Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
Journal of Nutrition and Health
/
v.52
no.4
/
pp.332-341
/
2019
Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.
Kim, Seung Won;Kwak, Jong Hyeok;Kim, Gyeong Rip;Choi, Min Gyeong;Sung, Hyun Chul;Song, Geun Sung
Journal of the Korean Society of Radiology
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v.15
no.2
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pp.201-210
/
2021
This study was conducted not only to find out the effect of straight body exercise on neck pain, necks disability and neck length change of turtle neck syndrome patients but also to provide fundamental data for this field in the future. Number of 60 persons were selected by pre-test and divided to 21 persons in straight body exercise group, 19 persons in exercise group and 20 persons in control group(non-exercise group). 5 kinds of straight body exercise were applied in straight body exercise group, 8 kinds of strengthening cervical vertebral exercise were applied in exercise group and no exercise was applied in control group. Neck pain, necks disability index and neck length were measured before and after exercise and 10 weeks later as well. The data were analyzed by SPSS(v18.0). In straight body exercise group and exercise group, neck length, neck pain and necks disability index were significantly decreased after eight weeks of exercise and there was no significant difference in control group. Neck length which was checked every week in straight body exercise group and exercise group was significantly decreased and there were significant differences after 3 weeks.. After 2 weeks of 8 weeks exercise, neck length, neck pain and necks disability were checked again in post test and those results were maintained just like 8 weeks exercise status. As above results, it was more efficient in the straight body exercise group than exercise group and control group to decrease neck pain, necks disability and neck length of turtle neck syndrome patients. Furthermore, after 2 weeks of 8 weeks exercise, the results were maintained just like 8 weeks exercise status. Therefore, the author consider that straight body exercise will be effective exercise for turtle neck syndrome patients, and this study would provide fundamental data for this field in the future.
The in vitro antioxidant activity of oregano seed fractions, fractionizing with 80% ethanol, n-hexane, ethyl acetate, n-butanol, and water, was evaluated, and their effects on edible oils were determined in corn oil at 180℃. The ethyl acetate fraction had the highest radical-scavenging activity. The ferric reducing antioxidant power activity and total phenol content of the ethyl acetate fraction were determined as 6,130 µmol ascorbic acid equivalents/g extract and 770 µmol tannic acid equivalents/g extract, respectively, which were significantly higher than those of the other fractions (p<0.05). Primary and secondary oxidation products in corn oil added with the ethyl acetate fraction of oregano seed significantly decreased by 1.5 and 1.26 times, respectively, compared with those in the control groups. The major volatile ingredients in the ethyl acetate fraction of oregano seeds were determined to be carvacrol, thymoquinone, and 3-cyclopentylcyl-cyclopentan-1-one. Ethyl acetate is a suitable solvent for extracting antioxidant compounds from oregano seeds and can be used as a natural antioxidant.
The purpose of this study is to compare of growth and chlorophyl between old-barley seed (OBS, 2019) and New-barley seed (NBS, 2020) exposed by X-ray. After germination the OBS and NBS, experimental group was exposed by 30 Gy X-ray using linear accelerator (Clinac IS, VERIAN, USA), by 6 MV X-ray, SSD 100 cm, 18 × 10 cm2, 600 MU/min. Length was measured every day until 9th day, and chlorophyl was analyzed using spectrophotometer(uv-1800, shimadzu, japan) after measuring weight in 9th day. Data analysis was performed the Independent T-test using SPSS ver 26.0(Chicago, IL, USA). NBS grow more faster than OBS in control group, but OBS grow more faster than NBS in experimental group. Length of control group was longer significantly every day than that of experimental group in OBS. NBS weighted more than OBS in control group, but OBS weighted more than NBS in experimental group. In comparing chlorophyl density, NBS high more than OBS in control group as well as experimental group. Growth and weight of OBS was effected more those than NBS by X-ray, but NBS in chlorophyl by X-ray. It is expected to be used as basic data for future X-ray research in barley seed.
