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Outcomes of Combined Mitral Valve Repair and Aortic Valve Replacement (대동맥판막 치환술과 동반시행한 승모판막 성형술 결과)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Choi, Hyun-Seok;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.463-471
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    • 2003
  • The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.

A Survey of Korean Consumers' Awareness on Animal Welfare of Laying Hens (산란계 동물복지에 대한 국내 소비자의 인지도 조사)

  • Hong, Eui-Chul;Kang, Hwan-Ku;Park, Ki-Tae;Jeon, Jin-Joo;Kim, Hyun-Soo;Kim, Chan-Ho;Kim, Sang-Ho
    • Korean Journal of Poultry Science
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    • v.45 no.3
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    • pp.219-228
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    • 2018
  • This study was conducted twice to investigate egg purchase behavior and perception on animal welfare of Korean consumers. This study included women, who were the main decision makers and caretakers in the household, and men with one-person household. This survey was conducted with by the Computer Assisted Web Interview and Gang Survey methods. On the key considerations factor, the highest response rate was considered to be 'price', and the response rate of considering 'packing date' increased in the second survey. At a reasonable price based on 10 eggs, the response rate was the highest at 53.8% and 42.9% in both the first and second surveys and the appropriate price averages were 2,482 won and 2,132 won, respectively. The highest rate of purchase of egg consumers from 'Large Mart' followed by 'Medium sized supermarket' and 'Chain supermarket'. As for the awareness about animal welfare, the recognition ratio (73.5%) was higher in the result of the second survey than the first. The cognitive period of animal welfare was 59.0% before the insecticide egg crisis and 41.0% thereafter. Regarding whether or not they have ever seen an animal welfare certification mark and an animal welfare animal farm certification mark, 59.6% of respondents said that they saw it for the first time and 37.6% answered that they knew the animal welfare certification mark. On the animal welfare system, the 'free-range' response rate was the highest at 85.8%. The 'free-range' fit response decreased by 34.2%p, while the 'barn' and 'European type' fit response increased by 13.2%p and 24.1%p, respectively. The number of 'I have never seen' and 'I have ever eaten' responses to the recognition and eating experience of animal welfare certified eggs decreased while the number of those who answered 'Have ever seen' and 'Have eaten' increased. The answer of purchasing animal welfare certified eggs at department stores, organic farming cooperatives, and internet shopping malls was higher than that of buying conventional eggs. Of the total respondents, 92.0% were willing to purchase an animal welfare egg before the price was offered, but after offering the prices of animal welfare eggs, the intention to purchase was 62.7%, which was about 30%p lower than before. The reason for purchasing an animal welfare certified egg was the highest score of 71.0% for 'I think it is likely to be high in food safety', and 38.1% for 'I think the price is high' for lack of intention to purchase. In the sensory evaluation of animal welfare eggs, egg color and skin texture of conventional eggs were significantly higher than those of certified welfare eggs (P<0.05), and boiled eggs showed that egg whites of animal welfare certified eggs were more (P<0.05). As a result, the results of this study will contribute to the activation of the animal welfare certification system for laying hens by providing basic data on consumer awareness to animal welfare certified farmers.

Social division of labor in the traditional industry district - foursed on Damyang bamboo ware industry of Damyang and Yeoju pottery industry of Yeoju, South Korea (우리나라 재래공업 산지의 사회적 분업 - 담양죽제품과 여주 도자기 산지를 사례로 -)

