• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.169-208
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• 2016

"Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.338-342
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• 1994

Pulmonary clearance of Tc-99m-DTPA(PCD) has been used for the measurement of polmonary epithelial permeability. It has been reported to be increased not only in variety of polmonary diseases including ARDS, interstitial fibrosis, and smokers, but also in normal subjects on positive end expiratory pressure respirator, or after exercise. It was also noted that decrease of pulmonary blood flow due to pulmonary arterial obstruction results in delayed PCD. Normal range of PCD varies with institutes. We prospectively measured PCD in 17 normals (5 males and 12 females) consisted of staffs and trainees in the department of radiology of Kangnam St. Mary's hospital using original Bark Nebulizer (India). Age ranged from 32 to 43 years. 370 MBq of Tc-99m-DTPA was inhaled in supine position and supine posterior images were subsequently obtained with 1 min/frame, $64{\times}64$ matrix and word mode for 30min. Regions of interest were set on each lung, whole lungs, and upper, middle and lower thirds of right lung, respectively. Best fit regression curve was obtained by least square method from initial 7min after peak activity on each curve and time for half clearance of maximum activity (t1/2) was calculated. Mean t1/2 was $51{\pm}11.2min$ for whole lung. There was no significant difference between t1/ 2 of right and left lungs. Initial uptake was higher in the lower third and t1/2 was shorter in the lower third than in the upper third(P<0.05). We reviewed several reports on PCD and compared our data with the others. In this study, faster clearance in the lower third may be due to the position imaged with or the environment the subjects belong to, and further investigation is under way.

• Journal of Korea Water Resources Association
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• v.51 no.4
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• pp.347-354
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• 2018

In urban areas, runoff flow is drained through sewer networks as well as surface areas. Therefore, it is very important to consider sewer networks as a component of hydrological drainage processes when conducting urban inundation modelling. However, most researchers who have implemented urban inundation/flood modelling, instinctively simplified the sewer networks without the appropriate criteria. In this research, a 1D-2D fully coupled urban inundation model is applied to estimate the influence of sewer network simplification on urban inundation modelling based on the dendritic network classification. The one-dimensional (1D) sewerage system analysis model, which was introduced by Lee et al. (2017), is used to simulate inlet and overflow phenomena by interacting with surface flow. Two-dimensional (2D) unstructured meshes are also applied to simulate surface flow and are combined with the 1D sewerage analysis model. Sewer network pipes are simplified based on the dendritic network classification method, namely the second and third order, and all cases of pipes are conducted as a control group. Each classified network case, including a control group, is evaluated through their application to the 27 July 2011 extreme rainfall event, which caused severe inundation damages in the Sadang area in Seoul, South Korea. All cases are compared together regarding inundation area, inflow discharge and overflow discharge. Finally, relevant criterion for the simplification method is recommended.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.205-211
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• 2012

Purpose: This study was performed to identify the level of stress perceived by nurses who attend dying patients in the cancer care unit; their understanding regarding end-of-life care and related training needs. Methods: A cross-sectional descriptive study was conducted with 151 nurses stationed at the cancer care units of four general hospitals located in Seoul and Gyeonggi province in Korea. Data were collected using self-reported questionnaires and the response rate was 96%. The data were analyzed using t-test, ANOVA and Pearson's correlation analysis. SPSS 12.0 was used for data analysis. Results: Nurses experienced a high level of stress in the end-of-life care settings. Their understanding of end-of-life care was above the mid-point of the scale while their training needs for end-of-life care was relatively high. The more experienced the nurses were, the more stressed they were, particularly due to excessive workload. Nurses who served longer in the cancer unit tended to show greater needs for end-of-life care training. Conclusion: This study found nurses perform end-of-life care with a high level of stress but with insufficient understanding, and thus, showed great needs for related training. Such findings can be useful to develop an end-of-life care training program for nurses.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.220-227
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• 2009

