• Journal of Gastric Cancer
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• 제17권3호
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• pp.246-254
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• 2017

Purpose: The significance of hospital volume remains inconsistent and controversial. In particular, few studies have examined whether hospital volume is associated with the outcome of gastrectomy for gastric cancer in East Asia. This study examined the effect of hospital volume on the short-term surgical and long-term oncological outcomes of patients undergoing curative gastrectomy for gastric cancer. Materials and Methods: Between 2009 and 2011, 1,561 patients underwent curative gastrectomy for gastric cancer at Seoul St. Mary's Hospital (n=1,322) and Bucheon St. Mary's Hospital (n=239). We defined Seoul St. Mary's Hospital as a high-volume center and Bucheon St. Mary's Hospital as a low-volume center. Results: The extent of resection, rate of combined resection, tumor stage, operating time, and hospital stay did not differ significantly between the 2 hospitals. In addition, the hospital volume was not significantly associated with the 30-day morbidity and mortality. When the overall and disease-free survival rates of the patients were stratified according to stage, hospital volume was not significantly associated with prognosis at any stage. Conclusions: Hospital volume might not be a decisive factor with respect to the surgical and oncological outcomes of patients if well-trained surgeons perform gastrectomy for gastric cancer.

• Clinical Endoscopy
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• 제56권1호
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• pp.65-74
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• 2023

Background/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for end stage liver disease sodium [MELD-Na] >18 and Child-Turcotte-Pugh [CTP] C with GV) are scarce. Thus, we performed a retrospective comparison of endoscopic glue injection with EUS-guided therapy in cirrhotic patients with large GV. Methods: A retrospective study was performed in the tertiary hospitals of India. A total of 80 patients were recruited. The inclusion criteria were gastroesophageal varices type 2, isolated gastric varices type 1, bleeding within 6 weeks, size of GV >10 mm, and a MELD-Na >18. Treatment outcomes and complications of endoscopic glue injection and EUS-guided GV therapy were compared. Results: In this study, the patients' age, sex, liver disease severity (CTP, MELD-Na) and clinical parameters were comparable. The median number of procedures, injected glue volume, complications, and GV obturation were better in the EUS group, respectively. On subgroup analysis of the EUS method (e.g., direct gastric fundus vs. paragastric collateral [PGC] coil placement), PGC coil placement showed decreased coil requirement, less injected glue volume, decreased luminal coil extrusion, and increased successful GV obturation. Conclusions: EUS-guided treatment is more efficient and safer, and requires a smaller number of treatment sessions, as compared to endoscopic treatment in severe liver disease patients with large GV. Furthermore, PGC coil placement increases the complete obliteration of GV.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.423-426
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• 2023

Backgrounds/Aims: Patients who undergo pancreatic surgery with venous resection have high rates of morbidity/mortality. Also, they are high-risk for postoperative venous thromboembolism. Whether this group should be routinely anticoagulated is unknown. This study aimed to establish current anticoagulation practices. Methods: A survey (https://form.jotform.com/220242489107048) was sent out to pancreatic surgeons. Questions covered center volume, venous resection/reconstruction techniques and anticoagulation policies. Results: Sixty-five centers from 17 countries responded. Following a "side-bite" venous resection with a patch repair, 40% used an autologous vein patch, 27% used peritoneum, and 27% used a bovine patch. After formally resecting a segment of vein, 17% of centers used an interposition graft (IG). Left renal vein (41%) and polytetrafluoroethylene (73%) grafts were the most commonly used autologous and prosthetic IGs, respectively. Following a prosthetic IG, an autologous IG, and a "side-bite" resection, 59%, 28%, and 19% of centers provided therapeutic anticoagulation, respectively (66% used low molecular-weight heparin). The duration of therapy provided varied from inpatient stay only (14%) to six months (32%). Conclusions: Our global survey indicates that anticoagulation practices are highly variable. Centers do not agree on when to anticoagulate, how to anticoagulate, or the duration of therapy. A robust trial is required to provide clarity.

• 한국의료질향상학회지
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• 제24권2호
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• pp.62-75
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• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• 가정간호학회지
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• 제23권2호
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• pp.121-128
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• 2016

Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.

