• Title/Summary/Keyword: Hospital Management

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A Study on the Factors that Determine the Initial Success of Start-Up (스타트업의 초기 성공을 결정하는 요인에 관한 연구)

  • Lee, Hyun Ho;Yun, Hwangbo;Gong, Chang-Hoon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.1
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    • pp.1-13
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    • 2017
  • The purpose of this study is to find out which factors determine the success of start-up in the initial market and what are the most important determinants. For the empirical analysis, the questionnaire related to the analysis of success factors for start-up success was designed according to the quantitative analysis (AHP technique). First, we selected 8 representative success factors for successful start-up in the initial market. In order to determine the degree of priority among these factors, we surveyed 12 entrepreneurs who are interested in entrepreneurship, universities, research institutes, and public officials. As a result of the empirical analysis, 51% of the funds in the tier 1 were ranked as the top priority to determine success factors. Followed by research and development (32.5%), management (8.7%) and marketing (7.8%). In particular, when each of the four items is calculated as 100 according to the result of the tier 1, and the tier 2 is converted, the foreign investment is analyzed as 43.7%. It was followed by 15.14% of R & D facilities, 14.07% of ideas, 8.7% of managerial ability, 7.29% of domestic investment, 5.85% of buyer feedback, 3.3% of development strategy and 1.95% of marketing strategy. Among the eight success factors, overseas investment items showed the closest preference to half, and it was the most important variable that determines the success or failure of market entry. The implication of this study is that many start-ups in Korea expect to receive investment and support from overseas accelerators. This means that overseas investment itself has been recognized as a start-up that makes services and products that can be used in the global market. A high preference for attracting foreign investment is due to the fact that the amount of investment is larger than that of Korea and that it can flexibly cope with the pressure on the performance compared to domestic investors. In this study, it was meaningful that we could confirm this fact through questionnaires of start-up experts. In future research, we need to find a viable alternative through studying how to provide start-up to foreign direct investment at the national level.

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Viral Patterns and Clincal Analysis of Acute Respiratory Tract Infections of Children in Korea(September, 1998~August, 2002) (바이러스에 의한 소아 급성 하기도 감염의 유행 및 임상양상(1998년 9월~2002년 8월))

  • Lee, Su-Jin;Park, Eun-Young;Oh, Phil-Soo;Lee, Kon-Hee;Kim, Kwang-Nam;Lee, Kyu-Man
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.102-113
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    • 2003
  • Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTI) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus (PIV), influenza virus(INF), adenovirus(ADV), etc. Our purpose of this study was to examine the seasonal occurrence, clinical and laboratory features of each viral infections. Methods : Nasopharyngeal aspirates(NPA) were collected from 913 hospitalized children on the first day of admission. They were all admitted to Hangang Sacred Heart hospital and diagnosed as LRTIs. The study period was from September 1998 to August 2002. Specimens were inoculated onto HEp-2 cell, LLC-MK2 cell and MDCK cell. Viruses were detected by immunofluorescent method performed at day 10 postinoculation. Respiratory viruses were detected in 251(27%) cases. Medical records of 208 cases diagnosed as acute LRTIs were all taken reviewed and analyzed. Results : The identified pathogens were RSV 122 cases(58%), PIV 30 cases(14%), INFA 20 cases(10%), INFB 21 cases(11%) and ADV 15 cases(7%) during the study period. Outbreaks of RSV infections occurred every year but mostly on December, 1998 and November, 1999. LRTIs by PIV and ADV occurred during all seasons of the year. INFA was isolated moslty on March, 1999 and January, 2000. INFB infections occurred largely on April, 2002. The clinical diagnoses were bronchiolitis 88 cases(43%), pneumonia 87 cases(42%), croup 19 cases(9%) and tracheobronchitis 14 cases(6%). Common symptoms and signs were cough, rhinorrhea, sputum and fever. WBC counts in peripheral blood showed normal findings in 123 cases(59%). Each viral infections also showed some differences in auscultatory findings and chest X-ray findings. Conclusion : We learned that viruses are one of the major and important etiologic agents of acute LRTIs of children in Korea. However, we still need to find out more about its characteristic clinical features and continue studying on their seasonal occurrence to focus on their management and also prevention.

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Efficacy of Dextranomer/Hyaluronic Acid Copolymer ($Deflux^{(R)}$) Injection for Vesicoureteral Reflux in Children (방광요관역류 환아에서 내시경적 요관 점막하 Dextranomer/hyaluronic acid copolymer ($Deflux^{(R)}$) 주사요법의 효과에 대한 연구)

  • Hong, Suk-Jin;Hwng, Hyun-Hee;Hong, Eun-Hui;Cho, Min-Hyun;Chung, Sung-Kwang
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.229-234
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    • 2009
  • Purpose : The aim of this study was evaluating the efficacy of endoscopic $Deflux^{(R)}$ submucosal injection in children with primary vesicoureteral reflux (VUR). Methods : Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic $Deflux^{(R)}$ injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of $Deflux^{(R)}$ was 0.77 cc. After $Deflux^{(R)}$ injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later. Results : The success rate of endoscopic $Deflux^{(R)}$ submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<.01). Degree of improvement of VUR by endoscopic $Deflux^{(R)}$ submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of $Deflux^{(R)}$. However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047). Conclusion : Endoscopic $Deflux^{(R)}$ submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.