  • ;;;Park, Yang-Choon;Lee, Chul-Woo;Park, Soon-Ho
    • Journal of the Korean Geographical Society
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    • v.30 no.3
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    • pp.269-295
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    • 1995
  • This research is concerned with the social division of labor within the traditional industry district: Damyang bamboo ware industry district and Yeoju pottery industry district in South Korea, Damyang bamboo ware and Yeoju pottery are well known of the Korean traditional industry. The social division of labor in an industry district is considered as an important factor. The social division of labor helps the traditional industry to survive today. This summary shows five significant points from the major findings. First, Damyang bamoo ware industry and Yoeju pottery industry have experienced the growth stages until 1945, the stagnation in the 1960s, and the business recovery in the 1980s. Most Korean traditional industries had been radically declined under the Japanese colonization; while, Damyang bamboo ware industry and Yeoju pottery industry district have been developed during above all stages. The extended market to Japan helped the local government to establish a training center, and to provide financial aids and technical aids to crafts men. During the 1960s and 1970s, mass production of substitute goods on factory system resulted in the decrease of demand of bamboo ware and pettery. During the 1980s, these industries have slowly recovered as a result of the increased income per capita. The high rate of economic growth in the 1960s and 1970s was playing an important role in the emerging the incleased demand of the bamboo ware and pottery. Second the production-and-marketing system in a traditional industry district became diversified to adjust the demand of products. In Damyang bamboo ware industry district, the level of social division of labor was low until the high economic development period. Bamboo ware were made by a farmer in a small domestic system, The bamboo goods were mainly sold in the periodic market of bamboo ware in Damyang. In the recession period in the 1960s and 1970s, the production-and-marketing system were diversified; a manufacturing-wholesale type business and small-factory type business became established; and the wholesale business and the export traders in the district appeared. In the recovery period in the 1980s, the production-and-marketing systems were more diversified; a small-factory type business started to depend On subcontractors for a part of process of production; and a wholesale business in the district engaged in production of bamboo ware. In Yeoju pottery industry district, the social division of labor was limited until the early 1970s. A pottery was made by a crafts man in a small-business of domestic system and sold by a middle man out of Yeoju. Since the late 1970s, production-and-marketing system become being diversified as a result of the increased demand in Japan and South Korea. In the 1970s, Korean traditional craft pottery was highiy demanded in Japan. The demand encouraged people in Yoeju to become craftsmen and/or to work in the pottery related occupation. In South Korea, the rapid economic growth resulted in incline to pottery due to the development of stainless and plastic bowls and dishes. The production facilities were modernized to provide pottery at the reasonable price. A small-busineas of domestic system was transformed into a small-factory type business. The social division of labor was intensified in the pottery production-and-maketing system. The manufacturing kaoline began to be seperated from the production process of pottery. Within the district, a pottery wholesale business and a retail business started to be established in the 1980s. Third the traditional industry district was divided into "completed one" and "not-completed one" according to whether or not the district firms led the function of the social division of labor. The Damyang bamboo ware industry district is "completed one": the firm within the district is in charge of the supply of raw material, the production and the marketing. In the Damyang bamboo ware district, the social division of labor w and reorganized labor system to improve the external economics effect through intensifying the social division of labor. Lastly, the social division of labor was playing an important role in the development of traditional industry districts. The subdivision of production process and the diversification of business reduced the production cost and overcame the labor shortage through hiring low-waged workers such as family members, the old people and housewives. An enterpriser with small amount of capital easily joined into the business. The risk from business recession were dispersed. The accumulated know-how in the production and maketing provided flexiblility to produce various goods and to extend the life-cycly of a product.d the life-cycly of a product.

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The Effects of Functional Tea (Mori Folium, Lycii Fructus, Chrysanthemi Flos, Zizyphi Fructus, Sesamum Semen, Raphani Semen) Supplement with Medical Nutrition Therapy on the Blood Lipid Levels and Antioxidant Status in Subjects with Hyperlipidemia (고지혈증 환자에서 의학영양치료와 병행하여 섭취한 기능성차(상엽, 구기자, 국화, 대추, 참깨, 나복자)의 혈중 지질 농도 저하 및 항산화 효과)

  • Lim, Hyun-Jung;Cho, Kum-Ho;Choue, Ryowon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.1
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    • pp.42-56
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    • 2005
  • Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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A Study on Risk Factors for Early Major Morbidity and Mortality in Multiple-valve Operations (중복판막수술후 조기성적에 영향을 미치는 인자에 관한 연구)