Purpose: The purpose of the study was to investigate how much understand about artificial hydration in patients with terminal cancer, according to the subject groups, including patients, families, and general public. Methods: Data were collected from June 2007 to December 2007 and the participants included 22 hospitalized patients in the hospice unit of S Hospital, 100 families, and 101 participants who participated in a hospice education program for the general public. The questionnaire was developed through literature review, interview with patients' families, and expertise consultation. Data were analyzed using descriptive statistics with an SAS program. Results: Understanding of artificial hydration among patients, families and general public was examined from three perspectives. From an ethical perspective, 'if you receive artificial hydration, you can live longer', 45.5%, 63%, and 52.4% of the above three groups, respectively, answered "yes". From an emotional perspective, 'artificial hydration must be provided', 81.8%, 70% and 58.4%, respectively, agreed. From a cultural perspective, 'if artificial hydration is not provided for the patient, the families will feel painful', 95.5%, 83%, and 88.2%, respectively, answered "yes". Conclusion: This study found the differences in understanding of artificial hydration among patients, families and general public, and also found that less than 50 percent of the participants understood artificial hydration appropriately. We suggest, therefore, that patients' understanding about artificial hydration should be determined in the clinical setting and then followed by individualized education according to given medical situations.

• Journal of Digital Convergence
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• v.14 no.4
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• pp.285-294
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• 2016

The purpose of this research study is to analyze the influence on the necessity of establishment of eco-friendly hospital by evaluating hospital employees' awareness and their satisfaction level of working environment. Questionnaire investigation was conducted in April 2014 throughout five different medium-size hospitals in Seoul, Gyeonggi and Chungcheongbuk provinces. 213 sets of survey were used to conduct Frequency Analysis, T-test, Dispersion Analysis(ANOVA) and Structural Equation Modeling Analysis. The research concluded that employees with higher level of education, working position and longer term of working experience were more aware about Eco-friendly hospital. In addition, male, doctor, and employees with higher level of education and working position were more satisfied with their working environment. And male, employees with higher level of education and working position were more aware about necessity of establishment of eco-friendly hospital. According to the Structural Equation Modeling Analysis, the awareness of Eco-friendly hospital and the satisfaction level of working environment were the varying factors that influence the necessity of establishment of Eco-friendly hospital. Therefore, it is crucial for hospitals that are preparing for establishing Eco-friendly hospital to raise employees' level of understanding of Eco-friendly hospital and their working environment satisfaction level.

• Korea Journal of Hospital Management
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• v.11 no.1
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• pp.31-53
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• 2006

The objective of this study is to examine the effectiveness of the strategy of hospital specialization by analyzing the differences in expected and perceived services, perceived service quality, satisfaction, and intentions to revisit and recommend the hospital to others between general and specialty hospitals. Data were collected using self-administered questionnaire from patients admitted to four study hospitals: two speciality and two general hospitals. The questionnaire was developed based on SERVQUAL to measure five dimensions of service quality. Four hundreds questionnaires were distributed to inpatients or their guardians and 282 returned questionnaires were used in the analyses. The significance of the differences in study variables between specialty and general hospitals were tested by t-test and $x^2$-test. The factor analysis result confirmed the construct validity of 28 questions asked to measure service quality and resulted in four dimensions of service quality: reliability, assurance, tangible and empathy/responsiveness. Cronbach's Alpha ranged from .9013 to .9358, that confirmed the internal consistency of answers. The study results indicated that patients who used specialty hospitals had higher levels of expected and perceived service, a higher level of perceived service quality, and higher levels of service satisfaction than patients who used general hospitals. Percents of patients who had the intention to revisit the hospital and to recommend the hospital to others were higher among patients in specialty hospitals. The most frequent reason to choose the hospital was the excellence of doctors in both general(29.9%) and specialty(43.8%) hospitals, that was followed by convenient transportation(15.3%) and someone know works at the hospital(15.3%) in general hospitals and other's recommendation(14.6%), and nice amenities(13.1%) in specialty hospitals. Although there were no significant differences in clinical department, age, and sex of patients between general and specialty hospitals, patients who visited speciality hospitals had higher levels of education and income than their counter part in general hospitals. These results suggested that specialty hospitals performed better than general hospitals. Specialization could be a viable strategy to tide over recent financial difficulties experienced by hospitals, particularly small- and medium-sized hospitals.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.124-130
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• 2007

