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A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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Identification of Pre-pasteurization or Pre-irradiation Treatment in Frozen Crushed Garlic Commercially Available in Korean Market (시판 유통 중인 냉동 다진 마늘의 사전 살균 및 조사처리 여부 판별 모니터링)

  • Kim, Hyo-Young;Ahn, Jae-Jun;Kim, Gui-Ran;Jeong, Jin-Hwa;Park, Ki-Hwan;Kwon, Joong-Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.10
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    • pp.1673-1681
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    • 2013
  • Five different chopped frozen garlic products samples, three from Chinese and two from Korean origins being commercially available products in Korean market, were used to confirm their pre-pasteurization or pre-irradiation status by screening (direct epifluorescent filter technique/aerobic plate counts, DEFT/APC; electronic nose, E-nose; photostimulated luminescence, PSL) and identification (thermoluminescence, TL; electron spin resonance, ESR) techniques. Some parts of samples were gamma-irradiated at 1 kGy to be used as control samples in irradiation history identification. DEFT/APC and e-nose successfully showed distinct results between the domestic and imported samples. The PSL photon counts of all the unknown samples were less than 700 (negative), while most of 1 kGy-irradiated samples gave PSL photon counts more than 5,000 (positive). The domestic unknown samples produced the TL glow peaks after $300^{\circ}C$ or more, whereas the imported samples showed TL peaks at the range of $240{\sim}250^{\circ}C$. A clear TL glow peak was obtained from all irradiated samples at $150{\sim}250^{\circ}C$. The unknown samples of Chinese origin gave radiation-specific cellulose ESR signal that was not shown by domestic samples. A multiple step of applying the physical analytical methods is recommended for the effective identification of irradiation status on chopped frozen garlic products.

The Effect of Steroid Therapy in Patients with Late ARDS (후기 급성호흡곤란증후군환자에서 스테로이드의 사용 효과)

  • Huh, Jin Won;Lim, Chae-Man;Jegal, Yang-Jin;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Youn Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.376-384
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    • 2002
  • Background : The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is ${\geq}80%$. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit (MICU). Methods : Over a 3-year period, the medical records of 48 ARDS patients who had been on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the $8^{th}$ day of ARDS as first day of the study. Results : Initially, the groups had similar PF($PaO_2/FiO_2$) ratio, LIS, APACHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). Conclusion : Although the data of this study was retrospective and was not randomized, in order to improve the patient's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.

A Study on the Factors Related to the Cognitive Function and Depression Among the Elderly (일부지역 노인들의 인지기능과 우울에 관련된 요인에 관한 연구)

  • Shin, Cheol-Ho;Kim, Soo-Young;Lee, Young-Soo;Cho, Young-Chae;Lee, Tae-Yong;Lee, Dong-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.199-214
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    • 1996
  • To investigate the factors which affecting the cognitive function and depression of the 65 or more age group, the authors surveyed for the subjects in the region of Taejon and nearby Taejon area. 729 studied subjects were tested for cognitive function with MMSE and depression with GDS. The main results were followings; In the studied subjects, the rate of normal cognitive function was 56.8%, the rate of mildly impaired was 24.1% and the rate of severe impairment was 19.1%. The cognitive function level was closely related to the depression score. As the age increased, the cognitive function was more impaired. Sexual difference was also existed in the cognitive function level and the depression score. After adjusting the effect of age, the variables such as sex, marital status, education level, past job, instrumental ability of daily living, regular physical exercise, frequencies of going out the house, chest discomfort, visual and auditory disturbance, and dizziness had the significant relationship with cognitive function impairment. Among these variables instrumental ADL, age, visual disturbance, and sex showed statistical significance in the logistic regression model. In the multiple stepwise regression, the variables which had significant relationship to depression score were education level, frequencies of going out house, current job and house work activity, regular physical exercise, instrumental ADL, self-rated health and nutritional status, dimness, visual disturbance, and chest pain. In conclusion, main characteristics which had close relationship to the cognitive function and depression symptoms in the studied subjects were physical function and self rated health status.

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Alterations of Cerebral Blood Flow and Cerebrovascular Reserve in Patients with Chronic Traumatic Brain Injury Accompanying Deteriorated Intelligence (지능 저하를 동반한 두부외상 환자에서 뇌혈류 및 혈류예비능의 변화)

  • Song, Ho-Chun;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.183-198
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    • 2000
  • Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

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The Associated Factors with Xerostomia in Adults Aged 30 Years and Over (일부 만 30세 이상 성인에서 구강건조증 관련요인 분석)

