• Title/Summary/Keyword: 개선항목

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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Status of Tuberculosis Control in Rural Area (일부 농촌지역 결핵환자들의 관리 양상)

  • Park, Chan-Byoung;Chun, Byung-Yeol;Yeh, Min-Hae
    • Journal of agricultural medicine and community health
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    • v.18 no.2
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    • pp.141-151
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    • 1993
  • This study was done about 371 tuberculosis(TB) patients composed 195 newly registered at Kyungju Gun Health Center from May 1989 to April 1990 (Group A) and 176 being treated at hospitals or private clinics from January 1988 to November 1989(Group B). When Group A patients visited and newly registered at Health Center, data was obtained by interviewing with a prepared questionnaire paper. And well trained inquirer visited Group B patients and obtained data by the same method from February 1990 to April 1990. The results are as follows ; Group A was generally lower than Group B in socioeconomic status and in family history of TB, the rate of Group A was 24.1% and higher than 11.9% in Group B(p<0.05). Knowledge about TB was improved more than past, but those who answered that TB is 'a communicable disease' were 59.5% in Group A and 51.7% in Group B(p<0.05). Those answered that TB is 'a inherited disease' were 9.2% and 11.4% each. And 1.7% of Group B answered that TB is 'a incurable disease'. Knowledge about TB treatment also was improved more than past, but in the rate of those who answered that TB is a curable disease provided by well treatment Group B(77.8%) was worse than Group A(91.3%). The rate of those who answered that TB were been able to cure by regularly anti-TB medication were 98.0% in Group A and 89.8% in Group B. Its difference was statistically significant. The rate that patients took the first diagnosis and wanted to receive treatments at the same organ were 34.9% of Group A at Health Center and 72.2% of Group B at hospitals or private clinics. And its difference was statistically significant. In the reasons that Group B knew Health Center treated pulmonary TB but they was treated at hospitals or private clinics, unreliability to Health Center was 48.1%. The reasons that Group A was treated at Health Center were 'because of trust' 63.1%, 'because of low cost' 50.3%, 'because of low cost except trust' 9.3%, 'no specific reasons' 27.7%. In the courses of knowing that TB was controlled at Health Center, 'by neighborhood, health worker and doctors' were 84.9% in Group A and 69.0% in Group B. But 'by TV or radio' were 8.2% in Group A and 14.7% in Group B, 'by school education' 2.5% in Group A and 6.2% in Group B. Conclusively, Group A patients were lower than Group B in socioeconomic status, but better than in knowledge about TB. Its reasons was suggested that Health Center had controlled TB patients better than hospitals and private clinics. But considering, that difference in the rate of the same organ for the first diagnosis and treatment, that the only 63.0% of Group A have treated due to 'reliability to Health Center', and that 48.1% of Group B knew that Health Center treated pulmonary TB but didn't visit it due to 'unreliability to Health Center', that public relations(PR) about use Health Center for pulmonary TB and health education for TB was thought to have to strengthened.

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A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

The Analysis of the Current Status of Medical Accidents and Disputes Researched in the Korean Web Sites (인터넷 사이트를 통해 살펴본 의료사고 및 의료분쟁의 현황에 관한 분석)

  • Cha, Yu-Rim;Kwon, Jeong-Seung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.297-316
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    • 2006
  • The increasing tendency of medical disputes is one of the remarkable social phenomena. Especially we must not overlook the phenomenon that production and circulation of information related to medical accidents is increasing rapidly through the internet. In this research, we evaluated the web sites which provide the information related to medical accidents using the keyword "medical accidents" in March 2006, and classified the 28 web sites according to the kinds of establishers. We also analyzed the contents of the sites, and checked and compared the current status of the web sites and problems that have to be improved. Finally, we suggested the possible solutions to prevent medical accidents. The detailed results were listed below. 1. Medical practitioners, general public, and lawyers were all familiar with and prefer the term "medical accidents" mainly. 2. In the number of sites searched by the keyword "medical accidents", lawyer had the most sites and medical practitioners had the least ones. 3. Many sites by general public and lawyers had their own medical record analysts but there was little professional analysts for dentistry. 4. General public were more interested in the prevention of medical accidents but the lawyers were more interested in the process after medical accidents. The sites by medical practitioners dealt with the least remedies of medical accidents, compared with other sites. 5. General public wanted the third party such as government intervention into the disputes including the medical dispute arbitration law or/and the establishment of independent medical dispute judgment institution. 6. In the comparison among the establishers of web sites, medical practitioners dealt with the least examples of medical accidents. 7. The suggestion of cases in counseling articles related to dental accidents were considered less importantly than the reality. 8. Whereas there were many articles about domestic cases related to the bloody dental treatment, in the open counseling articles the number of dental treatment regarding to non insurance treatment was large. 9. In comparing offered information of medical accidents based on the establishers, general public offered vocabularies, lawyers offered related laws and medical practitioners offered medical knowledge relatively. 10. They all cited the news pressed by the media to offer the current status of domestic medical accidents. Especially among the web sites by general public, NGOs provided the plentiful statistical data related to medical accidents. 11. The web sites that collect the medical accidents were only two. As a result of our research, we found out that, in the flood of information, medical disputes can be occurred by the wrong information from third party, and the medical practitioners have the most passive attitudes on the medical accidents. Thus, it is crucial to have the mutual interchange and exchange of information between lawyer, patients and medical practitioners, so that based on clear mutual comprehension we can solve the accidents and disputes more positively and actively.

