• The Journal of Korean Physical Therapy
• /
• v.23 no.2
• /
• pp.17-21
• /
• 2011

Purpose: The purpose of this study was to determine the correlations, if any, between SPPB (Short physical performance battery), FRT (Functional reach test), and TUG (Timed up and go test) in hospitalized frail people. Methods: Seventy frail elderly patients (male/female: 16/54) participated in this study. All subjects could walk with or without an assisting device and they had no mental problems. Subjects were scored on physical functioning using the SPPB, FRT, and TUG. The data were analyzed using Pearson Correlation Coefficients. Results: There was a statistically significant difference between (a) SPPB and (b) FRT (p<0.01) and TUG (p<0.01). SPPB and FRT scores showed a positive correlation (r = 0.38) and SPPB and TUG scores showed a negative correlation (r = -0.56). Conclusion: SPPB, FRT, TUG scores are correlated with each other. From these results, we conclude that the SPPB is a useful method for predicting walking, balance, and physical function in frail elderly people.

• Health Policy and Management
• /
• v.29 no.4
• /
• pp.445-453
• /
• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.7
• /
• pp.272-280
• /
• 2019

This descriptive research study investigated the relationships between different degrees of family support, ego-resilience and employment volition of patients suffering from alcohol use disorder, and we identified the factors that had an influence on employment volition. This study used the survey research technique and structured questionnaires. The data was collected from 128 males (aged 20 years or older) and who had been diagnosed with alcohol use disorder. They had also undergone either inpatient hospital care or outpatient treatment. The data was analyzed using descriptive statistics, one-way ANOVA, Pearson's correlation coefficient and multiple regression analysis. The results of the study showed that family support had a value of 4.30, an ego resilience had a value of 2.37 and the employment volition had a value of 4.06. The results of the multiple regression analysis showed that there was statistically significant positive correlation between employment volition and ego resilience (${\beta}=-.314$, p<.01) and age (${\beta}=-.253$, p<.01), and the total explanatory power of these 2 factors was 16.3%. According to the results of this study, age-based approaches are needed to improve the employment volition of patients with alcohol use disorder. Additionally, the results of this study suggest that an ego resilience enhancement program be developed and implemented to help these patients.

• Journal of Chest Surgery
• /
• v.30 no.2
• /
• pp.179-186
• /
• 1997

The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

• Journal of Chest Surgery
• /
• v.39 no.10 s.267
• /
• pp.770-774
• /
• 2006

Background: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leak-age and observed the effects and efficiency of treatment. Material and Method: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. Results: Continuous air leakages disappeared in all f6 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complications were transient and disappeared without specific treatment. Conclusion: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.5
• /
• pp.409-415
• /
• 2001

Background : Multidrug-resistant tuberculosis(MDR-TB) in patients is mainly caused by acquired drug resistance. However, a small proportion of MDR-TB is caused by initial drug resistance(IDR), which may be somewhat different from acquired drug resistance. This study analyzed the clinical characteristics of IDR in MDR -TB patients to use the results as basic data in managing the disease. Methods : A retrospective study of 30 IDR cases in MDR-TB patients from Jan. 1995 to Dec. 1998 was performed. In order to analyze the clinical characteristics, the age, sex, family history, duration of negative conversion, number of resistant drugs, treatment regimens, duration of treatment, extent of disease and cavitary lesion on the chest X-ray was examined. In order to analyze the level of improvement, the extent of the disease and cavitary lesion on the chest X-ray, tested by Wilcoxon signed rank sum test, and the disease free interval rate of 1-year and 4-year was examined using the Kaplan-Meier method. Results : The mean age of the patients was 46.6 years and the sex ratio 1:1. Six(20%) patients had a family history. The mean negative conversion of the sputum AFB stain was 2.6 months. The number of resistant drugs was 7.6 and the number of used drugs 3.6. Twenty-three(67%) patients were treated for less than 12months and 28(93%) patients were treated with first-line drugs. The extent of the disease and the cavitary lesion on the chest X-ray improved after treatment(p<.05). Among 13 patients who were followed up for 22.6 months, 2(15%) patients relapsed and the disease free interval rate of I-year and 4-year was 85%. Conclusion: It is recommended that the duration of treatment of IDR in MDR-TB with first-line drugs be 9-12 months even if the extent of disease and cavitary lesion on the chest X-ray improves.