Clinical Evaluation of Nephrotic Syndrome Manifesting in the First Year of Life (1세 이하의 소아에서 발병한 신증후군의 임상적 고찰)

  • Cho, Sung-Hee;Lee, Joo-Hoon;Cho, Young-Mi;Park, Young-Seo;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.161-169
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    • 2009
  • Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.

The Effect of School Dental Service on Dental Health Knowledge, Beheaviors and Dental Health Status Among Elementary School Students (학교 구장보건실 운영이 초등학생들의 구강보건지식, 행태 및 건강상태에 미치는 영향)

  • Lee, Tae-Yong;Yun, Go-Eun;Kim, Kwang-Hwan
    • The Journal of Korean Society for School & Community Health Education
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    • v.10 no.1
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    • pp.87-104
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    • 2009
  • Objective: In this study, the dental health care knowledge, dental health behaviors and dental health status of elementary school students were compared and analyzed in the cases of their schools having dental health care center or not one. Methods: The target groups were 167 students of A school (experimental group) where pit-and-fissure sealants, fluoride mouthrinsing, and fluoride gel application were carried out with all grades of students by school dental health care center and 158 students of B school (control group) where fluoride mouthrinsing, for all grades students and pit-and-fissure sealants for the first grade students are carried out but have no the school dental health care center. Results: This study was carried out through the answer sheets and recordings of dental inspection. The findings of this study are as follows: 1. The dental health care knowledge was compared and the results showed that on average 14.2$\pm$2.1 in experimental group and 14.0$\pm$1.9 in the control group were no significantly different (p>0.05). 2. The dental health behaviors were compared and the results showed that the experimental group was significantly different(p<0.05) in terms of the number of times of dental brushing a day, the method of tooth brushing, the time of tooth brushing, the experience of tooth brushing with fluorine, the kinds of snacks and tooth brushing in school after lunch. But there was no significant difference(p>0.05) in the time of tooth brushing and the tooth brushing after eating snacks. 3. The DMF rate was compared and the results showed the significantly difference between the average experimental group and 53.8$\pm$5.0 in the control group(p<0.05). 4. The DMFT index was compared and the results showed the significantly difference between the average 0.6$\pm$2 in the experimental group and 1.4$\pm$1.6 in the control group(p<0.05). 5. The DMFI rate was compared and the results showed the significantly difference between the average 4.2$\pm$8.3 in the experimental group and 9.5$\pm$11.0 in the control group. (p<0.05). 6. The DT rate were compared and the results showed the significantly difference between the average 10.2$\pm$29.5 in the experimental group and 32.4$\pm$44.0 in the control group(p<0.05). 7. The FT rate were compared and the results showed the significantly difference between the average 88.5$\pm$31.0 in the experimental group and 67.5$\pm$44.0 in the control group(p<0.05). Conclusions: Based on the results, above there was no significant difference in dental health care knowledge between both the experimental and the control group. But we discovered that the experimental group is better than the other one in dental health care behaviors and dental health status. Therefore, we could conclude that the school dental health care center efficiently carried out the dental care and treatment. As school dental health care centers did not work out efficiently in terms of their educating on the dental health acre knowledge, the related programs to be developed and supported.

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Coronary Artery Bypass Surgery with Radial Artery -Early Results (요골동맥을 이용한 관상동맥우회술 -조기성적)

  • 나찬영;이영탁;박국양;이해영;김욱성;박?현;홍민수;심재천;권오춘
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.275-281
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    • 1997
  • The radial artery as a graft for myocardial revascularization was introduced by Carpentier in the early 1970s. Mid-term results were unfortunately discoura ing, and the clinical experience with this graft was interrupted. At the end of the 1980s, these authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a radial artery graft in Seiong General Hospital. Left internal mammary artery was concomitantly used as a pedicled Vift in 34 patients. Fifteen patients (42%) had a complete arterial waft revascularization. A total of 12) distal anastomoses were performed (average 3.4 per patient), including 36 left internal mammary artery wafts (two sequential in 2 patients), and 23 saphenous vein grafts. The remaining 64 distal anastomoses were perFormed with radial artery grafts (mean 1.8 per patient). The radial arteries were anastomosed to the circumflex (n=38), diagonal (n= 18), right coronary(n=G), and left anterior descending coronary artery(n=2). The percent ge of radial artery graft anastomoses (64) to the total anastomoses(123) was 52%. The radial artery was used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures coronary endarterectomy (14), coronary artery patch angioplasty (4), mitral valve repair (1), and repair of ventricular septal rupture (1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand aftcr removal of the radial artery. Only 1 patient required reexploration of the am, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiovaphic controls were obtained in 11 patients(31%) postoperative 79 to 210 days (mean 126 days). The patency rate were as follows : left internal mammary artery (100%), saphcnous vein (100%), and radial artery(95%). We concluded that the radial artery is useful alternative graft, but long term clinical and angiographic studies are required to derterminc whether wider application is warranted.

