• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.530-547
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• 2018

This study examines the importance of location and transportation in the operation of small- and medium-sized hospitals in the rapidly changing clinical environment. Approximately 350 persons were surveyed for approximately 40 days from July-August 2017, and responses were analyzed using SPSS and AMOS Statistical Package for 335 parts excluding 8 parts of 343.The main research results were as follows: First, a hypothesis was adopted that the attractiveness of building materials will positively affect customer satisfaction. Second, the hypothesis that transport infrastructure has a significant impact on customer satisfaction was rejected. Third, the hypothesis that the building appeal will positively affect the site was supported. Fourth, the hypothesis that transport infrastructure will have a significant impact on location marketability was supported. Fifth, the hypothesis that location marketability will significantly impact customer satisfaction was supported. Sixth, the hypothesis that the relationship between the site and customer satisfaction with the relationship between the client and the client is explained is partly attributable to the fact that there is a partial function. The assumption that the relationship between traffic infrastructure and customer satisfaction was confirmed. The hypothesis that the relationship between traffic infrastructure and customer satisfaction was supported. This research focuses on small- and medium-sized hospitals located in Seoul, which does not include the recognition of patients' awareness of the location and transportation of small- and medium-sized hospitals. Moreover, this study has the limitation in analyzing patient satisfaction, rather than the objective data of the financial management performance of the hospital. The results of this study could provide the basis for selecting the future locations of health care facilities.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4049-4052
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• 2013

Resistance to chemotherapy treatment, which may lead to limited efficacy of systemic therapy in breast cancer patients, is multifactorial. Among the mechanisms of resistance to chemotherapy treatment, there are those closely related to estrogen receptor ${\alpha}$, P-glycoprotein, multidrug resistance-related protein, glutathione S-transferase pi and topoisomerase-II. $ER{\alpha}$ is ligand-activated transcription factor that regulates gene expression and plays a critical role in endocrine signaling. In previous preclinical and clinical studies, positive $ER{\alpha}$ expression in breast cancer cells was correlated with decreased sensitivity to chemotherapy. This article reviews current knowledge on the predictive value of $ER{\alpha}$ with regard to response to chemotherapy. Better understanding of its role may facilitate patient selection of therapeutic regimens and lead to optimal clinical outcomes.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.1
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• pp.47-54
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• 2005

Objective: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. Methods: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). Results: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). Conclusion: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5073-5076
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• 2013

Objective: This study aimed to investigate whether the miR-198 expression level is related to clinicopathological factors and prognosis of esophageal cancer. Methods: MicroRNA was extracted from esophageal cancer patients who underwent surgery for assessment using the Taqman@ MicroRNA assay. The correlation between miR-198 expression and clinicopathological features was analyzed, and the significance of miR-198 as a prognostic factor and its relationship with survival was determined. Results: MicroRNA-198 (miR-198) expression was higher in patients with poor prognosis than those with good prognosis (P<0.05). Kaplan-Meier analysis results showed that the miR-198 expression level had a significant correlation with survival time (P=0.030) and that patients with a higher expression of miR-198 had a shorter survival time. Cox multi-factor model analysis showed that patient prognosis (P=0.014), tumor length (P=0.040) and expression (P=0.012), and survival time had a significant correlation; the corresponding risks were 7.268, 1.246, and 3.524, respectively. Conclusion: miR-198 overexpression is involved in the poor prognosis of esophageal cancer and can be used as a biomarker for selection of cases requiring especial attention.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.683-688
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• 2022

Background Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the lower leg are easier to dissect, they are thought to be more vulnerable to trauma and lead to a higher complication rate when using them instead of the deep accompanying veins as recipient vessels. No clear evidence exists that proves this concept. Methods We retrospectively studied the outcomes of 97 patients who underwent free flap plasty to reconstruct predominantly traumatic defects of the lower extremity at our institute. The most used flap was the gracilis muscle flap. We divided the population into three groups based on the recipient veins that were used for microvascular anastomosis and compared their outcomes. The primary outcome was the major complication rate. Results Overall flap survivability was 93.81%. The complication rates were not higher when using the great saphenous vein as a recipient vessel when comparing to utilizing the deep concomitant veins alone or the great saphenous vein in combination to the concomitant veins. Conclusions In free flap surgery of the lower extremity, the selection of the recipient veins should not be restricted to the deep accompanying veins of the main vessels. The superficial veins, especially the great saphenous vein, offer an underrated option when performing free flap reconstruction.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.18-40
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• 2001

This study purports to investigate the readiness of the university hospital employees in the knowledge-based management. Data were collected from 550 employees including administrative, nursing, and technical staff of 9 university hospitals located in Seoul and Kyunggi Province through the self-administered questionnaires. The response rate was 79% and 425 questionnaires were used as final data and analyzed using 2 test, t-test, and ANOVA. The main findings of the study are as follows. 1) It seems that most employees of the study hospitals have basic knowledge on the concept of knowledge-based management. This finding implies that the implementation of the knowledge-based management in Korean university hospitals will not likely to face strong resistance from their employees. 2) The results show that Korean hospital employees are still not so accustomed to using e-mail as the main communication tool. This finding suggests that it is necessary to use various communication tools which include electronic data interchange, teleconference, and cyber chatting for facilitating the knowledge-based management in Korean university hospitals. 3) It is desirable to appoint a chief knowledge officer(CKO) for operating knowledge-based management system effectively. 4) A reward system for employees who show a distinguished performance in the creation and sharing of new knowledge should be established. Knowledge mileage system, selection of the best knowledge employee and team will be a good example of the effective reward system. 5) The participation and support from the chief executive officers (CEO) of the hospitals is an important factor for successful knowledge-based management. Furthermore, to make physicians actively participate in the knowledge-based management is another important factor for obtaining valuable outputs from the system. 6) It is found that the knowledge and skills of the hospitals employees on the information technology (IT) are not sufficient for making knowledge-based management more popular. This implies that it is very important to select IT-oriented employees and educate them continuously on the knowledge-based management.

