• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.522-528
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• 1991

A successful repair of aortic dissection of descending thoracic aorta was performed in a 48 year old man. The patient was visited ER because of abruptly onset chest pain. On admission, Chest film showed mediastinal widening and undertaken chest CT, echocardiogram and angiogram There was evidence of dilation on descending aorta with internal separation of intimal calcification. Aneurysmal sac with dissection was noted from just below left subclavian artery to 2cm above of diaphragm. He underwent thoracotomy and the impending ruptured aneurysm of the aorta was replaced with a Woven Dacron graft[20Yo Albumin preclotted] using LA-femoral bypass. Postoperative course was uneventful.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• v.12 no.2
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• pp.119-131
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• 2008

The paper considers the computation method in the performance evaluation of cellular network in the phase-type distribution assumptions that the channel holding times induced from mobility are modeled by well-fitted distributions to reflect an actual situation. When ww consider a phase-type distribution model instead of exponential distribution, the complexity of the computation increase exponential even though the accuracy is improved. We consider an efficient numerical algorithm to compute the performance evaluations in cellular networks such as a handoff call dropping probability, new call blocking probability, and handoff arrival rate. Numerical experiment shows that numerical analysis results are well approximated to the results of simulation.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.367-373
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• 1987

Dissecting aneurysm has long been recognized as an ominous and highly lethal form of aortic disease. Aortic dissection are characterized by longitudinal separation of aortic media and extension proximally, distally or both from the site of intimal tear. DeBakey and associates defined three types based on where the process originates and how far extends. In type I, intimal tear is located in the ascending aorta and extend beyond the descending aorta. We experienced a case of dissecting aneurysm, Type I of DeBakey`s classification which dissection extend to the left iliac artery. The patient was 61 years old woman and suffered from excruciating pain on admission. Excision of aneurysm and ascending aorta reconstruction using to Dacron Vascular Prosthesis were performed under extracorporeal circulation. The post-operative course was uneventful and follow up is continued.

• The Journal of Pediatrics of Korean Medicine
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• v.24 no.1
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• pp.46-56
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• 2010

Objectives The purpose of this study is to report a Atopic dematitis patient treated by Horminis Placenta external wet therapy. Methods The patient was treated by acupuncture, herb medicine, especially Horminis Placenta external therapy. Kunz type, SCORAD index and Vas scale were used to measure the progression. Results and Conclusions We had evaluated the score during admission. SCORAD index include the extent, the intensity, pruritus, sleeping loss had increased from 52.88 score to 21.26 score. And the symptoms had improved with treatment.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.30 no.1
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• pp.33-40
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• 2007

A multi-server queueing system with finite buffer is considered. The input flow is the BMAP (Batch Markovian Arrival Process). The service time has the PH (Phase) type distribution. Customers from the BMAP enter the system according to the discipline of partial admission. Besides ordinary (positive) customers, the Markovian flow (MAP) of negative customers arrives to the system. A negative customer can delete an ordinary customer in service if the state of its PH-service process belongs to some given set. In opposite case the ordinary customer is considered to be protected of the effect of negative customers. The stationary distribution and the main performance measures of the considered queueing system are calculated.

• Journal of The Institute of Information and Telecommunication Facilities Engineering
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• v.9 no.1
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• pp.24-28
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• 2010

The Quality of Experience (QoE) of next Generation wired/wireless network services based upon IP networking is becoming a popular issue in recent years. The user experience of Internet services such as IPTV, online game, web surfing and etc, are becoming the most desirable factors to service providers to improve service performance and customer's satisfaction. However, collecting user experience from customers and obtaining the QoE parameters from the Quality of Service (QoS) parameters such as bandwidth, delay, jitter or admission control algorithm, are difficult subjects because of the various service types and user characteristics. In this paper, we propose a framework which contains service classification, QoE analysis and service enhancement steps for a suitable QoE measurement and management protocol. We define the user satisfaction indicators of the Internet services, classify the categories of each type of services, and analyse the Key Performance Indicator (KPI) in each type of services to perform the QoS parameters and improving the service qualities.

• Journal of Trauma and Injury
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• v.18 no.1
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• pp.47-52
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• 2005

Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.103-107
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• 2010

Background: The aim of the present study was to evaluate whether findings on initial chest computed tomography (CT) of influenza pneumonia can help predict clinical outcome. Methods: We reviewed all adult patients admitted to the Emergency Department (ED) with a confirmed diagnosis of novel influenza A H1N1 virus (2009 H1N1) pneumonia, who underwent chest CT upon admission between Aug 26, 2009 and Jan 31, 2010. Radiologic findings were characterized by type and pattern of opacities and zonal distribution. Clinical outcome measures were intensive care unit (ICU) admission, mechanical ventilation, and inhospital death. Results: Of 59 patients diagnosed with 2009 H1N1 pneumonia, 41 (69.5%) underwent chest CT on admission into ED. Nine (22%) of these patients developed adverse clinical outcomes requiring the following treatments: 9 (22.0%) ICU admissions, 5 (12.2%) mechanical ventilation, and 3 (7.3%) inhospital deaths. Counting the number of patients with more than 4 involved lobes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of adverse clinical outcome were 67%, 84%, 55% and 80%, respectively. Conclusion: Extensive involvement of both lungs (over 4 lobes) is related to ICU admission, mechanical ventilation, and inhospital death. Initial chest CT may help predict an adverse clinical outcome of patients with 2009 H1N1 influenza pneumonia.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.183-189
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• 1977

There has been an alarming rise in the incidence of carcinoma of the lung in the world. The increase of the disease has been greater in men than in women, but even in women the rate has doubled in the last 20 years. During the 20 year period 1957 through 1976, 33 women with proven primary carcinoma of the lung were treated at Department of Thoracic Surgery, Seoul National University Hospital. During the period of survey, 170 consecutive cases of primary bronchogenic carcinoma were encountered in men, a male to female ratio of 5.2: 1. Ages of patients with bronchogenic carcinoma in women ranged from twenty-seven to sixty-eight years and most of them were over 40 years of age. The duration between the onset of symptoms and admission was about 9 months and the most common complaints were cough [66.6%], chest pain [60.6%], hemoptysis [48.4%] and dyspnea [45.4%]. Bronchogenic carcinoma developed most frequently in the upper lobes, and twelve [36.3%] of cases were squamous cell type, nine [27.2%] were anaplastic cell type, six [18.2%] were adenocarcinoma, one was alveolar cell type and five were unclassified type, in contrast to the usual predominence of adenocarcinoma among women in other reports. One half of the patients were inoperable and resection was feasible in only 24.2 per cent of the patients. There was no operative mortality but one case had bronchopleural fistula after pneumonectomy. Most patients with bronchogenic carcinoma in women were from large cities. Cigarette smoking appeared to be related to the occurrence of the squamous cell and anaplastic cell carcinoma because all heavy smokers had squamous cell or anaplastic cell carcinoma.