Park, Ji Young;Kim, Dong Hwan;Bae, Seung Young;Choi, Chang Hee;Cho, Eun Young;Choi, Jeong Hoon;Kim, Sun Mi
Pediatric Infection and Vaccine
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v.14
no.2
/
pp.145-154
/
2007
Purpose : Rotavirus is one of the most important etiologic agents of nosocomial infections among the neonates. This study was designed to investigate nosocomial rotavirus infection in neonates who were admitted to a postpartum-care center after birth. Methods : From March 2005 to September 2006, 957 healthy neonates were examined for rotavirus antigen in stool by immunochromatographic method and 216 neonates were rotavirus antigen positive within 24 hours after admitted to a postpartum-care center. We reviewed the nursing charts retrospectively such as characteristics, monthly distribution, birth hospitals, delivery methods, feeding types and clinical manifestations. Results : Among 957 neonates, 216 neonates (22.6%) were rotavirus antigen positive and there were no differences in sex, birth weight, gestational age. Monthly positive rate of rotavirus antigen showed diversity from 10% to 36%. According to birth hospitals, positive rate showed diversity from 3.5% to 53.6%. Out of 957 neonates, 655 cases (68.4%) were born of vaginal delivery and mean hospitalized duration was 2.4 days, 302 cases (31.6%) were born of cesarean section and mean hospitalized duration was 5.7 days. 17.6% of vaginal delivery and 33.4% of cesarean section were rotavirus antigen positive. The positive rate was higher in neonates by cesarean section than vaginal delivery (P<0.001). According to feeding types, positive rate of rotavirus antigen was lower in breast-fed group than formula-fed group (P<0.001). Proportion of symptomatic case among rotavirus antigen positive was 34.7%. Most common clinical manifestation was diarrhea (61.3%), following poor feeding (45.3%), fever (40.0%), vomiting (25.3%), delayed weight gain (12.0%), and decreased urine amount (5.3%). Conclusion : Some neonates were already infected before admission to a postpartum-care center. Without meticulous management, nosocomial rotavirus infection would transmit rapidly in a postpartum-care center spreading to the community. Recommendation of breast-feeding, routine rotavirus screeing test with or without symptom, and isolation of all rotavirus antigen positive neonates in a postpartum-care center seem to be necessary. Also attentive hygiene education and further investigations of rotavirus infection in a postpartum-care center would be needed.
Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.
Lee, Hwa Yun;Kim, Gi Hwan;Choi, Jin Su;Kim, Sun Hee;Choi, Young Youn;Hwang, Tai Ju
Clinical and Experimental Pediatrics
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v.48
no.9
/
pp.946-952
/
2005
Purpose : Vancomycin-resistant enterococci(VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit(NICU). Methods : From January 2000 to December 2004, the medical records of 294 neonates(127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. Results : From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. Conclusion : VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.
Journal of agricultural medicine and community health
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v.28
no.2
/
pp.155-169
/
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.
The changes in contents of chlorophyll and free proline in the seedling leaves of ten rice cultivars as affected by salt stress were checked in order to obtain the basic information on the judgement of the degrees of salt injury. The difference in salt injury among the cultivars was clearly observed about 25 days after 6% salt treatment. Chlorophyll content was decreased in both Gayabyeo and Taebaegbyeo for 14 days after different salt treatment as salt concentration was increased and the decreased tendency was much higher in Taebaegbyeo than in Gayabyeo over 0.4% salt concentration. Chlorophyll content in Gayabyeo after 0.6% salt treatment was decreased slowly, while in Taebaegbyeo, deminished very rapidly as time progressed, therefore it decreased by about 16% in Gayabyeo and 67% in Taebaebyeo compared to the control at 20 days, respectively. The relationship between chlorophyll content and the degrees of salt injury in ten rice cultivars showed significant negative correlation at 10 day after 0.6% salt treatment. Free proline content in Gayabyeo was increased gradually for 14 days after different salt treatment as salt became higher, while in Taebaebyeo, it was increased rapidly under 0.6% but rather decreased under 0.8% salt concentration. Particularly, it was much higher Taebaegbyeo than in Gayabyeo under salt concentration from 0.4 to 0.6%. Free proline content in Gayabyeo after 0.6% salt treatment was increased from 15 days, on the other hand in Taebaegbyeo, it was increased from 5 days, but rather decreased from 20 days, and it was 6 times higher in Taebaegbyeo than in Gayabyeo at 10 days. There was significant positive correlation between free proline content and the degrees of salt injury in ten rice cultivars at 10 days after 0.6% salt treatment. From the above results, chlorophyll and free proline content may be used as an indicative character of intensity of salt stress as well as varietal difference in resistance to salt stress in the seedling stage.
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