  • Han, Hae-Seong;Kwon, Da-Ae;Kim, Ri-Na;Kim, Yu-Na;Lee, Gyeol-Hui;Lee, Na-Ram;Lee, Da-Jeong;Lee, Seung-Hui;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.62-70
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    • 2013
  • The aim of this study was to analyze factors related to xerostomia in adults aged 30 years and over. The data were analyzed using the t-test, one-way ANOVA and multiple linear regression analysis in the SPSS version 12.0 program. The results were as follow. 1. The respondents who were older than 51 years old, unemployed and had less than 3 million won of average monthly income were more aware of xerostomia (p<0.05). 2. The respondents who answered poor and moderate for their general and oral health and the group with duplicate medication and comorbidity were more aware of xerostomia (p<0.05). 3. The respondents that had problems in chewing, communication, ordinary activities and complained of pain discomfort and suffered from anxiety depression were more aware of xerostomia (p<0.001). 4. The respondents that answered frequent dryness on their skin, eyes, lips, and nasal mucosa were more aware of xerostomia (p<0.001). 5. Xerostomia showed highest correlation with quality of life ($\beta$=0.436) followed by the number of medications ($\beta$=0.239), sense of entire body dryness ($\beta$=0.200), feeling of hopelessness ($\beta$=0.160) and number of oral mucosa disease symptoms ($\beta$=0.099) (p<0.05). According to the results of the study, xerostomia may cause deterioration in quality of life. Thus, it is advised to improve the patient management system among dental professions to prevent various complications caused by xerostomia and conduct regular health education on the cause and management method of xerostomia.

Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

Prevalence of anatomical alar band (콧방울띠의 유병율)

  • Kim, Jung Suk;Kim, Cheol Soon;Cha, Jung Yul;Kim, Hee Jin;Hwang, Chung Ju
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.24 no.1
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    • pp.4-12
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    • 2015
  • Purpose: Due to the presence of various muscles around lips, variety of facial expression can be made and changes from aging process such as wrinkles can develop on the facial skin by the action of multiple muscles. In animals, skin and muscles are developed in the entire body. On contrast, they are well developed only in the face and just one is present in the neck and the palm. Alar band was defined as outer wrinkle formed by zygomaticus minor muscle, which is common in Koreans. This study aimed to investigate clinical prevalence of alar band. Materials & Methods: Subjects were chosen from 780 new patients who visited private clinic in Gyeonggi province for orthodontic treatment. Presence of alar band was examined from the smile extraoral photos. Correlation among skeletal form, lip protrusion, gender, and age were evaluated. Results: Prevalence of alar band was higher in women (27.9%) than in men (18.5%) with statistical significance (p<0.05). With respect to age, prevalence of alar band was 19.4% in age 0-9 y, 16.9% in age 10-19 y, 31.2% in age 20-29 y, 39.5% in age 30-39, 56.5% in age 40-49. Prevalence was gradually increased from patients in their 20s to patients in their 40s and statistical significance was found (p<0.001). Concerning SN_NP, prevalence was 26.2% in normodivergent facial type, 22.0% in hyperdivergent facial type, and 32.2% in hypodivergent facial type. Hypodivergent facial group had higher prevalence but statistical significance was not observed. Statistically significant difference was not found regarding upper lip. However, prevalence of the alar band was 26% in patients with normal lower lip, 14.7% in patients with pretruded lower lip, and 33.3% in retruded lower lip. The prevalence was higher in patients with retruded lower lip with statistical significance (p<0.05). Conclusions: 27.8% on previous anatomical study and this study showed 27.8% prevalence of alar band in clinical smile photographs. Clinical photograph study showed that alar band was more prominent in women, older people, and people with retruded lips with statistical significance. This will provide valuable diagnostic information for esthetic consideration.

Genomic selection through single-step genomic best linear unbiased prediction improves the accuracy of evaluation in Hanwoo cattle

  • Park, Mi Na;Alam, Mahboob;Kim, Sidong;Park, Byoungho;Lee, Seung Hwan;Lee, Sung Soo
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.10
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    • pp.1544-1557
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    • 2020
  • Objective: Genomic selection (GS) is becoming popular in animals' genetic development. We, therefore, investigated the single-step genomic best linear unbiased prediction (ssGBLUP) as tool for GS, and compared its efficacy with the traditional pedigree BLUP (pedBLUP) method. Methods: A total of 9,952 males born between 1997 and 2018 under Hanwoo proven-bull selection program was studied. We analyzed body weight at 12 months and carcass weight (kg), backfat thickness, eye muscle area, and marbling score traits. About 7,387 bulls were genotyped using Illumina 50K BeadChip Arrays. Multiple-trait animal model analyses were performed using BLUPF90 software programs. Breeding value accuracy was calculated using two methods: i) Pearson's correlation of genomic estimated breeding value (GEBV) with EBV of all animals (rM1) and ii) correlation using inverse of coefficient matrix from the mixed-model equations (rM2). Then, we compared these accuracies by overall population, info-type (PHEN, phenotyped-only; GEN, genotyped-only; and PH+GEN, phenotyped and genotyped), and bull-types (YBULL, young male calves; CBULL, young candidate bulls; and PBULL, proven bulls). Results: The rM1 estimates in the study were between 0.90 and 0.96 among five traits. The rM1 estimates varied slightly by population and info-type, but noticeably by bull-type for traits. Generally average rM2 estimates were much smaller than rM1 (pedBLUP, 0.40 to0.44; ssGBLUP, 0.41 to 0.45) at population level. However, rM2 from both BLUP models varied noticeably across info-types and bull-types. The ssGBLUP estimates of rM2 in PHEN, GEN, and PH+ GEN ranged between 0.51 and 0.63, 0.66 and 0.70, and 0.68 and 0.73, respectively. In YBULL, CBULL, and PBULL, the rM2 estimates ranged between 0.54 and 0.57, 0.55 and 0.62, and 0.70 and 0.74, respectively. The pedBLUP based rM2 estimates were also relatively lower than ssGBLUP estimates. At the population level, we found an increase in accuracy by 2.0% to 4.5% among traits. Traits in PHEN were least influenced by ssGBLUP (0% to 2.0%), whereas the highest positive changes were in GEN (8.1% to 10.7%). PH+GEN also showed 6.5% to 8.5% increase in accuracy by ssGBLUP. However, the highest improvements were found in bull-types (YBULL, 21% to 35.7%; CBULL, 3.3% to 9.3%; PBULL, 2.8% to 6.1%). Conclusion: A noticeable improvement by ssGBLUP was observed in this study. Findings of differential responses to ssGBLUP by various bulls could assist in better selection decision making as well. We, therefore, suggest that ssGBLUP could be used for GS in Hanwoo proven-bull evaluation program.

