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Rehospitalization Rate and Medical Cost of Infants in the First Year after Discharge from Neonatal Intensive Care Units (신생아중환자실 입원자의 퇴원 후 재입원의 빈도와 의료비용)

  • Bae, Chong-Woo;Shim, Kye-Shik;Hahn, Won-Ho;Kim, Ki-Soo;Kim, Beyong-Il;Shin, Son-Moon;Lee, Sang-Lak;Lim, Baek-Keun;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.13-20
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    • 2010
  • Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

A Pilot Study in Cognition and Attitude of Nursing Students on Oriental Nursing (한방간호에 대한 간호학생들의 인식 및 태도에 대한 예비연구)

  • Han, Sang-Sook;Kim, Won-Ock;Hyun, Kyung-Sun;Won, Jeong-Sook;Choi, Kyung-Ock;Chang, Kyung-Hwa;Lee, Mi-Aie;Kim, Sook-Young;Jeon, Eun-Young;Kim, Jeong-Sook;Lee, Eun-Sook;Bae, Yeong-Suk
    • Journal of East-West Nursing Research
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    • v.8 no.1
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    • pp.81-88
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    • 2003
  • This research has been conducted to examine the cognition and attitude of nursing students on Oriental Nursing, the subject of this research being 789 nursing students from 9 different universities who took the Oriental Nursing class. A questionnaire, the construct validity and reliability of which have been verified through enquiries into records and references as well as preliminary researches, was used as a research tool. The questionnaire, a set of 86 questions, was developed by the researchers of this study, and the reliability of the questionnaire is Cronbach's=.85. The collected data have been analysed using SPSS windows programme 11.0 for t-test and ANOVA, and the results are as follows: 1. There was a significant difference in cognition and attitude points according to the academic year (F=14.15, p=.000). After the post-hoc test, it was revealed that the points of the students in their 4th year were significantly higher than the points of the students in their 2nd or 3rd year. 2. There was a significant difference in cognition and attitude points according to the credits the students have taken (F=28.66, p=.000). After the post-hoc test, it was revealed that the points of the students who have taken from $3{\sim}5$ to $6{\sim}8$ credits were significantly higher than the points of those who have taken from 1 to 2 credits. 3. There was a significant difference in cognition and attitude points according to the period of time the students have experienced Oriental Nursing (F=32.06, p=.000). After the post-hoc test, it was revealed that the points of the students who have practised Oriental Nursing from 1 to 2 weeks were significantly higher than the points of those who have not practised it at all. 4. There was no significant difference in cognition and attitude points according to the treatment or hospitalisation of the students themselves or their family members. 5. The cognition and attitude points of the students who are deeply interested in Oriental Nursing were significantly higher than the points of those who are not (t=8.83, p=.000). 6. The cognition and attitude points of the students who have higher expectations for the development of Oriental Nursing were significantly higher than the points of those who have not(t=5.90, p=.000). 7. The cognition and attitude points of the students who believe that the Oriental Nursing will contribute to the expansion of the roles of nurses were significantly higher than the points of those who do not (t=6.60, p=.000). 8. The cognition and attitude points of the students who expect that the Oriental Nursing will be effective in prevention of chronic diseases were significantly higher than the points of those who do not (t=5.80, p=.000). According to the results above, it was confirmed that proper education on Oriental Nursing can have affirmative effects on the cognition and attitude of the nursing students towards Oriental Nursing.