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Transaortic Mitral Commissuroplasty with a Bentall Procedure or Artic Valve Replacement (대동맥 판막 치환술과 벤탈 수술 환자에서 대동맥 근부를 통한 승모판막 교련 성형술)

  • Kim, Si-Wook;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.727-732
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    • 2007
  • Background: The reciptents of aortic valve replacement or a Bentall operation usually display various degrees of mitral regurgitation. When deciding whether or not to correct the mitral regurgitation, one must consider its severity, underlying causes and operative risk. Recently, the operation method for correcting the concomitant mitral regurgitation has been done through aortic root to reduce the operation time and the cardiac trauma. We report our experiences that transaortic mitral valve commissuroplasty done with aortic valve replacement or a Bentall operation has been a simple, less invasive, effective method in the operative management of mitral valve regurgitation without significant organic changes. Material and Method: Between June 2002 and June 2005, twenty patients under-went mitral valve commissuroplasty via the aortic root with aortic valve replacement (n=14) or a Bentall operation (n=7). The mitral valve regurgitation of the patients didn't exceed a moderate (grade 2) degree and there was no significant organic disease. The preoperative diagnosis of MR was established by TTE and intraoperative TEE, and the patients were followed postoperatively by TTE. The operative technique was a simple anterolateral commissuroplasty of the mitral valve with a single mattress suture via the transaortic annular approach after excision of the aortic valve leaflets. Result: The mean patient age was 56.2 years and 65% (n=13) were male. The preoperative MR was mild (grade 1) in 9 (45%), mild to moderate in 8 (40%), and moderate (grade 2) in 3 (15%) patients. There were no operative mortalities. The MR improved in all patients (p=0.002) and the left ventricular ejection fraction (LV EF) improved in 14 (70%) patients (p=0.005). The mean cross-clamp time for the patients who under- went aortic valve replacement with transaortic mitral repair was $62.1{\pm}13.9 min$ and this was $137.5{\pm}7.2 min$ for the patients who underwent a Bentall operation with transaortic mitral repair. Conclusion: For selected patients without significant mitral organic disease, transaortic mitral valve commissuroplasty combined with aortic valve replacement or a Bentall operation may be a feasible, effective method without adding significant aortic cross clamping time and more cardiotomy.

Prevalence of Intimal Defect in the Patients urith Surgically Treated Acute Type A Intramural Hematoma of the Aorta (외과적으로 치료한 급성 A형 대동맥벽내 혈종 환자에서 대동맥 내막 결손의 존재 빈도)

  • Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.733-744
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    • 2007
  • Background: There is a controversy regarding the pathogenesis and management principle of an acute intramural hematoma (IMH) of the aorta, Recent studies have reported intimal defects in many patients diagnosed with IMH, and suggested that intimal defects play important roles in the pathogenesis, progression of the pathology, and prognosis. Material and Method: This study reviewed the preoperative and postoperative computed tomography (CT) scan images of 36 patients who underwent surgical treatment for Stanford type A acute IMH of the aorta. The surgical findings were also reviewed retrospectively from the medical records. Result: In 15 patients (41.7%), the findings suggestive of the intimal defects were found in the preoperative CT. During the operation, 20 patients (72.2%) were found to have small intimal defects in the ascending aorta or the arch, of which 13 patients (50.5%) did not have the CT findings suggestive of intimal defects. In 17 patients, the intimal defects were located in the aortic arch or distal ascending aorta, where a gross examination would have been impossible without total circulatory arrest. In all patients, the intimal defects identified were included in the resected aortic segment, or locally closed. Follow-up CT at 4 months or longer after surgery showed that the IMH in the descending aorta had disappeared or was markedly improved. Conclusion: Most patients undergoing surgical treatment for acute type A IMH had intimal defects. This suggests that a large proportion of IMH might have a similar pathogenic mechanism as classic dissection. Consequently, it is believed that those two entities of acute aortic syndrome should be treat-ed using the same principles.

Hospice and Palliative Care for Cancer Patients with Brain Metastases (전이성 뇌암 환자의 호스피스 완화의료)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.30-36
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    • 2005
  • Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

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Treatment of Developmental Dislocation of the Hip in Walking Age (보행기의 발달성 고관절 탈구의 치료)

  • Kim, Se-Dong;Jang, Jae-Hyuk;Lee, Dong-Chul;Shin, Duk-Seop
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.211-224
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    • 1996
  • The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows : 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better result in operative treatment can be expected.

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