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Management of an Intra-abdominal Fluid Collection after Gastric Cancer Surgery (위암 수술 후 발생한 복강 내 체액 저류의 치료)

  • Jeon, Young-Min;Ahn, Hye-Seong;Yoo, Moon-Won;Cho, Jae-Jin;Lee, Jeong-Min;Lee, Huk-Joon;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.256-261
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    • 2008
  • Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

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Vitamin D Deficiency and Related Factors in Patients at a Hospice (일개 호스피스 병동에서 비타민 D 결핍 현황 및 관련인자)

  • Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.27-33
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    • 2014
  • Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.

ICT Medical Service Provider's Knowledge and level of recognizing how to cope with fire fighting safety (ICT 의료시설 기반에서 종사자의 소방안전 지식과 대처방법 인식수준)

  • Kim, Ja-Sook;Kim, Ja-Ok;Ahn, Young-Joon
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.1
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    • pp.51-60
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    • 2014
  • In this study, ICT medical service provider's level of knowledge fire fighting safety and methods on coping with fires in the regions of Gwangju and Jeonam Province of Korea were investigated to determine the elements affecting such levels and provide basic information on the manuals for educating how to cope with the fire fighting safety in medical facilities. The data were analyzed using SPSS Win 14.0. The scores of level of knowledge fire fighting safety of ICT medical service provider's were 7.06(10 point scale), and the scores of level of recognizing how to cope with fire fighting safety were 6.61(11 point scale). level of recognizing how to cope with fire fighting safety were significantly different according to gender(t=4.12, p<.001), age(${\chi}^2$=17.24, p<.001), length of career(${\chi}^2$=22.76, p<.001), experience with fire fighting safety education(t=6.10, p<.001), level of subjective knowledge on fire fighting safety(${\chi}^2$=53.83, p<.001). In order to enhance the level of understanding of fire fighting safety and methods of coping by the ICT medical service providers it is found that: self-directed learning through avoiding the education just conveying knowledge by lecture tailored learning for individuals fire fighting education focused on experiencing actual work by developing various contents emphasizing cooperative learning deploying patients by classification systems using simulations and a study on the implementation of digital anti-fire monitoring system with multipoint communication protocol, a design and development of the smoke detection system using infra-red laser for fire detection in the wide space, video based fire detection algorithm using gaussian mixture mode developing an education manual for coping with fire fighting safety through multi learning approach at the medical facilities are required.

Locus of control of surgical-orthodontic patient (수술-교정 치료 환자의 통제 소재)

  • Lee, Shin-Jae;Ahn, Sug-Joon;Baek, Seung-Hak;Kim, Tae-Woo;Chang, Young-Il;Yang, Won-Sik;Suhr, Cheong-Hoon;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.32 no.4 s.93
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    • pp.235-240
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    • 2002
  • Surgical-orthodontic treatment is an increasingly more common dental procedure whose unique psycho-social or psychological feature has not been fairly quantified objectively. Since the treatment of a surgical-orthodontic (or orthodontic) patient is part science and part art, a subjective recognition of a patient about his or her own treatment may be more important than technical success during and after treatment. Therefore, the knowledge of the patient's underlying psychological status could be useful in the prediction of patient's response to surgical-orthodontic (or orthodontic) treatment. The purpose of this study was to investigate and evaluate the psychological difference between conventional orthodontic patient and surgical-orthodontic patient by using locus of control (LOC) examination. Locus of control scale has been proven to be extremely useful in the prediction of a variety of human behaviors. Two types of locus of control data (I-score, Internal locus of control score : I-score, External locus of control score) were obtained for 42 surgical-orthodontic patients and randomly selected 42 conventional orthodontic patients (as a control group) matched for age and gender. No statistically significant difference was observed in the scale of internal and external locus of control between the groups of surgical-orthodontic patients and conventional orthodontic patients. However, in the group of surgical-orthodontic patients, males showed lower E-score (external locus of control score, higher internal locus of control tendency) than females. The results of this study suggested that the psychological background of surgical-orthodontic patients, in contrast with that of cosmetic surgery patients, has a similar disposition with that of orthodontic patients.

Attempted Suicides in South Korea : A Multi-Center Analysis of Causes, Methods, and Psychiatric Diagnoses of Suicidal Attempters in 2013 (응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석)

  • Kim, Hyeyoung;Kim, Bora;Kang, Seung-Gul;Kim, Moon-Doo;Kim, Min-Hyuk;Kim, Soo In;Kim, Jae Min;Moon, Eunsoo;Ahn, Joon-Ho;Lee, Kyung-Uk;Lee, Sang-Hyuk;Lee, Seung Jae;Jeong, Seong Hoon;Chung, Young-Chul;Jung, Hee Yeon;Ju, Gawon;Cha, Boseok;Ha, Tae Hyon;Ahn, Yong-Min
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.187-194
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    • 2015
  • Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

Factors which Influence Customers' Intention to Switch from Call-Based Driver-for-hire Services to App-Based Driver-for-hire Services Based on Online to Offline (O2O) Business Model: Focusing on Kakao Driver service (콜 대리업체 서비스에서 O2O 방식이 적용된 대리운전 사업 모델로의 소비자 전환 의도에 관한 연구: 카카오 드라이버를 중심으로)