In the present study, I investigated the effects of N-methyl-D-aspartate (NMDA), arachidonic acid (AA), and Nitric Oxide Synthase Inhibitor (NOSI), alone or in combination, on the proliferation of cultured primary normal human oral keratinocytes (NHOK). The purpose of this study was therefore the preliminary study for the examination of the interaction between these agents and NHOK in order to elucidate the mechanisms by which epithelial growth and regeneration are regulated. NHOK were obtained from gingival tissue of 20 individuals aged 20 to 29, and third passage (P3) cells were used for this study. The DNA synthesis was measured by the BrdU assay. Addition of low concentration of AA ($1{\mu}M$) and high concentration of AA with NMDA group (NMDA+AA $10{\mu}M$) made DNA synthesis rate increase significantly at the early stage. Adding NNA ($10{\mu}M$) affected DNA synthesis rate to increase significantly in 4 hours. At the early stage, DNA synthesis was significantly active in the NOS-I with NMDA groups than in the control and the NMDA-only group, while it didn't become statistically meaningful in 24 hours. AA $1{\mu}M$ and NNA $10{\mu}M$ may induce the proliferation of the NHOK independently and NOS-I may induce the proliferation of the NHOK with NMDA. These reactions might be related to the NMDA receptor in the cell and the change of the intracellular calcium ion concentration.

• The Journal of Korean Academic Society of Nursing Education
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• v.8 no.1
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• pp.155-166
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• 2002

This study was performed to figure out the level of anxiety and relating factors of ICU patients as the hospitalization in ICU grows more recently. Data collection was conducted from July 1st to August 31st, 2001. The subjects of this study were consisted of 101 ICU patients who were selected according to the criteria in S hospital, C city. The instruments of the research were consisted of 14 questions of general characteristics, 20 items of STAI, VAS, 24 questions for the anxiety relating factors. And data were analyzed by t-test, ANOVA, and pearson correlation for group difference and correlation with SPSS Win 10.0 program. The followings were the results of the study: 1. In the anxiety level, mean score on STAI was 53.7(item mean $2.69{\pm}.83$), and mean score on VAS was 5.23. It means that the anxiety level of ICU patients was moderate. 2. Among the relating factors of anxiety, the most highest scores were 'by seeing other patient's emergency situation' and 'by seeing other patient's death' figured 3.85 and 3.79 each. And the lowest marks were 'by the unkind behavior of doctors and nurses'(2.13) and 'nurses' or doctors' indifferent actions'(2.21). And the anxiety according to the environmental factor was the highest (3.17) and the anxiety regarding to the human relationship was the lowest (2.53). 3. In the anxiety level STAI according to the general characteristics, the patients who didn't have to take care of their family showed more anxiety than who had to take care of their family(t=-2.38, p=.02). And the variables that shows a significant difference on VAS was sex and women's anxiety was higher than men's level (t=-2.56, p=.01). 4. When the physical anxiety level was compared, the patients who had to take care of their family showed more anxiety than the people who didn't have to take care of their family(t=-1.95, p=.05). In the level of anxiety relating the human relationship, the patients who had religion showed more anxiety than patients who didn't(t=2.43 p=.02). And the married patients(t=2.43, p=.01) and more educated people(F=3.77, p=.01) showed more anxiety. Even though environmental anxiety was the highest factor, it was not significant with general characteristics. 5. The anxiety and relating factors showed positive significant relationship, and physical anxiety factor showed the strongest relation with STAI(r=.21, p<.01). And VAS level showed stronger relation with every factor of the anxiety than STAI. When the VAS level became higher, the anxiety relating to physical factor(r=.72, p<.01), human relationship(r=.63, P<.01), and environment became higher. According to the above result, the environmental anxiety was the highest level than other factors in ICU patient and thus the environmental nursing intervention becomes very important in ICU. Also nurses in ICU have to support the patients who showed higher level of anxiety in this study and try to develop the nursing intervention to relieve the anxiety of patients. And it is recommended that VAS is convenient and practical instrument for measuring the anxiety level in ICU patients.