilateral filters (BFs), a single or multiple neural edge enhancer(s) (NEE), and a neural filter (NF) to combine them. The BFs take into account the difference in value from the neighbors, to preserve edges while smoothing. The NEE is used to clearly enhance the desired edges from noisy images. The NF acts like a fusion operator, and attempts to construct an enhanced output image. Several measurements are used to evaluate the image quality, like the root mean square error (RMSE), the improvement in signal to noise ratio (ISNR), the standard deviation ratio (MSR), and the contrast to noise ratio (CNR). Also, the modulation transfer function (MTF) is used as a means of determining how well the edge structure is preserved. In terms of all those measurements and means, the proposed filter shows better performance than the guided filter, and the nonlocal means (NLM) filter. In addition, there is no severe restriction to select the number of inputs for the fusion operator differently from the neuro-fuzzy system. Therefore, without concerning too much about the filter selection for fusion, one could apply the proposed hybrid filter to various images with different modalities, once the corresponding noise characteristics are explored.

• The Korean Journal of Community Living Science
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• v.15 no.3
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• pp.149-165
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• 2004

In Korea, as the elderly population is growing, the quality of life of the rural elderly is becoming a major concern. By the way, social welfare services is less available and accessible to the rural elderly. And we have very limited information about community -oriented welfare services for the elderly. The lack of social welfare services in rural area resulted from mainly geographic isolation and economic deprivation. So, the present research aimed at; 1) to explore what the social welfare service is benefited from governmental or local assembly. 2) to explore what kind of community services is provided for the rural village and elderly. 3) to appear the political propose for the rural elderly. In South Korea, The Rural Development Administration currently operate 'villages which is supported special programs for the improvement of QOL of rural elderly' in 110 villages. It is a model governmental welfare service for rural area. For the purpose, the survey data is gathered from community level data per village (107 villages), individual survey data(881people) who live in the village and qualitative data. Two kinds of quantitative data is combined to form a data. The statistical methods used for data analysis are descriptive statistics, t-test and ANOVA. The major findings of this study were as follows : It was founded that the majority family type of the rural elderly is elderly-only households(75%). In case of poor elderly, they have very limited social insurance benefit and they can not get medical services with satisfaction. The result show that the welfare facilities per village and welfare service for the elderly is extremely low while the needs of welfare service is greate high. A distinctive characteristics in rural villages is that they receive a lot of services from private sectors, like as Women Farmers Union, Adult Union. They operate voluntary welfare services related to food supporting, education for the elderly, free haircut services and so on. In conclusion, the community care services from private sector has specialty in rural area. We conclude it is a distinguishing characteristic of rural community.

• Journal of Korean society of Dental Hygiene
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• v.4 no.2
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• pp.209-223
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• 2004

The purpose of this study is to help dental hygienist's efficient work and 10 use this data as basic material for quality improvement of medical treatment by identify and analyze dental hygienist's job-stress and self-conception. This data was surveyed by 197 dental hygienists who working at Dental Clinic, Dentist's office, and Dental Dept on the General hospital in Daegu area. The result as follow. 1. General characters of dental hygienist who participated this survey was mostly less than 25years old and works in the Dentist's office. 2. The dental hygienist's job stress average 259, self-conception was average 3.06. 3. A stress degree by the primary factors appeared that the stress related to Role-conflict was the hygienist. On the other hand, stress related to employees was the lowest. 4. Concerning the stress of respondent's expert knowledge or technique, there exist statistically significant relations in age(p=0.000). Total period of work(p=0.000)), marriage(yes or no)(p=0.012), number of job movement(p=0.024). 5. Concerning the mutual analyze between stress by the primary factors and self-conception, there exist statistically significant relations in stress from expert knowledge or technique(p<0.05, r=0.l53), conflict with patient(p<0.001, r=0.347), conflict between dentist and patient(p<0.05, r=0.159), relationship with employee(p<0.05, r=0.l83). In conclusion, there were significant relations between job-stress and conception. The study of program development for the self-conceit, positive attitude and self-conception are highly required to help dental hygienist's efficient work.