• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.297-306
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• 2022

Objective : Intracranial atypical meningiomas have a poor prognosis and high rates of recurrence. Moreover, up to one-third of the recurrences undergo high-grade transformation into malignant meningiomas. We aimed to investigate the clinical factors that can predict the propensity of malignant transformation from atypical to anaplastic meningiomas. Methods : Between 2001 and 2018, all patients with atypical meningioma, in whom the tumors had undergone malignant transformation to anaplastic meningioma, were included. The patients' medical records documenting the diagnosis of atypical meningioma prior to malignant transformation were reviewed to identify the predictors of transformation. The control group comprised 56 patients with atypical meningiomas who were first diagnosed between January 2017 and December 2018 and had no malignant transformation. Results : Nine patients in whom the atypical meningiomas underwent malignant transformation were included. The median time interval from diagnosis of atypical meningioma to malignant transformation was 19 months (range, 7-78). The study group showed a significant difference in heterogeneous enhancement (77.8% vs. 33.9%), bone invasion (55.6% vs. 12.5%), mitotic index (MI; 14.8±4.9 vs. 3.5±3.9), and Ki-67 index (20.7±13.9 vs. 9.5±7.1) compared with the control group. In multivariate analysis, increased MI (odds ratio, 1.436; 95% confidence interval, 1.127-1.900; p=0.004) was the only significant factor for predicting malignant transformation. Conclusion : An increased MI within atypical meningiomas might be used as a predictor of malignant transformation. Tumors at high risk for malignant transformation might require more attentive surveillance and management than other atypical meningiomas.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.605-609
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• 1991

The formation of postlaminectomy arteriovenous fistula is unusual and the rongeur during discectomy with resultant simultaneous damage to artery and vein is causative. The delay in diagnosis is particularly distressing. The presence of a palpable abdominal thrill or bruit with or without congestive heart failure should results in a high index of suspicion of this entity. Prompt recognition and surgical closure of the post-laminectomy arteriovenous iliac fistula are most important in successful management.

• Health Policy and Management
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• v.20 no.3
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• pp.21-35
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• 2010

This study examined the changes in the service mix of Korean hospitals in 6 metropolitan cities between 2003 and 2005, and assessed whether the sample hospitals exhibit consistent trend or chance variation in multiple years. Three measures of hospital service mix, focusing on the specialization of services, were applied: information theory index, internal Herfindahl index, and number of distinct diagnosis-related groups (DRGs) treated. National Health Insurance claims were used to calculate the indexes. Specialization indexes were calculated in each year, and then examined to identify the pattern over time. Kappa analysis was applied to assess the agreements of specialization score between two years after hospitals were categorized into 4 groups with quartiles. Kappa score showed that the service mix of hospitals were changed during the study years. Specialization scores were increased given the market structure for three years. Hospitals which showed higher or lower specialization scores than the average of the scores consistently classified into the same group. Specialization indexes showed relatively consistent pattern over 3 years, and such consistencies were evident for hospitals regardless of the specialization status. Policy makers can identify the degree of specialization with the indexes, and it could provide a picture of how hospital services were mixed and changed over time.

• Proceedings of the Safety Management and Science Conference
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• 2004.05a
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• pp.1-4
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• 2004

Need safety diagnostic indicator pointer that is objective as estimation basis to be scientific and manages systematically safety existing condition and level for city gas facilities. Safety diagnostic indicator pointer can divide by greatly two. One is management (Software) side that one that differ with mechanical (Hardware) side that handle laying stress on equipment connected with safety manages organization and management connected with safety. Weight appropriates according to specific gravity that relevant element occupies in facilities. To give so big value in particular element in grant of weight pays attention because break balance of whole guideline and should gives. Finally, efficient safety net may see effect before self-regulation inside by minimum target establishment by government and legal, systematic countermeasure establishment for this, strict law application and each business proprietor and though activity and user's active safety activity forms harmony properly.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1411-1426
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• 2000

A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.7-15
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• 2011

Osteoporosis in gastric cancer patients is often overlooked or even neglected despite its high prevalence in these patients. Considering that old age, malnutrition, chronic disease, chemotherapy, decreased body mass index and gastrectomy are independent risk factors for osteoporosis, it is reasonable that the prevalence of osteoporosis in gastric cancer patients would be high. Many surviving patients suffer from back pain and pathological fractures, which are related to osteoporosis. Fractures have obvious associated morbidities, negative impact on quality of life, and impose both direct and indirect costs. In the era of a >55.6% 5-year survival rate of gastric cancer and increased longevity in gastric cancer patients, it is very important to eliminate common sequelae such as osteoporosis. Fortunately, the diagnosis of osteoporosis is well established and many therapeutic agents have been shown to be effective and safe not only in postmenopausal females but also in elderly males. Recently, effective treatments of gastric cancer patients with osteoporosis using bisphosphonates, which are commonly used in postmenopausal woman, were reported.

• Korean Journal of Occupational Health Nursing
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• v.17 no.1
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• pp.86-95
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• 2008

Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

• Korean Journal of Agricultural Science
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• v.33 no.2
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• pp.179-193
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• 2006

Technical efficiency of semiforcing watermelon growers is 0.8248 on average, and distributed between 0.6744 and 0.9268. The result showed that semiforcing watermelon growers had by 18% of technical inefficiency and could be assumed that increasing technical efficiency could induce watermelon production more increase. Consequently, if growers' technical efficiency were improved while other environments were constant, watermelon production could be increased. Following the results from the inefficiency effect model, all assumption coefficient such as growers age etc, are significant at 10% level. Estimate of dispersion parameter ${\gamma}$ is 0.89, which confirms those differences between practical output and frontier output were derived from the technical efficiencies among growers. Differences of production system between high and low level growers in production efficiency were showed at side altitude, ventilation and heat-retaining in section of facilities and automation, soil test and calcium application in section of environment management, transplant preparation and duration of pollination in section of crop management and shipment place, sorting degree and management record analysis in section of business management respectively. As a result of analyzing consulting data by using standard diagnosis table of watermelon cultivation under structure which cultivated on semi-forced watermelon growers, gap between high and low level growers was 7.0 points in facility automation section, 7.1 points in environment section, 8.8 points in crop management section and 13.6 points in business management section, respectively, which were the biggest one among them. In case of excluding information-related items from the evaluation index of business management section, changes of business achievement are to occur. Therefore, it is recommended for us to review the standard diagnostic table of watermelon cultivation under structure by dividing evaluation index of management section into management and information.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.1
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• pp.9-17
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• 2004

The purpose of this study are to determine the proper radiographic measurements for hip deformity in spastic cerebral palsy patients, and the correlation of hip deformity with neurological involvement, ability of ambulation. Thirty children with cerebral palsy(22 males, 8 females) were evaluated by measurement of the migration index, acetabular index, center edge angle from bilateral hip APs(anterior posterior view). The result are as follows; 1. The incidence of hip dislocation, among the thirty children fifteen children were found to be dislocated, and more significantly high in non-walking group than in walking group(p<0.05) and in quadriplegia than in diplegia(p<0.05). 2. When compared to normal hip and dislocation hip, the migration index was significantly higher(p<0.01) and the center edge angle was lower in the dislocation hip than in the normal hip. 3. Correlation of radiological findings in right and left hip, the migration index and the center edge angle were highly correlated(p<0.01). We recommand regular intervals X-ray study for early diagnosis and management of hip dislocation in spastic cerebral palsy.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.38-47
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• 2015

Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ${\geq}60years$ who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.