Hemophilia is a serious rare disease that requires continuous management and treatment for which the medicine is costly at the annual average of 100 million KRW for an individual. The aim of this study was to investigate trends in the utilization of coagulation factor (CF) used for hemophilia treatment using the National Health Insurance database from 2010 to 2013 in Korea and compare the utilization of CF with other countries. The consumption of CF per capita (IU) in Korea was not more than other countries with similar income to Korea. However, CF usage per patient IU was higher because the prevalence rate of hemophilia in Korea was lower than in other countries while the number of serious patients was much more. Therefore, it is difficult to say that the consumption of hemophilia medicine in Korea is higher than that in other countries. The consumption and cost of hemophilia medicine in Korea is likely to increase due to the increased utilization of expensive bypassing agents and the widespread use of prophylaxis for severe hemophilia. Even during the research period, it increased slightly and other countries show a similar trend. Thus, hemophilia patient management should accompany active monitoring on the health and cost outcomes of pharmaceutical treatment in the future. This study is expected to contribute to further insight into drug policies for other countries that face similar challenges with high price pharmaceuticals.
Adolescent ; Adult ; Aged ; Blood Coagulation Disorders, Inherited/*drug therapy/*economics/pathology ; Blood Coagulation Factors/*therapeutic use ; Child ; Child, Preschool ; Databases, Factual ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; National Health Programs/statistics & numerical data ; Republic of Korea ; Severity of Illness Index ; Young Adult

PURPOSE: This study attempted to identify influential variables on types of smoking in adult smokers, which have been derived from Q-study. METHODS: A survey was conducted with 328 adult smokers at community settings in Seoul, South Korea from April 2006 to July 2006. To identify the influential variables related to smoking, variables from the Trans-theoretical model(i.e., self-efficacy for smoking abstinence, smoking temptation, process of change, decisional balance(pros and cons)) and nicotine dependency were analysed by ANOVA. Post-comparison tests were also done. RESULTS: The scores of nicotine dependency and smoking temptation were higher in habitual craving types than any other types, while the scores of self-liberation and self-efficacy for smoking abstinence were higher in self control types than any other types. CONCLUSION: Specific smoking intervention methods for each of the smoking types needs to be developed, based on how different groups of individuals gets into a decisions to quit smoking within their contexts.
Adult ; Dependency (Psychology) ; Humans ; Nicotine ; Republic of Korea ; Smoke ; Smoking

PURPOSE: To evaluate the usefulness in diagnosing the gallbladder perforation MATERIALS AND METHODS: CT scans of surgically proved 11 cases of gallbladder perforation were retrospectively reviewed. CT findings analyzed were iuminal diameter of GB, GB wall thickness and configuration, presence or absence of fluid collection in the pericholecystic or intraperitoneal space, and observation of pericholecystic anatomic structures. All patients underwent cholecystectomy, and surgical findings were also compared. RESULTS: The GB was distended in 6 cases(55% with a range of 4.0-7.5cm, mean :5.2cm). GB wall was thickened in most cases(9/11,82%) with homogeneous(n=7) or inhomogeneous(n=2) enhancement. At the sites of perforation, focal defect or contour bulging was seen in the GB wall in 3 cases. in 2 cases with gangrene, GB wall showed loss of normal contour with mottled contrast enhancement. Pericholecystic or intraperitoneal fluid co11ection was noted in 9 cases(82%), especially in the region of perforation. In all cases, there was evidence of diffuse infiltration in the pericholecystic space, omenturn or mesentery. Other findings included cholecy-stoenteric fistula in 1 case, and intrahepatic or intraperitoneal abscess formation in 2 cases. CONCLUSION: CT is useful in correct diagnosis of gallbladder perforation.
Abscess ; Cholecystectomy ; Diagnosis ; Fistula ; Gallbladder* ; Gangrene ; Humans ; Mesentery ; Retrospective Studies ; Tomography, X-Ray Computed