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Clinical review of Epstein-Barr virus viremia in Korean children by using real-time PCR (한국인 소아에서 실시간 중합효소연쇄반응으로 검출된 Epstein-Barr virus 바이러스혈증의 임상적 고찰)

  • Ko, Il Yong;Suh, Jin Suk;Kim, Hwang Min;Sohn, Joon Hyung;Yeh, Byung-Il;Lee, Taek Jin;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.171-178
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    • 2007
  • Purpose : We investigated clinical characteristics of real-time PCR proven EBV viremia patients who were not serologically diagnosed but clinically suspected, and compared it to serologically proven EBV infected patients. Methods : The study population consisted of 45 patients, who were suspected acute EBV infection at Wonju Christian Hospital Department of Pediatrics, Yonsei University Wonju College of Medicine from Jan. 2004 to Dec. 2006. real-time PCR of cell free serum was performed to prove EBV viremia. Then we chose $102.5copies/{\mu}g$ DNA as a suitable cutoff level for EBV associated diseases. Results : There are 4 patients diagnosed as EBV infection by serologically and 15 patients diagnosed as EBV viremia by real-time PCR quantitative measurement. The most common presenting symptoms and signs of EBV viremia was fever in 11 cases (73%). Atypical lymphocytosis was found in 4 cases (27%). Increased AST, ALT levels were observed in 13 cases (87%), 12 cases (80%), respectively. We could diagnose 5 cases of EBV viremia younger than one year of age. They revealed clinical symptoms which could be found in EBV infection. The serologically diagnosed patients had hepatomegaly and splenomegaly in 3 cases (75%). All serologically confirmed patients have leukocytosis above $20,000/mm^3$, among them 2 cases (50%) had higher percentage (>15%) of atypical lymphocytes. The AST/ALT level above 50 IU/L were demonstrated in all cases. Conclusion : Serologically unproven real-time PCR EBV viremia patients revealed similar clinical findings with that of serologically proven EBV infected patients. So, it is meaningful to perform EBV real-time PCR for the diagnosis of EBV infection especially for the cases younger than 1 year of age.

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The Effect of Low-Intensity Pulsed Ultrasound on Fracture Healing in the Rabbit Model (토끼모델에서 저강도 맥동초음파가 골절치유에 미치는 영향)

  • Kim, Jong-Man;Yi, Chung-Hwi;Cho, Sang-Hyun;Park, Jung-Mi;Kwon, Hyuk-Cheol;Hwang, Tae-Sun
    • Physical Therapy Korea
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    • v.9 no.1
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    • pp.81-96
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    • 2002
  • The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 $mW/cm^2$ and 500 $mW/cm^2$) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 $mW/cm^2$ than the group with 500 $mW/cm^2$ (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 $mW/cm^2$ ultrasound intensity than those treated with 500 $mW/cm^2$ intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 $mW/cm^2$ to 500 $mW/cm^2$ is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.

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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.

FIRST Survey: Fentanyl-TTS is Rational Solution to Treat Cancer Pain and Pain Assessment as a $5^{th}$ Vital Sign in Korean Cancer Patients (암성통증: 제5의 활력징후인 통증의 강도 측정 및 펜타닐 패취(듀로제식$^{(R)}$)의 통증 조절 효과)

  • Choi, Youn-Seon;Lee, June-Young;Lim, Yeun-Keun;Kim, Chul-Soo;Song, Hong-Suk;Kim, Sam-Yong;Kim, Su-Hyun;Kim, Jun-Suk
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.238-247
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    • 2004
  • Purpose: Pain management is often needlessly suboptimal. Health care professionals are seldom trained in pain management, may not realize the importance of pain management or recognize that a patient is in pain, and may fear prescribing opioid medications. Noting that one of the problems related to health care professionals is poor assessment of pain, we studied a trend of pain severity and satisfaction with pain controls after using TTS-fentanyl in order to determine whether a regular pain assessment was effective for controlling cancer pain. Methods: We assessed the pain as a $5^{th}$ vital sign after using TTS-fentanyl in 471 hospitalized cancer patients during 4 days. The data were collected from September, 2003 to December, 2003. Pain severity was assessed by using a numeric pain intensity scale($0{\sim}10$) by ongoing pain assessment. Results: Pain assessment as a $5^{th}$ vital sign had led to reduce patient's pain scores. High degrees of satisfaction scores in both patients and doctors with TTS-fentanyl were observed. They were also negatively correlated with the pain severity. Conclusion: Regular pain assessment was effective in the management of cancer pain.

