• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6705-6709
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• 2015

Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.127-134
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• 2018

Objectives : This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. Methods : The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. Results : Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. Conclusions : Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.16-22
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• 2009

Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.213-223
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• 2013

Objectives Low back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients' treatment in Korean medical institutions are in need. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient characteristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results 1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the patients' age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%) were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients investigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients' duration of admission, type of insurance, frequency of the disease code use, type of intervention applied. Conclusions It is thought that the current study can be used as reference data in assessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in future researches, such data would act as better base line data in policy decision making.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.46-53
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• 2016

Purpose: Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient. Methods: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method. Results: A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs. Conclusions: This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.

• Korean Journal of Hospice Care
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• v.7 no.1
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• pp.29-45
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• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.1
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• pp.16-31
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• 2019

Objective : The purpose of this study is to analyze the charcateristics of inpatients in Ophthalmology, Otolaryngology & Dermatology Clinic by gender, age, season, and department of medical care after hospitalization from March, 2012 to February, 2018. Method : From March 1, 2012 to February 28, 2018, patients who were admitted to the Ophthalmology, Otolaryngology & Dermatology Clinic of Korean Medical Hospital were classified by gender, age, department, and season, and their relationship, hospitalization period, number of outpatient visits Differences were analyzed objectively using various statistical methods using IBM SPSS 18.0. Results : 1. The number of inpatients was 432, including duplication. Of these, 317 were female and 115 were male. The number of female patients was 2.8 times higher. 2. The average age of the inpatients was 43.9 years and the number of middle-aged 40-50 patients was 48.6%. 3. The number of inpatients in the departments was in the order of dermatology, otology, laryngology, rhinology, and ophthalmology. The most hospitalized diseases were eczema in the dermatology department, sudden hearing loss in the otology department, tonsillitis/peritonsillar abscess, rhinitis in the rhinology department, and dry eye syndrome in ophthalmology. 1) The effect of gender on the difference in the number of inpatients by subdivision was statistically significant. 2) The effect of age on the difference in the number of inpatients by subdivision was statistically significant. 3) The effect of seasons on the difference in the number of inpatients was not statistically significant. 4. The number of inpatients by season was in the order of winter, spring, summer, autumn, and the number of inpatients decreased significantly in autumn. 1) The effect of gender on the difference in the number of hospitalized patients by season was not statistically significant. 2) The effect of age on the difference in the number of hospitalized patients by season was not statistically significant. 5. The average length of hospital stay for inpatients was 10.7 days. 1) The effect of gender on length of hospital stay was not statistically significant. 2) The effect of age on hospital stay was not statistically significant. 3) The effect of the subdivision on hospital stay was statistically significant. 4) The effect of the season on hospital stay was not statistically significant. Conclusion : As a result of this study, the most distinctive feature of the present study was the high rate of inpatients with otic disease like idiopathic hearing loss and Meniere 's syndrome and the high rate of female patients. This may be related to the increased prevalence of the disease and the severity of the disease. In addition, the high rate of female patients suggests that women are more likely to be affected by illnesses, as well as to have more medical use and severe symptoms requiring hospitalization. In the future, it would be better to provide various treatment plans and policies for patients with otic diseases and female patients. Also it would be good if studies on these fields are made in the future.

• Journal of Digital Convergence
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• v.10 no.3
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• pp.207-218
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• 2012

The purpose of this study is to provide preliminary data for political measures to minimize the variations by understanding the regional variations and trends of hospital services for heart diseases, and analyzing the factors that could occur any variations. The various data collected from nation-wide inpatient services conducted separately by small region show that there have been some differences in income level, supply of medical resources, standardized rate of hospitalization by sex and age, health level in the residence, and the length of stay per head. Then it indicated that the number of special medical equipment per 10,000 people and the rate of vigorous physical activity have the highest influence over the regional variations in using hospital services. On the other hand, the number of sick-beds per 10,000 people, the number of special medical equipment, and the present smoking rate have significant degree of influence on the length of stay per head. Thus, it is imperative for the authorities to set aside health promoting policies and to distribute the medical resources equitably throughout the country and to enhance the accessibility of local residents to the health care services.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.616-624
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• 2020

This study analyzed the association between the type of transport accident and the associated mortality of elderly inpatients. The findings will contribute to the development and establishment of a systematic and effective policy according to the type of transport accident to reduce the mortality of inpatients. The data on elderly inpatients with transport accidents was extracted from the 2013-2017 Korean National Hospital Discharge In-depth Survey dataset. The data was analyzed by descriptive statistics analysis, chi-square tests and multiple logistic regression analysis. After adjustment for sociodemographic, disease, injury and policy factors, the elderly inpatient deaths due to transport accidents were significantly higher for pedestrian accidents (OR: 2.522 95%, CI: 1.291-4.972), bicycle/cart accidents (OR: 2.809, 95% CI: 1.328-5.942) and motorcycle accidents (OR: 2.330, 95% CI: 1.226-4.819) rather than that for car accidents. Likewise, elderly inpatients have a higher risk of death from other types of transport accidents than those caused by car accidents. However, Korean policies related to transport accidents of elderly inpatients are concentrated on car accidents. Effective policy is needed according to the characteristics of each type of transport accident to reduce the transport accident mortality of elderly inpatients.