  • 한일용;조용길;황윤호;조광현
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.233-241
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    • 1998
  • To define the risk factors affecting the early major morbidity and mortality after multiple- valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9$\pm$11.5(mean$\pm$SD) years. Using the New York Heart Association(NYHA) classification, 41 patients(33.1%) were in functional class II, 60(48.4%) in class III, and 20(16.1%) in class IV preoperatively. Seven patients(5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients(61.3%), a history of cerebral embolism in 5(4.0%), and left atrial thrombus in 13(10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57(46.0%) of combined mitral valve replacement(MVR) and aortic valve replacement(AVR), 48(38.7%) of combined MVR and tricuspid annuloplasty(TVA), 12(9.7%) of combined MVR, AVR and TVA, 3(2.4%) of combined MVR and aortic valvuloplasty, 2(1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A(27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B(97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time(ACT, group A:153.4$\pm$42.4 minutes, group B:134.0$\pm$43.7 minutes, p=0.042), total bypass time(TBT, group A:187.4$\pm$65.5 minutes, group B:158.1$\pm$50.6 minutes, p=0.038), and NYHA functional class(I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death(n=10) and survivor(n=114), there were significant differences in age(early death:45.2$\pm$8.7 years, survivor:37.2$\pm$11.6 years, p=0.036), sex(female:12.7%, male:1.9%, p=0.043), ACT(early death:167.1$\pm$38.4 minutes, survivor:135.7$\pm$43.7 minutes, p=0.030), and NYHA functional class(I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.

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Community Residents' Knowledge, Attitude, and Needs for Hospice Care (일부 지역주민들의 호스피스에 대한 인지와 태도 및 간호요구 조사)

  • Ro, You-Ja;Han, Sung-Suk;Ahn, Sung-Hee;Yong, Jin-Sun
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.23-35
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    • 1999
  • Purpose : The hospice movement began about 30 years ago in Korea. However, basic studies have seldom been conducted about the general public's knowledge concerning hospice care and their needs for it. The purpose of this study was to investigate the general public's knowledge of and attitude toward hospice, and their needs for hospice care, and to analyze the needs for hospice care in relation to their knowledge and attitude in residents from a specific community. Methods : The survey was conducted with 924 people randomly selected from a district in Seoul. The data were collected through a self-reporting questionnaire constructed by the authors. With 30 items given in the questionnaire, the level of hospice needs showed Cronbach's alpha .89 in a pilot study and .92 in this study and the items were classified into four areas by a factor analysis. The data collected were analyzed by means of t-test and ANOVA. Results : 1) The average age of the respondents was 38. The majority of the respondents were well-educated. 2) Regarding awareness of hospice care, 54%(501 people) indicated they have heard of hospice. About 74% thought that people should be able to prepare for death in advance. About 83% wanted to be informed when they have life threatening illnesses such as terminal cancer. Also, about 63% responded that patients with terminal diseases should be provided with physical, spiritual, and psychological care for minimizing pain and peaceful death. Regarding the attitude toward hospice care, 74% responded that they would use hospice care if needed. The number of the respondents who preferred home visitation by the hospice team to care for the terminally ill ranked first with 34%. Concerning needs for hospice care : 1) By needs area, physical need showed highest mean(M=4.37), followed by social need(M=3.96), emotional need(M=3.87), and the spiritual need(M=3.79). The overall need level showed the mean value of 4.00 which reflects a considerable need for hospice care. 2) By demographic characteristics, people age over 50, the married, and the unemployed indicated higher level of needs for hospice care. Women showed higher level of needs than did men, and Catholics demonstrated higher level of needs than believers of other religion(P<0.0001). 3) As for the knowledge of and attitude toward hospice rare, the level of hospice care needs was significantly higher in the following groups: those who have heard of hospice, those who are aware of death preparation, those who want information on terminal diseases, those who want to use every method to sustain life, and those who are aware of hospice needs(P<0.001). Conclusion : It is assumed that the findings of this study on the knowledge, attitude, and needs for hospice care in the public can contribute to planning a successful hospice care program. Furthermore, the findings of this study will serve as useful data for the promotion of home hospice care to improve the quality of life of community residents, and contribute to the development of hospice care as a whole.