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The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$) (국내 호스피스 논문 분석($1991{\sim}2004$))

  • Kim, Sang-Hee;Choi, Sung-Eun;Kang, Sung-Nyun;Park, Jung-Suk;Sohn, Sue-Kyung;Kang, Eun-Sil;Lee, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.145-153
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    • 2007
  • Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

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The Physiological Effects of Controlled Respiration on the Electroencephalogram (호흡유도(呼吸誘導)에 따른 전두부(前頭部) 뇌파(腦波)에 관한 연구(硏究))

  • Kim, Hye-Kyung;Shin, Sang-Hoon;Nam, Tong-Hyun;Park, Yong-Jae;Hong, In-Ki;Lee, Dong-Hoon;Lee, Sang-Chul;Park, Young-Bae
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.10 no.1
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    • pp.109-140
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    • 2006
  • Background: In practicing qigong, People must achieve three Points : adjust their Posture, control their breathing and have a peace of mind. That is, Cho-Sin [調身] , Cho-Sik [調息] , Cho-Sim [調心] . Slow respiration is the important pattern of respiration to improve the human health. However, unsuitable breathing training have been occurred to mental disorder such as insomnia, anorexia etc. So, we think that the breathing training to consider the individual variations are desired. Objectives: We performed this study to examine the physiological effects of controlled respiration on the normal range of frequency domain electroencephalogram(EEC) in healthy subjects Also, to study examine individual variations according to the physiological effects between controlled respiration and Han-Yeol [寒熱] , respiration period, gender and age-related groups on the EEC in healthy subjects. Methods: When the subjects controlled the time of breathing (inspiration and expiration time) consciously, compared with natural respiration, and that their physiological phenomena are measured by EEC. In this research we used breathing time as in a qigong training (The Six-Word Excise) and observed physiological phenomena of the controlled natural respiration period with the ratio of seven to three(longer inspiration) and three to seven(longer expiration) . We determined, heat-cold score by Han-Yeol [寒熱] questionnaire, average of natural respiration period, according to decade, EEC of 140 healthy subjects (14 to 68 years old; 38 males, 102 females) by means of alpha, beta spectral relative power. Results: 1) In Controlled respiration compared with the natural respiration, ${\alpha}\;I\;(Fp2)\;and\;{\beta}$ I (Fpl, Fp2, F3, F4) decreased on the EEC. 2) In controlled respiration compared with the natural respiration, ${\beta}$ I (Fpl, Fp2, F3, F4) increased with cold group, ${\alpha}/{\beta}$(F3) decreased with heat group, ${\alpha}$ I (Fp2)increased with cold group in longer inspiration. But by means of compound effects, ${\alpha}$ II(F3) increased with cold group in longer inspiration, the other side ${\alpha}$ I (F3) decreased with heat group in controlled respiration on the EEC. 3) In controlled respiration compared with the natural respiration, ${\alpha}$ I (Fp2) decreased with decreased-respiratory-rate(D.R.R.) group, ${\beta}$ I (Fpl, Fp2, F3, F4) increased with D.R.R. and D.R.R. groups, ${\alpha}/{\beta}$(F3) decreased with D.R.R. group. But by means of compound effects, in controlled respiration compared with the natural respiration, ${\alpha}/{\beta}$(F3) decreased with D.R.R. group on the EEG. 4) In controlled respiration compared with the natural respiration, ${\beta}$ I (Fpl, F3, F4) increased with female cup, ${\beta}$ I (Fp2) increased with male and female groups, ${\alpha}/{\beta}$(F3) decreased with male group. But by means of compound effects, in controlled respiration compared with the natural respiration, ${\alpha}$ I (Fp2) increased with female group on the EEC. 5) Compared with the natural respiration, in longer expiration ${\alpha}$ I (Fp2) increased in their forties group, in longer inspiration ${\alpha}$ I (Fp2) increased in their fifties group. But by means of compound effects, in controlled respiration compared with the natural respiration, ${\beta}$ I (Fpl) decreased in teens group on the EEG.