A Study on the Fashion Information Activities of Clothing Manufactures (의류제조업체의 패션 정보활동에 관한 연구)

  • 송미령
    • Journal of the Korean Society of Costume
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    • v.22
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    • pp.135-158
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    • 1994
  • The fashion industry of today is closely re-lated with the information activity. This study investigates now they take advantage of the fashion information by analysing some related fields including fashion design. Furthormore this study identify the factor which makes the design activity distinctive and predict and fu-ture trend in design. The purposes of this study through analysis are : to help find the way to facilitate the fashion industry and to develop the fashion merchandising in order to activate the re-cession of manufacturers and to improve competitiveness in the world market and to contribute to the academic achievement in the study of fashion merchandising. In the experimental approach the tasks of research are as follows: Research 1: The application of fashion infor-mation is discussed in terms of process and level. Research 2: The differences of the fashion design activities are captured on the basis of the characteristics of manufactures and fashion specialists and fashion information ac-tivities. The factors are identified which pre-dict and discriminate the results of fashion de-sign activities. The questionaire and interview were conduc-ted among women's clothing manufactures in Seoul and their fashion specialists in charge of merchandise development. The methods of survey were designed on the basis of theories developed so far and on he advice from the social scientists and fashion specialists. the methods were corrected and complemented through the 1st and 2nd preliminary investigations before their application For data analysis cronbach's a coefficient fre-quency percentage average standard devi-ation pearson's correlation coefficient were calculated and t-test F-test(ANOVA) Duncan's multiple range test regression and Discriminant analysis were conducted. The results of analysis throughout the experimen-tal studies were as follows: 1. The analysis of fashion in formation (1) the present application of information a. The source of information : Both the foreign and the domestic information came mostly from fashion journals magazines newspapers and other periodicals, the main source of market information was collected from the survey of popular items in recent years the data about the life-style of customers and their tastes for wearing were widely used as the information about consumers. b. The applicaton of information : The most widely used information was about fabrics. The foreign information was prefered on the whole. The domestic problems pointed out in this investgation were that the domestic journals showed the lack of specialty and the special organizations for fashion informatino were in urgent need. (2) The research of fashion information a. The various processes and levels of in-formation activities: Among the process of collection analysis and distribution the collec-tion process showed a good acheivement whereas the distribution whereas the distribution didn't. In levels of the systematic activities the acceptance of support and the utility of supported instruments the first indicated a high degree whereas the second showed lowest. b. The correlationship among subvariables : There was a significant correlation between the collection and the analysis process. The systematic activities revealed close relation-ship with the analysis process and the accept-ance of support with the distribution process. The close correlation was found between the utility of supported instruments and the analy-sis process. 2. The analysis of the fashion design activities (1) No significant differences were found in the design activities when the characteristics of companies were compared only. (2) According to the characteristics of fashion specialists the one with age experi-ence and high income showed rather good achievement but no significant differences were captured among sex department in charge title academic background education in abroad and field experience (3) The fashion information activities were strongly correlated with the design achieve-ment : The analysis process and the system-atic activity level had a great influence on the design activities. (4) In order to examine which cha-racteristics in (1-3) made it possible to pre-dct and discriminate the achievement in de-sign activities the Discriminant analysis was carried out. The results were as follows: the fashion information activities showed the highest discriminant rate. Next came the in-come level experience and age in that order Those four variables discrimated 37 from 50 who showed great achievement in design area (74%) and 51 from 83 in low achievement group (81%) Thus the total discriminant rate was 77.5%.

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