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Relationship between Glycated Hemoglobin and Depression, Anxiety, Alexithymia, Stress Response in Diabetic Patients - A Preliminary Study - (당뇨환자에서 당화혈색소와 관련된 우울, 불안, 감정표현불능, 스트레스반응 - 예비적 연구 -)

  • Jeong, Jong-Hyun;Ko, Seung-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.157-164
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    • 2004
  • Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress responses between well-controlled and poorly-controlled diabetic patients by glycated hemoglobin levels. Methods : The subjects were 55 diabetic patients(mean age : $49.9{\pm}9.9$, 27 men and 28 women) who were confirmed to have diabetes depending on the laboratory findings as well as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Aug. 2004. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on glycated hemoglobin levels, the patients were divided into 10 well-controlled group(below 7%) and 45 poorly-controlled group(above 7%). We compared BDI, STAI, TAS and SRI scores between two groups by independent t-test. Results 1) Well-controlled diabetics, compared with poorly controlled group, manifested decreased illness duration($12.2{\pm}55.4$months vs. $55.4{\pm}66.6 months)(p=0.000), but other demographic data showed no difference between two groups. 2) The STAI scores of poorly-controlled group were significantly higher in both state anxiety sores $(38.7{\pm}3.8 \;vs.\;43.7{\pm}6.7)(p=0.29)$ and trait anxiety scores$(36.9{\pm}5.7\;vs.\;41.5{\pm}6.4)(p=0.43)$ than well-controlled groups. 3) No significant differences were found in the score of BDI, TAS, SRI between well and poorly-controlled diabetic groups. Conclusion : The above results suggest that poorly-controlled diabetic patients are more likely to have higher anxiety level than well-controlled diabetic patients. However, there were no differences in depression, alexithymia, stress responses between two group. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetic patients.

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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A Case Study on Application of the Menu Engineering Technique in Government Offices Contract Foodservice (관공서급식소의 메뉴엔지니어링기법을 적용한 메뉴분석 사례연구)

  • Rho, Sung-Yoon
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.78-96
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    • 2009
  • The purpose of this study was to analyze and evaluate the menu served in government offices foodservice by using Kasavana & Smith's Menu-Engineering. Sales and food costs were collected from the daily sales reports for a year from Jan 2 to Dec 31 in 2007. Calculation for menu analysis and customer's data were done by computer using the MS 2003 Excel spreadsheet program and SPSS 12.0 package program. Menu mix% (MM%) and unit contribution margin were used as variables by Kasavana & Smith. Four possible classifications by Menu-Engineering technique were turned out as 'STAR', 'PLOWHORSE', 'PUZZLE', 'DOG'. The main menus served during a year were 128 dishes and about 141 peoples visited this restaurant daily. The mean age of the men was $44.1\;{\pm}\;6.3$, women were $32.7\;{\pm}\;6.4$ and showed that was statistically higher than that of women (p < .0001). The rates of STAR menus were 'Western style (75.0%)', 'guk/tang-ryu (48.1%)', 'jjigae/ jeongol-ryu (23.1%)', 'bap-ryu (17.2%)' in sequence. There were no STAR menus in gui/jorim/jjim-ryu. PLOWHORSE menus were 'gui-ryu (75.0%)', 'guk/tang-ryu (29.6%)', 'bap-ryu (27.6%)' in sequence. There were no PUZZLE or DOG menus in 'jjigae/jeongol-ryu'. PUZZLE menus were 'jorim/jjim-ryu and Myeonryu (each 33.3%)', 'bap-ryu (31.0%)' in sequence. PUZZLE menus were a lots of 'Chinese food (75.0%)' and 'myeonryu (55.6%)'. This study provides the basic data based on regularly menu analysis method applied the scientific menu analysis techniques in government offices food services, I'd like to suggest that the menu management must be done based on the necessity and result of menu analysis according to the seasonal and middle, long-term plans.