• 한국간호교육학회지
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• 제30권2호
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• pp.170-181
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• 2024

Purpose: This study aims to assess the importance and performance of patient safety activities for inpatients in small- and medium-sized hospitals. The objective is to identify the need for patient safety education by analyzing differences in importance and performance ratings. Methods: The study involved 300 patients hospitalized in three small- and medium-sized hospitals. Data collection took place in October 2023, focusing on investigating the importance and performance of patient safety activities. Descriptive statistics and an Importance-Performance Analysis (IPA) were conducted using the IBM SPSS statistics 25.0 program. Results: The average importance of patient safety activities was 3.51±0.41, and the average performance was 3.37±0.43, indicating that the importance of patient safety activities was higher than their performance. According to the IPA, the components of patient safety activities that fell into the second quadrant of high importance but low performance included three medication-related items and one test/procedure/surgery-related item. Conclusion: In this study, it was found that inpatients in small- and medium-sized hospitals had a higher importance on patient safety activities than performance and needed ways to increase their performance. Therefore, it is necessary to develop a customized educational program that can increase the practical performance of inpatients' patient safety activities based on the contents that were determined to need improvement.

• 보건행정학회지
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• 제15권4호
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• 한국측량학회지
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• 제39권6호
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• pp.609-618
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• 2021

COVID-19의 확산과 피해는 대한민국 정부를 포함한 전 세계에 큰 영향을 주고 있다. 대다수 국가는 시민들 간의 접촉을 최소화하기 위해 이동과 집합에 제약을 두고 있으며, 이러한 정책들은 사회적 패턴에 새로운 변화를 가지고 왔다. 본 연구는 COVID-19가 미치는 사회적 영향 중 택시 운행에 대한 영향을 분석하기 위해 COVID-19 3차 대유행 초기에 수집된 대구광역시 택시 이동 데이터를 이용하여 도로 네트워크 규모의 교통량 데이터를 생성하였다. 이후 대구광역시의 확진자 데이터와 상관성 분석을 수행하였으며, 공간적 특성이 가지는 영향을 분석하기 위해 Local Moran's I를 적용하였다. 결과적으로, 전체 도로 네트워크의 택시 운행량과 확진자 수는 음의 상관관계(-0.615)를 나타내었고 이는 확진자 수의 증가에 따른 시민들의 이동 불안감이 반영된 것을 확인하였다. 또한, 본 연구에서는 도로 네트워크의 링크 기반으로 분석을 수행한 결과 도심 중심부의 상업 및 산업 지역은 음의 상관관계와 Local Morna's I의 값이 low-low로 cold spot을 확인하였으며, 병원 같은 의료기관 주변 및 공동주거지와 같은 공간적 특성을 가진 지역의 도로 네트워크는 high-high로 hot spot인 것을 확인하였다. 향후 이러한 분석이 COVID-19에 따른 정책 결정자들의 예방 대책에 활용될 수 있을 것이다.

• International Journal of Internet, Broadcasting and Communication
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• 제12권1호
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• pp.122-129
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• 2020

The circumference of the body is not only an indicator in order to buy clothes in our life but an important factor which can increase the effectiveness healing properly after figuring out the shape of body in a hospital. There are several measurement tools and methods so as to know this, however, it spends a lot of time because of the method measured by hand for accurate identification, compared to the modern advanced societies. Also, the current equipments for automatic body scanning are not easy to use due to their big volume or high price generally. In this papers, OpenPose model which is a deep learning-based Skeleton Tracking is used in order to solve the problems previous methods have and for ease of application. It was researched to find joints and an approximation by applying the data of the deep camera via reference data of the measurement parts provided by the hospitals and to develop a program which is able to measure the circumference of the body lighter and easier by utilizing the elliptical circumference formula.

• 약학회지
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• 제50권2호
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• pp.78-83
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• 2006

VISA and VRE are the main causes of surgical infection, urinary tract infections and bacteremia in hospitals. In this study; we selected VISA (Vancomycin Intermediate resistant Staphylococcus aureus) and VRE (Vancomycin Resistant Enterococcus) isolated from the clinical isolates. One of the isolated strains indicated the high resistance to severel anti-biotics (Vancomycin, Teicoplanin, Mupirocin, Synercid, Ciprofloxacin, Gentamicin, Lincomycin, Cefotaxim, Meropenem). Antimicrobial activity of Bifidobacterium spp. against VISA and VRE were measured. About $10^4$ cells of VISA or VRE were mixed with 1,5 and 9 ml of Bifidobacterium and the final volume was adjusted to 10 ml with brain heart infusion (BHI) broth. The cell suspension was incubated for 3, 6, 9, and 24 hr, serially diluted and then plated on BHI agar plate. As numbers of Bifidobacterium were increased viable cell count of VISA and VRE decreased. The strongest antimicrobial activity of the Bifidobacterium was observed after 9hr incubation in any mixture, almost completely inhibiting the growth of VISA and VRE.