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Comparison of Radiation Dose in the Measurement of MDCT Radiation Dose according to Correction of Temperatures and Pressure, and Calibration of Ionization Chamber (MDCT 선량측정에서 온도와 압력에 따른 보정과 Ionization Chamber의 Calibration 전후 선량의 비교평가)

  • Lee, Chang-Lae;Kim, Hee-Joung;Jeon, Seong-Su;Cho, Hyo-Min;Nam, So-Ra;Jung, Ji-Young;Lee, Young-Jin;Lee, Seung-Jae;Dong, Kyung-Rae
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.49-55
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    • 2008
  • This study aims to conduct the comparative analysis of the radiation dose according to before and after the calibration of the ionization chamber used for measuring radiation dose in the MDCT, as well as of $CTDI_w$ according to temperature and pressure correction factors in the CT room. A comparative analysis was conducted based on the measured MDCT (GE light speed plus 4 slice, USA) data using head and body CT dosimetric phantom, and Model 2026C electrometer (RADICAL 2026C, USA) calibrated on March 21, 2007. As a result, the $CTDI_w$ value which reflected calibration factors, as well as correction factors of temperature and pressure, was found to be the range of $0.479{\sim}3.162mGy$ in effective radiation dose than the uncorrected values. Also, under the routine abdomen routine CT image acquisition conditions used in reference hospitals, patient effective dose was measured to indicate the difference of the maximum of 0.7 mSv between before and after the application of such factors. These results imply that the calibration of the ion chamber, and the correction of temperature and pressure of the CT room are crucial in measuring and calculating patient effective dose. Thus, to measure patient radiation dose accurately, the detailed information should be made available regarding not only the temperature and pressure of the CT room, but also the humidity and recombination factor, characteristics of X-ray beam quality, exposure conditions, scan region, and so forth.

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CONDITIONS FOR CONGER EEL AND HAGFISH SKIN GLUE PROCESSING AND THE QUALITY OF PRODUCT (붕장어피 및 먹장어피를 이용한 피교의 가공조건에 제품의 성상)

  • LEE Eung-Ho;KIM Se-Kwon;CHO Duck-Jae;KIM Jin-Dong;no Sudibjo;KIM Soo-Hyun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.11 no.4
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    • pp.189-195
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    • 1978
  • Using the skins of conger eel, Astroconger myriaster, and hagfish, Eptatretus burzeri, from fillet manufactory, the optimum conditions of skin glue processing were investigated and physical ana chemical properties of the product were also determined. The yields of conger eel and hagfish skin to the total body weight were $10.6\%$ and $11.4\%$, respectively. The optimum processing conditions for conger eel skin glue were the extraction of skins which were previously tinted with $0.3\%$ calcium hydroxide solution for one hour, in water at pH 5.5 and $60^{\circ}C$ for four hours. The additional water was six times sample weight. In case of the hagfish skin glue, the liming time with $0.3\%$ calcium hydroxide solution was suitable for three hours, and the skins were extracted with water as much as nine times sample weight at pH 5.0 and $60^{\circ}C$ for three hours. The contents of crude protein of conger eel and hagfish skin glue were $91.5\%$ and $90.2\%$, respectively. The content of crude lipid was slightly higher than that of chemical grade gelatin. Relative viscosity, melting point, gelation temperature and jelly strength of conger eel skin glue were 13.6, $15.2^{\circ}C$, $6.2^{\circ}C$ and 13.0g respectively and those of hagfish skin glue were 12.9, $14.8^{\circ}C$, $4.3^{\circ}C$ and 23.3g respectively. The turbidity of conger eel skin glue and hagfish skin glue were slightly superior to those of dry glue.

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