• Pediatric Infection and Vaccine
• /
• v.8 no.2
• /
• pp.191-198
• /
• 2001

Purpose : The purpose of this study was to investigate clinical features of hospitalized infants 28~90 days of age with fever without source and to analyze those of young febrile infants using risk criteria for serious bacterial infection. Methods : The clinical features of 131 infants 28~90 days of age admitted to the Ulsan Dong-Kang General Hospital Pediatric Department because of fever(temperature ${\geq}38^{\circ}C$ rectally) without source, from January 2000 to December 2000, were investigated by retrospective chart review. The clinical features of 131 febrile infants were analyzed using Rochester criteria. Results : Among 131 cases, there were 60 cases(45.8%) of urinary tract infection, 33 cases (25.2%) of aseptic meningitis, 2 cases(1.5%) of bacteremia and 36 cases(27.5%) of no specific diagnosis. Among 131 cases, there were 57 cases(43.5%) in low risk group and 74 cases(56.5%) in not low risk one by Rochester criteria. A significant difference in the incidence of urinary tract infection, aseptic meningitis and no specific diagnosis was not found between both groups. Male to female ratio was 1.8 : 1. Sex ratio between both groups was not significantly different. Most febrile infant were noted in spring(35.1%) and the summer(36.7%). The peak incidence of aseptic meningitis was noted in May and June. The fever subsided mostly within 48~72 hours after administering antimicrobial agents(61.8~83.2%). A significant difference in duration of fever after administering antimicrobial agents was not found between both groups. Conclusion : A selected group of low risk infants 28~90 days of age with fever without source can be managed as outpatients provided that a thorough initial evaluation is performed, that parents can reliably monitor their infant closely at home and that careful follow up can be assured. Because bag collected specimens were more likely to yield indeterminate urine culture result, a suprapubic or catheter obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants 28~90 days of age. The further prospective study on evaluation and management of young febrile infant should be performed in our hospital.

• Journal of agricultural medicine and community health
• /
• v.45 no.4
• /
• pp.235-244
• /
• 2020

Objectives: Gyeongsangbuk-do has entered a super-aged society with 20.7% of the population aged 65 and older. As of April 30, 2020, the death rate of COVID-19(3.8 people) in Gyeongsangbuk-do is higher than the national mortality rate (2.3 people), and the fatality rate of COVID-19 by age accounts for more than half of the total of 58.6%, so it is time to propose to prevent infectious diseases in the event of additional infectious disease disasters COVID-19. Methods: We collected daily data on the number of confirmed cases and deaths due to COVID-19 from 19 February to 30 April 2020. The data collected was evaluated using the SPSS 21.0 statistical package. Results: As a result of comparing the incidence and death-related factors of confirmed patients in Gyeongsangbuk-do, there were significant differences in age group (p<0.001), underlying disease (p<0.001), and residence type (p<0.033). Conclusion: Factors affecting the mortality rate of confirmed patients in Gyeongsangbuk-do have been combined with individual level factors(age, gender, underlying disease), which means individual characteristics that have existed since before the disease, and regional level factors(Type of Residence), which are external factors that enable the use of medical resources. Therefore, each local government is required to establish preventive measures considering individual and regional level factors.

• Journal of Hospice and Palliative Care
• /
• v.4 no.2
• /
• pp.145-153
• /
• 2001

Purpose : This study was conducted to describe the attitude of hospital staff toward the hospice program. The purpose of this study was to promote the extension and organization of hospice activities to include hospital staff. Method : This is a descriptive study using a survey method. The subjects for this study were the nurses, physicians, technicians, and support staff at Wonju Christian Hospital. Using a stratified sampling method based on position of staff, the researchers recruited 430 staff members as the sample for this study. Data collection was done through a questionnaire developed by the researchers. The data were analyzed using descriptive statistics and content analysis. Findings : 1)Ninety seven percent (n=417) of the subjects understood the concept of hospice care, and 97.4% (n=419) answered that dying patients should be respected. When considering the hospice team, the subjects of this study indicated that the team should include family members (n=245), physicians (n=77), pastors (n=41), and nurses (n=34), in that order of priority. 2) When asked to indicate priorities for systematic operation of a hospice program, the subjects indicated that the highest priority was "setting up a team for hospice service(31.4%)", followed by "setting up a hospice ward(28.6%)". Sixty seven percent(n=289) recognized the importance of the hospice activities provided by the volunteers, and 85.3%(n=367) intended to use the hospice service of the hospital. The highest merit of hospital-based hospice program is 'acomplishment of mission'. 3) The average score on attitude toward death was 2.84(maximum=4), and the best needful service except hospitalization is 'constructing of support system'. Conclusion : Most of the staff at Wonju Christian Hospital perceive the necessity for systematic hospice activities, and that to achieve this goal, administrative and structural support at the hospital governance level is the first necessity. The results of this study could be useful for any hospital which is in the first stages of setting up and promoting a hospice program.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.5
• /
• pp.414-421
• /
• 2004

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.