Cochlea hair cell death is regarded to be responsible for the radiation-induced sensorineural hearing loss (SNHL), which is one of the principal complications of radiotherapy (RT) for head and neck cancers. In this mini-review, we focus on the current progresses trying to unravel mechanisms of radiation-induced hair cell death and find out possible protection. P53, reactive oxygen species (ROS) and c-Jun N-terminal kinase (JNK) pathways have been proposed as pivotal in the processes leading to radiation hair cell death. Potential protectants, such as amifostine, N-acetylcysteine (NAC) and epicatechin (EC), are claimed to be effective at reducing radiation-inducedhair cell death. The RT dosage, selection and application of concurrent chemotherapy should be pre-examined in order to minimize the damage to cochlea hair cells.
The purpose of the study is to find the factors influencing small or middle size clinics and hospitals CEOs' expectation level on the affiliation with the large size teaching hospitals. Data for analysis was collected to use self-administrative structured questionnaire on 164 CEOs of small or middle sized clinics and hospitals affiliated with large sized teaching hospital located in Kyung Ki Province. For the study, the researchers develop the constructs for questions on the expectation on the affiliation, the attitude such as confidence, knowledge on the affiliation, previous relationship of the affiliation, and selection guideline of the affiliation with exploratory factor analysis and reliability test. Through the confirmative factor analysis using AMOS 4, the researchers develop constructs based on exact relationship between constructs and questions. CEOs' expectation level on the affiliation is influenced on attitude or confidence, gender, types of clinics and hospitals, distance to the affiliated large hospital, types of recommender, and number of affiliated hospitals. Large sized hospitals that want to affiliation with other clinics and hospitals can promote the affiliation to consider these factors from the results.
The purpose of this study is to find determinants for service mind and skills of hospital employees to seek ways to improve the service level of hospitals. The past studies focused on the perspectives of customers in finding the solutions for service improvement. However, the existing approach failed in delving into the whole picture of service system. The behind operation of service system(e.g., selection and training of employees, support system) needs to be examined to have a balanced solution of service improvement. The personal characteristics, organizational characteristics, and customer experience were considered as the independent variables in predicting service mind and skills. The data collected in this study was gathered through questionnaire survey with 291 employees in five hospitals - from Sept. 10 to Oct. 16 in 2004. The results are as follows. 1. The regression analysis showed that job satisfaction and service commitment of organization were statistically significant in predicting service mind and skills. 2. The hierarchical regression analysis showed that the effect of hospital type on service mind was explained by service commitment of organization.
Objective: To evaluate the association between tea consumption and the risk of renal cell carcinoma. Methods: We searched PubMed, Web of Science and Scopus between 1970 and November 2012. Two evaluators independently reviewed and selected articles based on predetermined selection criteria. Results: Twelve epidemiological studies (ten case-control studies and two cohort studies) were included in the final analysis. In a meta-analysis of all included studies, when compared with the lowest level of tea consumption, the overall relative risk (RR) of renal cell carcinoma for the highest level of tea consumption was 1.03 (95% confidence interval [CI] 0.89-1.21). In subgroup meta-analyses by study design, there was no significant association between tea consumption and renal cell carcinoma risk in ten case-control studies using adjusted data (RR=1.08, 95% CI 0.84-1.40). Furthermore, there was no significant association in two cohort studies using adjusted data (RR=0.95, 95% CI 0.81-1.12). Conclusion: Our findings do not support the conclusion that tea consumption is related to decreased risk of renal cell carcinoma. Further prospective cohort studies are required.
Objective: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. Materials and Methods: During the period of January 2006- March 2012, percutaneous transhepatic catheter drainage (PTCD)/ percutaneous transhepatic biliary stenting (PTBS) were performed for 89 patients. According to percutaneous transhepatic cholangiography (PTC), external drainage was selected if the region of obstruction could not be passed by guide wire or a metallic stent was inserted if it could. External drainage was the first choice if infection was diagnosed before the procedure, and a metallic stent was inserted in one week after the infection was under control. Selection by new infections, the degree of bilirubin decrease, the change of ALT, the time of recurrence of obstruction, and the survival time of patients as the parameters was conducted to evaluate the methods of different interventional treatments regarding prognosis of patients with hilar obstruction caused by hilar cholangiocarcinoma. Results: PTCD was conducted in 6 patients and PTBS in 7 (p<0.05). Reduction of bilirubin levels and ALT levels was obvious after the procedures (p<0.05). The average survival time with PTCD was 161 days and with PTBS was 243 days (p<0.05). Conclusions: With both drainage procedures for obstructive jaundice caused by hilar cholangiocarcinoma improvement in liver function was obvious. PTBS was found to be better than PTCD for prolonging the patient survival.