• The Journal of the Korea Contents Association
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• v.18 no.5
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• pp.191-214
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• 2018

This research empirically analyzed the selection factors and the locational selection factors of the medical service facilities according to the gradual increase of the importance of the selection factors and the locational selection factors regarding the establishments of the small- and medium-sized hospitals according to the rapid changes of the socio-economic conditions. By analyzing the priority order according to the levels of the importance of each evaluation item factor through a research related to the selection factors and the locational selection factors of the small- and medium-sized hospitals and by drawing what the important factors that have the influences on the competitiveness of the pre-existent small- and medium-sized hospitals are through the classification of the real estate locational factors and the non-locational factors, the purpose lies in utilizing them as the basic data and materials for the opening strategies of the small- and medium-sized hospitals considering the special, locational characteristics according to the important factors of the selection factors of the small- and medium-sized hospitals, regarding the medical suppliers that have been preparing, for opening the new, small- and medium-sized hospitals. Based on the results of the preceding researches and the researches on the case examples, 28 evaluation factors were arrived at in terms of the level of the medical treatment, the medical services, the accessibilities of the hospitals, the conveniences of the hospitals, and the physical environment. And, regarding the 28 detailed evaluation factors that had been collected, through the interviews with the related experts, the 5 factors of the medical level, the medical service, the expertise of the hospital, the convenience of the hospital, and the physical environment were selected as the upper class evaluation factors. And, according to each upper class, a total of 28 low-part evaluation factors were selected. Regarding the optimal evaluation factors that were selected, the optimal locational factors were selected by carrying out an AHP questionnaire survey investigation with 200 medical experts as the subjects. Regarding the AHP analysis results, similarly with the case examples of the precedent researches, the levels of the importance appeared in the order of the medical level, the medical services, the accessibility of the hospital, the physical environment, and the convenience. And the factors that were related to the facilities of a hospital appeared low. The results of this research can be applied in providing the basis for the decision-makings regarding the selections of the locations of the small- and medium-sized hospitals in the future.

• Korean Journal of Radiology
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• v.23 no.9
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• pp.921-930
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• 2022

Objective: To identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics. Materials and Methods: We retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated. Results: The area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort. Conclusion: The combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.

• Korean Journal of Community Nutrition
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• v.2 no.5
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• pp.721-727
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• 1997

This study investigated whether dietary factors are more influential factor than other health behavior such as drinking, smoking and exercise on abnormal serum cholesterol level inspite of Korean dietary pattern differences compared to Europeans and Americans. A double case control study model has been used for the study design. One model consisted of high blood cholesterol cases and control. the other model consisted of low blood cholesterol cased and controls. 5.398 sedentary male workers who had taken medical examinations at a university hospital were used as the study subjects. Out of the study subjects, 36individuals with high blood cholesterol cases and 30 individuals with low blood cholesterol cases were selected. For the 66 individual control selection, the individual control selection, the individuals matching method was adopted. The food frequency method was used to collect the data for assessment of the dietary factors. A standardized questionnaire was used to investigate other health behavior. logistic regression analysis was employed to measure the relative importance between the factors considered. There were no statistically significant differences observed in nutrients consumption or other health behavior among the low, normal and high blood cholesterol groups, An overmatching effect had been suspected as the cause of those findings. However, the results of logistic regression analysis to identify the factors influencing high serum cholesterol showed that odd ratios of dietary factors such as tocopherol(3.0) and saturated fatty acid(1.6) were higher than I. I of smoking and 1.2 of drinking. Similar results were also observed incases of low serum cholesterol. The above findings imply that although the dietary pattern is quite different from that of Europeans and America, the dietary factor is still a significant factor for abnormal blood cholesterol in Koreans. Therefore, the dietary risk factor identified in high fat consumption populations are still relevant for the relatively healthy Korean as guideline for preventive health practices. (Korean J Community Nutrition 2(5) : 721∼727, 1997)

• Journal of the Korean Dietetic Association
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• v.8 no.4
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• pp.372-386
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• 2002

The purposes of this study were to find factor which influence on the selection criteria of food supplier. Questionnaire were distributed to 52 general hospitals with more than 400 beds located in Seoul and Kyongin province, and responded questionnaires were collected from 44 dietetic departments (84.6%) and 18 purchasing departments (34.6%). The main results of this study can be summarized as follows: (1) supplier selection criteria include quality, service, cost and supplier competency. (2) With having been met with tight competition and market opening, hospitals plan a strategy to improve quality, service and they tend to have more interest in various supplier selection criteria. (3) Purchasing departments estimate more highly the rate of reflection in considering supplier selection criteria than the rate of importance about cost criteria, which reveals that purchasing departments sensitively respond to cost cutdown. (4) When selecting suppliers, a significant(p<.01) influence of stability of supplier industry environment on the selecting criteria such as the importances of quality, service, and supplier quality are recognized only after recognizing the stability of food delivery industry. Food supplier industry secures stability more quickly through major companies' participation in food distribution industry and this will reveal the importance of supplier selection criteria. (5) Suppliers which are selected by the quality criteria, service criteria, supplier quality criteria make efforts to communicate with foodservice departments, to give more proper information about substitute food, new product, and to make commitments, while suppliers which are decided by cost criteria do not establish supportive relationships with foodservice departments.