  • Kim, Daewon;Jeong, Hye Seung
    • The Journal of Society for e-Business Studies
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    • v.21 no.3
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    • pp.51-78
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    • 2016
  • Online-to-offline (O2O) commerce is the new trend that merges online commerce with traditional industries in various fields. The primary purpose of this paper is to find out which factors influence customers' intention to switch from call-based driver-for-hire services to O2O app-based services. This study used variables and factors based on Theory of Switching Intention, and Extended Unified Theory of Acceptance and Use of Technology in order to design research questions. We surveyed 500 users of call-based driver-for-hire services. According to the result of this study, dissatisfaction with the current call-based driver-for-hire services is estimated to be a significant factor that strengthens customers' intention to switch from the call-based driver-for-hire services to the app-based services. Loyalty to the previous call-based driver-for-hire services was not seen as a crucial motivator that causes customers to switch to the new O2O driver service. Switching cost also did not play a key role in explaining the relationship between dissatisfaction with the current call-based service and the intention to use the new app-based service. Performance expectancy, easiness in use, the level of user's knowledge or available assistance in relation to the use of app-based services, and expectancy for reasonable price was found to have meaningful impacts on customers' intention to switch from the call-based driver-for-hire services to the app-based services. Age, gender and user experience on the new service were found incapable of moderating the relationship between aforementioned factors which influence customers' choice of the app-based driver-for-hire service, and customers' intent to switch to the app-based service.

A Study on the Health Status of Dental Technicians by Todai Health Index(THI) (THI에 의한 일부 치과기공사의 건강상태에 관한 조사 연구)

  • Kwon, Soon-Suk;Moon, Hee-Jung;Shin, Myung-Suk;Kim, Yoon-Shin
    • Journal of dental hygiene science
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    • v.9 no.2
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    • pp.169-179
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    • 2009
  • This study aims to present a fundamental data base to figure out the mental and the physical conditions that the dental technicians are facing and ultimately to develop a health care program to deal with their health related problems. To this end, we took an analysis on the health status among the subjects of 895 dental technicians currently working at the dental lab around the nation from January 15 to March 31, 2009 by way or Todai Health Index(THI). Of the average scale point in accordance with 12 scale scores of the physical and the mental subjective symptom, the results revealed that the physical appeals (21.10) were higher than the mental appeals (18.49) and the multiple subjective symptom was marked as 38.44 followed by the mental irritability (25.92). In gender differences, the females proved to be higher than the males in both physical appeals and mental appeals while the physical appeals were dominant in both genders. The physical appeals were higher than the mental appeals with regard to the general characteristics. In the case or the group or age twenties as shown in the physical and mental average scale point, the other groups showed 21.55% of the physical appeals among the married whereas the mental appeals showed the highest point as 18.70 in the unmarried group. In job position, the other groups marked the highest, in working condition, below average group marked the highest, in frequency of break time, none group marked the highest. We drew a conclusion form this study that the dental technicians gained the higher points in the item or the multiple subjective symptom, the menial irritability, and the irregular life. More research on th is phenomena should be followed along with the development of various and practical health care programs to promote the health or dental technicians.

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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Association of Bone Mineral Density with the Metabolic Syndrome (건강검진 수진자들에서 골밀도와 대사증후군의 연관성)

  • Kang, Yeong-Han;Kam, Shin
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.259-266
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    • 2008
  • Objective : The purpose of this study was to examine the relationship between bone mineral density (BMD) and the metabolic syndrome. Method : We conducted a cross-sectional study of 1204 adults(males: 364 females: 840) in a general hospital health promotion center. They were grouped into the normal and lower BMD group according to bone loss(osteopenia, osteoporosis), as determined by duel energy X-ray absorptiometery(DEXA). We analyzed the association between BMD and metabolic syndrome by multiple logistic regression analysis. After adjustment for age, weight, alcohol intake, smoking, regular exercise, regular intake of meals, and menopausal status, odds ratios for the prevalence of the metabolic syndrome by gender were calculated for lower BMD. Results : After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with bone loss in men(p<0.001). If the odds ratio of normal group is 1.00, then that of the lower BMD group is 3.07(95% CI=1.83-5.16). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome was significantly decreased in High BMI, Low HDL in men and in High BMI in women(p<0.05). Conclusions : This study shows that BMD was associated with metabolic syndrome. Further studies needed to obtain evidence concerning the association between BMD and metabolic syndrome.

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The Study on the Perceptions of Radiological Technologist in Medical Imaging Equipment Used by the Oriental Doctor (한의사의 의료영상장비 사용에 대한 방사선사의 인식도)

  • Choi, Jae-Ho;Kang, Gi-Bong;Kim, Sang-Hyun;Kim, Tae-Hee;Kim, Gyoo-Hyung;Lee, Mi-Hwa;Ahn, Jung-Seong;Hong, Seong-Wan;Lee, Jae-Seok;Kwon, Ick-Su;Park, Jae-Yoon
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.109-120
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    • 2017
  • In order to examine how Radiological Technologists perceive the oriental doctor's use of Medical Imaging Equipment, surveys were conducted for the members of the Korean Radiological Technologists Association. The total number of respondents were 515 and 481, with 34 insincere responses removed caused of nonvalidated answer. The results of the analysis are as follows. Although there were no statistical significance in the difference in perception by location of residence, work place, and educational background, respondents with higher education showed a tendency to agree on the use of comprehensive medical imaging equipment, but tended to oppose the use of special medical imaging equipment. Differences in perception by gender showed a greater negative perception toward the oriental doctor's use of medical imaging equipment by women than men. In particular, women showed more negative tendency for oriental doctor's use of special medical imaging equipment such as MRI, CT, and ultrasound equipment compared to men, and this was statistically significant. The difference in perception by age showed that the oriental doctor's use of medical imaging equipment was negative in the 20~30s, neutral in the 40~50s, and positive in the 60s, which were statistically significant. The difference in perception by work experience showed that the longer the work experience was, the more positive it was toward oriental doctor's use of medical imaging equipment. Specifically, the most favorable tendency was found with work experience of more than 30 years, which was statistically significant. The results of this study revealed the Radiological Technologists' perceptions on the oriental doctor's use of Medical Imaging Equipment and this can contribute to the direction of public health promotion in the future.