• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1115-1118
• /
• 2016

Background: There is controversy about ablation efficacy of low or high doses of radioiodine-131 (RAI) in patients with differentiated thyroid cancers (DTC). The purpose of this prospective study was to determine efficacy of 30 mCi and 100 mCi of RAI to achieve successful ablation in patients with low to intermediate risk DTC. Materials and Methods: This prospective cross sectional study was conducted from April 2013 to November 2015. Inclusion criteria were patients of either gender, 18 years or older, having low to intermediate risk papillary and follicular thyroid cancers with T1-3, N0/N1/Nx but no evidence of distant metastasis. Thirty-nine patients were administered 30 mCi of RAI while 61 patients were given 100 mCi. Informed consent was acquired from all patients and counseling was done by nuclear physicians regarding benefits and possible side effects of RAI. After an average of 6 months (range 6-16 months; 2-3 weeks after thyroxin withdrawal), these patients were followed up for stimulated TSH, thyroglobulin (sTg) and thyroglobulin antibodies, ultrasound neck (U/S) and a diagnostic whole body iodine scan (WBIS) for ablation outcome. Successful ablation was concluded with stimulated Tg< 2ng/ml with negative antibodies, negative U/S and a negative diagnostic WBIS (triple negative criteria). ROC curve analysis was used to find diagnostic strength of baseline sTg to predict successful ablation. Results: Successful ablation based upon triple negative criteria was 56% in the low dose and 57% in the high dose group (non-significant difference). Based on a single criterion (follow-up sTg<2 ng/ml), values were 82% and 77% (again non-significant). The ROC curve revealed that a baseline sTg level ${\leq}7.4ng/ml$ had the highest diagnostic strength to predict successful ablation in all patients. Conclusions: We conclude that 30 mCi of RAI has similar ablation success to 100 mCi dose in patients with low to intermediate risk DTC. A baseline $sTg{\leq}7.4ng/ml$ is a strong predictor of successful ablation in all patients. Low dose RAI is safer, more cost effective and more convenient for patients and healthcare providers.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.4 no.1
• /
• pp.66-80
• /
• 1998

With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.12
• /
• pp.333-339
• /
• 2019

Our country has become an aging society with unparalleled speed, compared to other advanced countries. Many of the elderly are physically, economically, and psychologically dependent; this dependence is a factor that increases the cost burden not only on the children and relatives of the elderly, but also at the social level. Under the prevailing environment of the family-oriented informal support system, the burden of support for elderly parents who rely on limited resources is highly likely to lead to abuse. Until now, dealing with the abuse of senior citizens has been mostly a one-off approach through media rather than academics. Therefore, this study attempts to take an objective approach to the elder abuse problem (which has so far been dealt with in the media as a form of domestic violence) in order to grasp the specificity and factors of elder abuse and to present the Korean situation with regard to elder abuse. In addition, this study seeks to find ways to prevent elder abuse in formal and informal ways.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.12
• /
• pp.384-389
• /
• 2017

This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

• Journal of Software Engineering Society
• /
• v.29 no.2
• /
• pp.7-12
• /
• 2020

A project to establish an information system with a project cost of more than 500 million won at a local public firm is subject to the Information System Audit (hereinafter referred to as IS Audit), and the IS Auditor shall conduct audit according to the audit criteria. Recently, as blockchain technology has been applied to various fields such as manufacturing, healthcare, distribution, and public sectors beyond the financial industry, the development of systems that apply blockchain technology is increasing. The use of Hyperledger Fabric, a private blockchain, is on the rise to utilize blockchain technology in public firms and private firms. However, the newly emerging blockchain-based system is not sufficient to carry out auditing with existing audit check items, so it has no choice but to make and use audit items individually. Therefore, a need for verified audit items for systems that base on blockchain technology has emerged. In this study, we customized the Delphi process to derive audit items suitable for the system development project using the blockchain technology, and verified the completeness and accuracy of the audit items derived through a survey by the IS Auditor. This research will be of direct help to the IS Auditor, and it is expected that operators and organizers who provide services through the blockchain-based system will also contribute to improving the quality of the system.