Investigation of Poultry Farm for Productivity and Health in Korea (한국에 있어서 양계장의 실태와 닭의 생산성에 관한 조사(위생과 질병중심으로))

  • 박근식;김순재;오세정
    • Korean Journal of Poultry Science
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    • v.7 no.2
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    • pp.54-76
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    • 1980
  • A survey was conducted to determine the status of health and productivity of poultry farms in Korea. Area included Was Kyunggido where exist nearly 50% of national poultry population. From this area, 41 layer and 34 broiler farms covering 21 Countries were selected randomly for the survey. When farms were divided in the operation size, 95.1% of layer and 82.3% of broiler farms were classified as business or industrial level while the rest were managed in a small scale as part time job. Generally layer farms had been established much earlier than broiler farms. Geographically 10.7% of layer farms were sited near the housing area such as field foreast and rice field. No farms were located near the seashore. The distance from one farm from the other was very close, being 80% of the farms within the distance of 1km and as many as 28% of the farms within loom. This concentrated poultry farming in a certain area created serious problems for the sanitation and preventive measures, especially in case of outbreak of infectious diseases. Average farm size was 5,016${\times}$3.3㎡ for layers and 1,037${\times}$3.3㎡ for broilers. 89.5% of layer ana 70.6% of broiler farms owned the land for farming while the rest were on lease. In 60% of layer farms welters were employed for farming while in the rest their own labour was used. Majority of farms were equipped poorly for taking necessary practice of hygiene and sanitation. The amount of disinfectant used by farms was considerably low. As many as 97.6% of lave. farms were practised with Newcastle(ND) and fowl pox(F$.$pox) vaccine, whereas only 43.6% and 5.1% of broiler farms were practised with ND and F$.$pox vaccine, respectively. In 17-32.7% of farms ND vaccine was used less than twice until 60 days of age and in only 14.6% of farms adult birds were vaccinated every 4months. Monthly expense for preventive measures was over 200,000W in 32% of farms. Only 4.9-2.7% of vaccine users were soaking advice from veterinarians before practising vaccination, 85% of the users trusted the efficacy of the vaccines. Selection of medicine was generally determined by the farm owner rather than by veterinarans on whom 33.3% of farms were dependant. When diseases outbroke, 49.3% of farms called for veterinary hospital and the rest were handled by their own veterinarians, salesmen or professionals. Approximately 70% of farms were satisfied with the diagnosis made by the veterinarians. Frequency of disease outbreaks varied according to the age and type of birds. The livabilities of layers during the period of brooding, rearing ana adultwere 90.5, 98.9 and 75.2%, respectively while the livalibility of broilers until marketing was 92.2%. In layers, average culling age, was 533.3 day and hen housed eggs were 232.7. Average feed conversion rates of layers and broilers were 3.30 and 2.48, respectively. Those figures were considerably higher than anticipated but still far lower than those in developed countries.

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Importance and Satisfaction Analysis for Vitalization of River Estuary - Focused on the Nakdong Estuary - (강 하구역 활성화를 위한 자원의 중요도·만족도 분석 - 낙동강 하구역의 사례를 중심으로 -)