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.
Angiography ; Arteries ; Arteriovenous Malformations* ; Brain ; Gastrointestinal Tract ; Hemorrhage ; Hepatic Artery ; Hepatic Veins ; Liver* ; Lung* ; Radiography ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Thorax ; Tomography, Spiral Computed ; Veins

PURPOSE: This study was done to identify types of smoking decision making-temptation in adolescents and characteristics related to type among student smokers. METHOD: Data collection was done from March to July. 2006. A survey was administered to 275 students in 13 high schools and 15 middle schools in Seoul, South Korea. To identify types and characteristics smoking decision making-temptation in adolescents, cluster analysis using the K-mean method was employed. Characteristics of the influential variables according to the identified types of adolescent smokers were evaluated using ANOVA. RESULTS: Four types of smoking pattern in adolescents were identified: habitual craving (17.7%), nicotine dependence (35.8%), feeblemindedness (28.4%), and self control p=.001), while the score for self efficacy for smoking abstinence was higher in the self control type (F=23.06, p=.000). Conclusions: Findings from this study suggest that effective interventions for smoking cessation in adolescents require not only active implementation of nicotine replacement therapy but also development of individualized approaches for each person targeting change in the social environment that may lead to positive smoking decisional balance.
Adolescent ; Data Collection ; Humans ; Nicotine ; Republic of Korea ; Self Efficacy ; Smoke ; Smoking ; Smoking Cessation ; Social Environment ; Tobacco Use Disorder

PURPOSE: The purpose of this study was to identify family resiliency, ADL in elders with dementia, and symptom for families with an elder with dementia. METHOD: The participants were 102 people who were caregivers to elders with dementia and who visited the out-patient department at S. hospital for follow up care. Data were collected from August to October 2003 using a questionnaire. The collected data were analyzed using descriptive statistics and t-test aided by the SPSS/PC. RESULT: Family resiliency for the whole sample was within normal limits but when the sample was quarter-divided by good and poor family resiliency, based on established cut-off scores, there were differences for some characteristics according to good/poor family resiliency. These differences were for perceived health state of caregivers (t=-2.78, p=.008), economic state of family (t=-3.34, p=.002), and ADL (t=-2.56, p=.014). CONCLUSION: Future research should focus on the way in which family resiliency can be enhanced and on the effects of interventions for those caregivers who report poor family resiliency.
Activities of Daily Living* ; Caregivers ; Dementia* ; Follow-Up Studies ; Humans ; Outpatients ; Surveys and Questionnaires

PURPOSE: This study was done to identify the types of pain identification made by nurses caring for patients with dementia in nursing homes. METHOD: To collect the Q-population, 12 nurses working in nursing homes were interviewed. From the collected data, 69 statements were derived and eight patterns of pain identification were categorized. Thirty statements were derived as the Q-sample. Thirty nurses were sampled as the P-sample. The 30 Q-cards with Q-statements were Q-sorted by the P-sample. The results of the Q-sorting were coded and analyzed using the PC QUANL program. RESULTS: Five types of pain identification were identified by nurses for patients with dementia living in nursing homes; Type 1 was named "estimating based on verbal expressions". Type 2 was named "reasoning through physical symptoms". Type 3 was named "confirming pain based on nonverbal expressions being consistent with conditions of physical function". Type 4 was named "empathizing with vocal expressions". Type 5 was named "confirming by comparison with objective pain indicators one by one". CONCLUSIONS: The results of this study indicate that comprehensive understanding of pain identification by nurses could help improve the assessment of pain in patients with dementia.
Dementia ; Humans ; Nursing Homes ; Q-Sort

