• Korean Institute of Interior Design Journal
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• v.19 no.2
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• pp.216-224
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• 2010

This study aims to examine a special type of hospital known as Western Oriental medicine treatment designed to provide the best treatment by combining the advantages of Western and Oriental medicine, The actual conditions of the organizations and operations of O.P.D and how the cooperative treatment between Western and Oriental medicine is conducted at general hospitals that operate the cooperative treatment by applying a drawing analysis and an area analysis, and provide materials that help design hospitals that offers the cooperative treatment based on the information. According to the results of this study, the forms of the cooperative treatment between Western and Oriental medicine included several methods; to operate the cooperative center separately between an Oriental hospital and a general hospital, to operate the cooperative hospital, using several floors for an Oriental hospital inside a general hospital, and to operate the cooperative center in specialized centers inside a general hospital and the type of cluster that offers the cooperative treatment in specialized centers is known as the best appropriate treatment.

• Journal of Nutrition and Health
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• v.28 no.7
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• pp.675-687
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• 1995

The purpose of this study were to analyze work patterns of clinical dietitians by time study, to investigate labor time used in each clinical dietetic activity, and to develop standardized indices of clinical dietetic staffing needs. Two general hospitals(A & B) in Seoul were selected for study. The results of this study can be summarized as follows. 1) For the A hospital, the percentage of clinical dietetic activities such as attending meeting, professional research, foodservicemanagement, clerical activity for the foodservice, administrative activity and delay were 17.5%, 1.3%, 14.5%, 23.4%, 21.3%, 4.6%, and 17.3% respectively, while 22.4% 3.5%, 23.7%, 10.9%, 15.8%, 4.2%, and 19.5% respectively for the B hospital. 2) For the A hospital, the percentage of direct patient care like outpatient nutrition education, group nutrition education, and patient meal planning were 69.5%, 10.5%, 7.6%, and 12.4% respectively while 78.9%, 7.3%, 8.9%, and 5.1% respectively for the B hospital. 3) Time spent for performing direct patient care such as basic care, intermediate care, and indepth care per patient were 28.0min, 73.1min, and 53.0 min respectively for the A hospital, while 45.3 min, 76.2 min, and 52.6 min respectively for the B hospital. 4) Full time clinical dietitian staffing needs were calculated for the three parts ; basic care, intermediate care, and in-depth care. For A hspital, the appropriate numbers of full time clinical dietitian were 3.5 persons in basic care, 3.6 persons in intermediate care, and 1.3 persons in in-depth care, while 6.1 persons, 6.3 persons, 3.2 persons respectively for B hospital.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.3
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• pp.206-210
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• 2010

Bisphosphonates are widely used to treat osteoporosis, hypercalcemia of malignant tumor. Despite their clinical benefit, bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a newly documented complication to patients receiving these drugs and first recognized by Marx in 2003. Thus, consideration of prevention and needs regarding unequivocal treatment regimen have emerged. Recently, several authors emphasized reports on appropriate clinical availability of surgical approach. It serves to concern about guideline for surgical and conservative treatment modalities. So, it is the purpose of this paper to review the current literatures about treatment regimens of BRONJ.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.457-462
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• 2009

While receiving appropriate treatment, patients with tuberculosis occasionally have unusual, paradoxical reactions, with transient worsening of lesions or the development of new lesions. This report is a case of tuberculosis brain abscess and tuberculosis peritonitis with intra-abdominal abscess that developed during appropriate anti-tuberculosis chemotherapy. A 45-year-old male patient had been diagnosed as with all-drug susceptible pulmonary tuberculosis with pleurisy. Subsequently, the patient underwent standard treatment with anti-tuberculosis therapy; the pulmonary lesions improved. Three months after initial treatment, the patient developed brain abscesses and peritonitis. With the addition of corticosteroid treatment, the patient's neurologic symptoms were relieved. Exploratory laparotomy with surgical drainage was performed and a diagnosis of tuberculosis peritonitis was confirmed on biopsy. Anti-tuberculosis therapy was continued for 19 months, the patient improved eventually without further complications, although the therapeutic regimen had not been altered. In this case, the paradoxical response to treatment may have been involved in the pathogenesis of disease.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.20-24
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• 2020

BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.12-24
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• 2022

Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• Archives of Reconstructive Microsurgery
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• v.20 no.2
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• pp.116-120
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• 2011

Myositis ossificans is a solitary benign ossifying lesion in the soft tissue. Occurring predominantly in muscles, a similar lesion may occasionally be found in subcutaneous tissues, tendons, fascia and periosteum. It is often misdiagnosed as an extraskeletal osteosarcoma because of its rapid growth. Therefore, it is sometimes called pseudomalignant myositis ossificans. Myositis ossificans rarely occurs in the distal portion of the finger. We present a case of myositis ossificans of finger and review the the clinical, radiographical, and histological presentation, as well as the appropriate therapeutic management.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.135-149
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• 2010

The objective of this study is to investigate the influence of role conflict, childcare stress, and stress coping type on organizational commitment among female workers at hospital settings, and thus, to suggest implications for improving their productivity and quality of working life. Data were collected from 195 female employees working at a general hospital in Busan Metropolitan Area by using structured self-administered questionnaire. Among study variables, role conflict(-) and direct-positive stress coping type(+) had statistically significant effect on organizational commitment. This study results imply that role conflict, and stress coping type are crucial for managing desirable job attitude of female employees. Therefore, education and training, and consultation programme for diminishing role conflict and adopting appropriate stress coping type should be developed and utilized.