  • An, Byung-Chul;Kwon, Jin-Wook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.6
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    • pp.49-59
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    • 2018
  • The purpose of this study was to analyze the importance and satisfaction of resources in the mouth of Nakdong River. A Pearson's chi-square test was performed in SPSS 24.0 for statistical analysis and the result of the study was summarized by three points. First, the results of importance analysis on resources in Nakdong estuary found that the importance of ecology resources was the highest with 27.1%, followed by landscape resources (18.5%), waterside leisure resources (6.5%), complex cultural resources (5.4%), and historic and cultural resources (3.3%). The probability values (p-value) of each group had shown significant differences depending on gender, age, and the location of the survey. For instance, women respondents reported a higher preference to ecology resources and complex cultural resources such as museums than men respondents as much as two times and three times, respectively. Meanwhile, men respondents showed a higher preference to waterside leisure resources in three times as much as women respondents. As for the analysis by age, the respondents in their 20s and 30s recorded a higher value than those in other age groups, and people in their 30s reported a higher preference to waterside leisure resources than those in different age groups by three times. Lastly, no significant differences were found in the preference analysis by occupation (p>.05). With regard to the results of satisfaction analysis, the average level of satisfaction on landscape resources was 6.01, and that of ecology resources and complex cultural resource were 5.65 and 5.15, respectively. Also, significant differences were found between landscape and ecology resources in the satisfaction analysis by age, landscape resources by age, ecology resources by region, and between landscape resources and ecology resources by occupation. The p-value of complex cultural resources was p=0.012, although the satisfaction level of landscape resources and ecology resources were reported to have no significant differences by age. As for the level of satisfaction in landscape resources, respondents in their 40s and 50s showed a high level of satisfaction. However, those in their 20s showed a relatively low level of satisfaction in the same category. The survey respondents living in Busan and South Gyeongsang Province and those living outside the regions revealed no significant differences in terms of satisfaction in landscape resources and complex cultural resources. However, the two same groups were found to show significant differences in the satisfaction analysis on ecology resources. In the satisfaction analysis of landscape resources and ecology resources by occupation, significant differences were found among college students, government employees, ordinary citizens, and expert groups. However, they showed no significant differences in the level of satisfaction to complex cultural resources. Third, the results of importance-satisfaction analysis on Nakdong estuary found that the average levels of satisfaction to landscape resources for each group of respondents who considered landscape, ecology, and cultural resources as important was 6.19, 6.08, and 5.67, respectively. Their levels of satisfaction on ecology resources were 5.95, 5.57, and 5.41 for each. Its correlation to the importance was insignificant. However, it was confirmed that the correlation to the level of satisfaction on complex cultural resources had a significant difference (p=0.025). In addition, the results of the analysis on 15 detailed items that was carried out with the aim to improving values and vitalizing resources in the mouth of Nakdong River found that respondents considered that the vitalization of eco-tourism (49.5%) and restoration of reed marsh (47.5%) were important. The results of detailed analysis revealed respondents' high awareness on the need of enhancing values on ecology resources. Also, improving infrastructure nearby the mouth, creating cycling routes, walkways, waterside leisure facilities, and others were considered as the requirements for the vitalization of Nakdong estuary.

Analysis of Management Status and Optimum Production Scale of Quarrying Firms in Korea -Comparative Analysis of Aggregate and Building-Stone Quarrying Firms- (산지채석업체(山地採石業體)의 경영실태(經營實態) 및 적정규모설정(適正規模設定) -골재용(骨材用) 채석업체(採石業體)와 건축용(建築用) 채석업체(採石業體)의 비교(比較) 분석(分析)-)

  • Joung, Ha Hyeon;Cho, Eung Hyouk
    • Journal of Korean Society of Forest Science
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    • v.80 no.1
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    • pp.72-81
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    • 1991
  • This study was carried out to provide necessary information for improving quarrying industry management in Korea. The results of the study are summarized as follows : 1. In aggregate and building-stone quarrying firms the managers over 40 years of age are 97% and 89.1%, the ones above education level of high school are 90% and 85% and the ones not more than 10 years of quarrying experience are 70% and 52%, respectively. Accordingly it can be pointed out that most of the managers of two types of firms are relatively old, have high educational background, while quarrying experiences of building-stone firm managers are longer than that of aggregate firm managers. 2. Most of the management forms are social corporation(60%) for aggregate quarry firms and private management(76%) for building-stone firms. Average areas of permitted stone-pits of aggregate and building-stone quarries are about 2.86ha and 1.66ha respectively. That is, aggregate quarrying firms are carried on a larger scale than building-stone quarrying firms. 3. The yearly average product of aggregate quarrying firms has increased steadily from $88.961m^3$ in 1985 to $144.028m^3$ in 1988, while, in case of building-stone quarry firms, it has significantly increased from $4.155m^3$ to $19.462m^3$ from 1985 to 1987, but reduced to $13.400m^3$ in 1988. Unstable production activities of building-stone quarrying firms may require continuous government support. 4. Major cost items are equipment rental, depreciation, salaries, repair, maintenance for aggregate quarrying firms, and salaries, depreciation, fuel, tax for building-stone quarrying firms. The yearly average rate of return is about 9.7% for aggregate quarry firms and 2.6% for building-stone quarry firms. It can be pointed out that aggregate quarrying firms is better managed than building-stone quarrying firms. 5. The production elasticity of salary for aggregate quarrying firms is 0.495, that of employees is 0.559, and that of capital service is 0.513. The sum of the elasticities is 1.257>1. Fur building-stone quarrying firms, that of employees is 0.492, that of variable costs is 0.192, and that of capital service is 0.498. The sum of elasticities is 1.172>1, thus denotes the increasing returns to scale for both types quarrying firms. 6. The ratio of marginal value product to opportunity cost of empolyees is 2.54, that of variable costs is 3.62, and that of capital service is 1.45, in aggregate quarrying firms. That of employees is 2.47, that is variable costs was 2.34, and that of capital service is 19.67 in building-stone quarrying firms. Therefore the critical factors for more expansion of management scale in aggregate quarrying firms are variable cost and employees, and are capital service in building-stone quarry ing firms. 7. The break-even points of stone sales are about 0.587 billion won and 0.22 billion won in aggregate and building-stone quarrying firms respectively. The optimum sales Level for profit maximization are about 2.0 billion and 0.5 billion in aggregate and building-stone quarry firms respectively.

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