Health care marketing can be defined as a process of developing, promoting and administering health care services for the benefits of hospitals as well as consumers. Researchers have reported that one of the significant attributes in the selection of hospital is a client's perceived image of the hospitals. Especially the image of nursing services was one of the important factors of the hospital image. The main purposes of the study were 1) to define the positioning about 5 hospitals' image of nursing services. 2) to define the effects of image attributes to the iamage of hospital nursing services. Eighteen hundred questionnaires were distributed to the parents of middle schools and high schools in Seoul. Among them, 1340 cases were returned but 849 cases were turned out to be useful data and used in final analysis. In data analysis, $SPSS\;/PC^+$ and PC-MDS programs were used for descriptive statistics, multiple regression, and drawing perceptual maps. The image of hospital nursing services was measured developed by the author through literature review and content validation. Reliability coefficients was found to be statistically appropriate level of confidence(Cronbach's Alpha=.8617). The results were as follows : 3) The perceptual map shows that hospital A, B and C,D,E were divided into five groups(See Fig. 1). That is, hospital A, and B are located in a close position and hopital C & E are located at opposite position between X-axis, Hospital D was located in the middle area of the hospital C and:E. In conclusion, this research visiblely depicted perceptual maps using MDS of the consumer's image about hospital nursing services. Since hopital nursing services were differentiated by the image attributes in consumer's perception, the results of the study can help hospital managers plan marketing strategy according to their strong points or weak points. Because the necessity of marketing in recent health care was importantly recognized, this research which is adopting posititioning concept will contribute to the consumers and hospital organizations.
Background/Aims: Selective bile duct or pancreatic duct cannulation remains a significant initial hurdle in endoscopic retrograde cholangiopancreatography (ERCP) despite advances in endoscopy and accessories. This study evaluated our experience with a rotatable sphincterotome in cases of difficult cannulation. Methods: We retrospectively reviewed ERCP cases using TRUEtome, a rotatable sphincterotome, as a rescue device for cannulation at a cancer institute in Japan from October 2014 to December 2021. Results: TRUEtome was used in 88 patients. Duodenoscopes were used for 51 patients, while single-balloon enteroscopes (SBE) were used for 37 patients. TRUEtome was used for biliary and pancreatic duct cannulation (84.1%), intrahepatic bile duct selection (12.5%), and strictures of the afferent limb (3.4%). Cannulation success rates were similar in the duodenoscope and SBE groups (86.3% vs. 75.7%, p=0.213). TRUEtome was more commonly used in cases with steep cannulation angles in the duodenoscope group and in cases requiring cannulation in different directions in the SBE group. There were no significant differences in adverse events between the two groups. Conclusions: The cannulation sphincterotome was useful for difficult cannulations in both unaltered and surgically altered anatomies. It may be an option to consider before high-risk procedures such as precut and endoscopic ultrasound-guided rendezvous techniques.
Objectives : This study investigated the health information such as the general health information, the health product information, and the hospital information, and we wanted to identify the association between internet health information and the health related behavior by analyzing the process after people search the Internet. Methods : A telephone survey with structured questionnaire was performed by trained surveyors. The respondents were sampled proportionate to the Korean demographic distribution with considering the city size and the populations' ages and gender. The survey was conducted from October 2006 to November 2006. Results : Out of 3,758 successfully connected persons of age 20 or more, 871(23.2%) respondents had used Internet health information during the last year. The purposes of searching the Internet for health was, 1) to get general health information (717 cases, 81.0%), 2) shopping for health product (109 cases, 12.3%) and 3) seeking information about hospital selection (59 cases, 6.7%). Our research showed that the process after searching the Internet for health information depends on the purpose of the search. 68.8% of the searchers for general health information, 67% of the searchers for health product shopping and 64.4% of the searchers seeking information to guide hospital selection were satisfied with their Internet search. However one third of the respondents reported not being satisfied with the result of the search. Conclusions : Unsatisfied consumers with internet health information tended to ask lay referrals from others or they gave up seeking health information. The health information system should be improved to increase the accessibility and to provide reliable and effective information. Also, a more user-centric community is needed in order to strengthen the effective role of lay referrals among the internet users.
Purpose: This study aims to provide primary data for policy alternatives by identifying the problem of the nursing workforce shortage. Methods: For quantitative data, 446 questionnaires were analyzed. The mean and standard deviation were used for content description. ANOVA analysis and Scheffe? test were used to compare the differences according to the hospital level. For qualitative data, 1:1 in-depth and group interviews were conducted for six participants. Results: The factors nurses prioritized when choosing a workplace were salary, commuting distance, and work-life balance. Clinical nurses cited low wages, heavy workloads, and burnout as the most considerable difficulties in performing their duties. Factors influencing nurse's turnover intention were low wages, unmanageable workload, and rotation to unwanted departments in that order. New nurses tend not to apply to small-medium-sized hospitals, experienced nurses in their 30s-40s leave hospitals due to childcare and shift work difficulties, and nurses in their 50s and older tend to move to nursing homes rather than acute hospital settings. Conclusion: In this study, wage and workload were mentioned as the most critical factors in nurses' workplace selection, job performance difficulties, and turnover intention, so it is necessary to pay attention to this aspect when improving treatment for nurses.
Background: Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years. Methods: This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital. Results: Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged <4 years tended to decrease, while that of children aged >5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females. Conclusion: Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.
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