• Quality Improvement in Health Care
• /
• v.9 no.2
• /
• pp.116-133
• /
• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Korean Society of Environmental Engineers
• /
• v.35 no.2
• /
• pp.131-136
• /
• 2013

The aim of this study was to investigate the removal of fluoride using thermally treated pyrophyllite as adsorbent. Sorption experiments were conducted under batch conditions to examine the effects of adsorbent dose, reaction time, initial fluoride concentration and solution pH on fluoride removal. In the experiments, the pyrophyllite thermally treated at different temperatures [untreated (P-U), $400^{\circ}C$ (P-400), $600^{\circ}C$ (P-600)] were used. Results showed that the adsorption capacity was in the order of P-400 > P-U > P-600. The XRD analysis indicated that both P-U and P-400 were composed of quartz, dickite and pyrophyllite while P-600 was quartz. The BET analysis showed that the specific surface area was in the order of P-600 > P-400 > P-U. Kinetic data showed that fluoride sorption to P-400 arrived at equilibrium around 24 h. Equilibrium test demonstrated that the maximum sorption capacity of P-400 was 0.957 mg/g. In addition, fluoride removal by P-400 was not sensitive to solution pH between 4 and 10. However, fluoride removal decreased considerably at highly acidic (pH < 4) and alkaline (pH > 10) conditions. This study demonstrates that pyrophyllite could be used as a low-cost adsorbent for fluoride removal from aqueous solution.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.6
• /
• pp.4031-4039
• /
• 2015

The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.7
• /
• pp.2549-2558
• /
• 2010

A Remote Vital Sign Monitor is an in-home healthcare system designed to wirelessly monitor core-body temperature. The Remote Vital Sign Monitor provides accuracy and features which are comparable to hospital equipment while minimizing cost with ease-of-use. It has two parts, a bandage and a monitor. The bandage and the monitor both use the Chipcon2430(CC2430) which contains an integrated 2.4GHz Direct Sequence Spread Spectrum radio. The CC2430 allows Remote Vital Sign Monitor to operate at over a 100-foot indoor radius. A simple user interface allows the user to set an upper temperature and a lower temperature that is monitored with respect to the core-body temperature. If the core-body temperature exceeds the one of two defined temperatures, the alarm will sound. The alarm is powered by a low-voltage audio amplifier circuit which is connected to a speaker. In order to accurately calculate the core-body temperature, the Remote Vital Sign Monitor must utilize an accurate temperature sensing device. The thermistor selected from GE Sensing satisfies the need for a sensitive and accurate temperature reading. The LCD monitor has a screen size that measures 64.5mm long by 16.4mm wide and also contains back light, and this should allow the user to clearly view the monitor from at least 3 feet away in both light and dark situations.

• Journal of KIISE:Computing Practices and Letters
• /
• v.15 no.4
• /
• pp.244-254
• /
• 2009

This paper describes a remote system to monitor the circadian behavioral patterns of elders who live alone. The proposed system was designed and implemented to provide more conveniently and reliably the required functionalities of a remote monitoring system for elders based on the development of first phase prototype[2]. The developed system is composed of an in-house sensing system and a server system. The in-house sensing system is a set of wireless sensor nodes which have pyroelectric infrared (PIR) sensor to detect a motion of elder. Each sensing node sends its detection signal to a home gateway via wireless link. The home gateway stores the received signals into a remote database. The server system is composed of a database server and a web server, which provides web-based monitoring system to caregivers (friends, family and social workers) for more cost effective intelligent care service. The improved second phase system can provide 'automatic diagnosis', 'going out detection', and enhanced user interface functionalities. We have evaluated the first and second phase monitoring systems from real field experiments of 3/4 months continuous operation with installation of 9/15 elders' houses, respectively. The experimental results show the promising possibilities to estimate the behavioral patterns and the current status of elder even though the simplicity of sensing capability.