PURPOSE: The present study purposed to investigate and analyze domestic websites providing information about dementia and to suggest future directions for the development of dementia-related websites. METHOD: For this purpose, the researcher selected 13 domestic websites that were available in November and December 2004, and evaluated them in terms of construction, operation, accessibility and contents on a scale 4 point (0~3). RESULT: The construction of dementia-related websites got 6~13 out of 18 points, which suggests that management policies for the operation of dementia-related websites are inadequate. The operation of dementia-related websites got 7~15 out of 24 points. In particular, all 13 sites got a low score in the aspect of continuance. With regard to accessibility, the sites were evaluated on how easily users could access the sites and they got 2~8 out of 15 points. In evaluating contents, the sites got 9~18 out of 21 points with regard to the purpose and appropriateness of the contents. CONCLUSION: This shows that most sites did not provide diverse types of dementia-related information. Because it is highly advantageous to perform primary dementia-preventing management through websites, this study proposes to develop a website evaluation system in order to provide high quality dementia-related informatio.
Korea ; *Internet ; Humans ; *Dementia

BACKGROUND AND OBJECTIVES: The frontal recess is the drainage pathway for the frontal sinus and its boundaries are formed by adjacent structures: they include agger nasi (anterior wall), medial orbital wall (lateral wall), ethmoid bulla/agger nasi (lateral wall), ground lamella (posterior wall), and anterior ethmoid air cells (posterosuperior). It is known that the drainage of the frontal recess is influenced by anatomic variants (agger nasi cell, frontal cells, supraorbital cell, intersinus septal cell, and attachment type of uncinate process). Because of its complex anatomy, the frontal sinus has been a difficult area in which to obtain consistently good long-term surgical results. SUBJECTIVES AND METHOD: To show the prevalence of anatomic variants and the relationship between the variants and frontal sinusitis, we analyzed the coronal and axial computed tomography of 225 patients, and 450 side sinuses (from 2001-6-1 to 2002-12-31). RESULTS: Frontal cells are observed in 176 cases (40.1%), agger nasi cell in 380 cases (84.8%), supraorbital cell in 17 cases (3.8%), and intersinus septal cell in 19 cases (11%). In the attachment type of the uncinate process, the lamellar type was seen in 272 cases (60.2%), the skull base type in 171 cases (26%), and the middle turbinate type in 62 cases (13.8%). The frontal sinusitis were seen in 8 cases (88.9%) among the type IV frontal cell group (9 cases) and in 149 cases (39.1%) among the agger nasi group. CONCLUSION: Relatively higher prevalence of anatomic variants was seen. The type IV frontal cells and agger nasi cells were significantly related to the frontal sinusitis.
Drainage ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Orbit ; Prevalence ; Sinusitis ; Skull Base ; Turbinates

OBJECTIVES: The aim of this research was to determine intra-oral factors that affect halitosis in young women. METHODS: This study was performed between March 2014 to May 2014, and included 35 women in their 20s with good oral health. Correlation and logistic regression analyses were performed to investigate the change in halitosis immediately, and 1 hour after scaling. RESULTS: In both oral gas (OG) and extraoral gas (EG) groups, halitosis was reduced after scaling compared to before scaling. The logistic regression analysis of oral state factors in OG showed that as oral fluid [odds ratio (OR) = 0.792, p = 0.045] and dental plaque (OR = 0.940, p = 0.016) decreased by 1 unit, the OR in the OG group decreased (> 50). In addition, as glucose levels in the oral cavity (OR = 1.245, p = 0.075) and tongue coating index (OR = 2.912, p = 0.064) increased by 1 unit, the OR in the OG group increased (> 50). Furthermore, in the EG group, as oral fluid (OR = 0.66, p = 0.01) and dental plaque (OR = 0.95, p = 0.04) decreased, the OR in the EG group decreased (> 50) significantly. CONCLUSION: To control halitosis, it is necessary to increase oral fluid and decrease the amount of tongue plaque. Furthermore, maintaining a healthy oral environment, aided by regular scaling and removal of dental plaque, may significantly control halitosis.
Dental Plaque ; Female ; Glucose ; Halitosis* ; Humans ; Logistic Models ; Mouth ; Oral Health ; Tongue