Park, Jong-Ho;Kim, Yoo-Mi;Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.4
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pp.1739-1750
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2012
This study was to develop the assessment of medical service outcome using administration data through compared with hospital standardized mortality ratios(HSMR) in various hospitals. This study analyzed 63,664 cases of Hospital Discharge Injury Data of 2007 and 2008, provided by Korea Centers for Disease Control and Prevention. We used data mining technique and compared decision tree and logistic regression for developing risk-adjustment model of in-hospital mortality. Our Analysis shows that gender, length of stay, Elixhauser comorbidity index, hospitalization path, and primary diagnosis are main variables which influence mortality ratio. By comparing hospital standardized mortality ratios(HSMR) with standardized variables, we found concrete differences (55.6-201.6) of hospital standardized mortality ratios(HSMR) among hospitals. This proves that there are quality-gaps of medical service among hospitals. This study outcome should be utilized more to achieve the improvement of the quality of medical service.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.12
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pp.381-393
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2016
This was a qualitative study to explore and better understand the adaptation experience and processes of peoples with fibromyalgia syndrome (FMS), as well as to develop a substantive theory using the grounded theory method. There were 13 patients (12 females and 1 male) who received FMS treatment from Rheumatic Medicine outpatient department of one general hospital. The data were collected through an in-depth interview between January and May of 2014. Transcribed interview contents were analyzed by the grounded theory method of Corbin and Strauss (2008). As a result, a total of 98 concepts, 26 sub-categories, and 10 categories were identified through the open coding process. The process of adaptation experience showed 4 steps: perception of uncertainty and limited condition, evaluation of self-control possibility and determinations of expectations of life, searching and trying of strategies, as well as self-regulation. The 4 types of adaptation experience were expansionary, complacently, effusively and withering. The 'protective self-regulation' theory was derived from the core category of 'learning to self-regulation method'. Patients with FMS has repeatedly attempted these strategies of protective self-regulation in order to gain stability from uncertainty and limited condition of the disease. Based on these results, it is necessary to develop an educational program for patients and families which has appropriate nursing intervention strategies in accordance with the types of adaptation.
Studies on pathogenicities and developmental stages of Nosema apis (Zander, 1909) were carried out through artificial infection to Nosema free honey bees with various levels of spores isolated from local honey bee colony. The results obtained were summarized as follows: 1. The clinical symptoms were observed as dysentery, enteritis of mid-gut (enlargement and decoloration), crawling posture and shortening of the longevity of worker bees in the rearing honey bee colony inoculated with the spores. 2. Number of spores harvested from laboratory rearing honey bees were progresively increased to 4 weeks after inoculation. The regression equations and coefficients of correlations to various spore levels were as follows in each treatment colony. Colony 1. ($$1,000{\times}10^4spores/ml$$) $$y_{c1}=471{\times}10^{4}x+454{\times}10^4(r=0.65^*$$) Colony 2. ($$500{\times}10^4spores/ml$$) $$y_{c2}=340{\times}10^{4}x+207.8{\times}10^4(r=0.99^{**}$$) Colony 3. ($$100{\times}10^4spores/ml$$) $$y_{c3}=150{\times}10^{4}x+84.2{\times}10^4(r=0.99^{**}$$) Colony 4. ($$10{\times}10^4spores/ml$$) $$y_{c4}=13.8{\times}10^{4}x+13{\times}10^4(r=0.98^{**}$$) 3. Average longevity of worker bees artificially infected with Nosema apis was shortened as 21.7~43.8% compare to the control. (p<.05, p<.01) 4. The spores which were isolated from honey bee colony infected with Nosema disease were ovoid or spherical form, and measured, as a rule, from $4.7{\mu}m$ to $6.1{\mu}m$ (mean $5.3{\mu}m$) in length and from $2.4{\mu}m$ to $3.2{\mu}m$ (mean $2.9{\mu}m$) in width. 5. In the mid-gut of honey bees, the spore was progresively germinated and became trophozoite stage. The trophozoites were grown to meronts and their binary fission were begun. The divided two sporoblasts were developed to the spores which had elastic membrane. The new spores were shed in excreta of honey bees 10~15 day after inoculation at $25{\pm}2$ centigrade. 6. The ultrastructure of spore membrane consisted of three layers, such as, outer, middle and inner layer. The sporoplasm consisting lamellar structure occupied only anterior part of the spore and was often extended to posterior direction where definite vacuoles and a polar filament was able to detect.
Background: Hepatocellular carcinoma (HCC) is a dreadful complication of end stage liver disease with high morbidity and mortality. Aim: The aim was to assess the role of serum talin-1 and non-invasive fibrosis in patients with HCC. Materials and Methods: A total of eighty seven subjects were enrolled, with 22 two healthy individuals as a control group (n=22), 22 patients in the cirrhosis group and finally 43 in the group with HCC diagnosed with positive triphasic CT abdomen criteria. Serum talin-1 and noninvasive fibrosis parameters were assessed in all subjects. Results: Compared to the cirrhosis group, patients with HCC had higher serum talin-1 ($32.9{\pm}12.6$ vs. $11.1{\pm}2.79ng/ml$), FIB4 ($9.96{\pm}15.3$ vs. $2.90{\pm}1.87$) and $fibro-{\alpha}$ ($10.9{\pm}18.1$ vs. $1.55{\pm}0.28$) but not fibrosis index scores ($4.47{\pm}0.95$ vs. $4.98{\pm}0.96$; p=0.046). Patients with large focal lesions (${\geq}5cm$) had different ALBI scores ($-1.02{\pm}0.63$ vs. $-1.72{\pm}0.59$; p=0.001) serum talin-1 ($9.72{\pm}13.81$ vs. $28.6{\pm}38.89ng/ml$; p=0.007) and fibrosis index scores ($0.85{\pm}0.99$ vs. $4.20{\pm}4.85$; p=0.026). No statistical differences were noted between patients with and without portal vein thrombosis. For detection of HCC, serum talin-1 had 97.7% sensitivity and 100% specificity with a 17.2 ng/ml cutoff. AFP at a 13.7 ng/ml cutoff had 72.1% sensitivity and 6.3.6% specificity. The cutoff for the $fibro-{\alpha}$ score was 1.61 with 81.4% sensitivity and 77.3% specificity. Serum talin-1 (odds=1.08; C.I=1.016-1.150; p=0.014), fibrosis index score (odds=2.35; C.I=1.055-5.217; p=0.037) and the ALBI score (odds=6.9; C.I=1.924-24.708; p=0.003) were predictors of large focal lesions. Conclusions: Serum talin-1, AST/ALT ratio, $fibro-{\alpha}$ score are useful for the assessment of HCC patients.
The study is designed to grasp school adminstrators' attitudes toward school health education and practices of school health education and to analyse relationships between characteristics of school administators and their attitudes to school health education and between their attitudes and practices of school health education in elementary and secondary schools, so that it may offer the basic materials for improving the school health education. This study was obtained from 740 school administrators all over the country, who have attended Certification Training of Elementary and Secondary Principal opened at Korea National University of Education from July, 1, 1991 to August 9, 1991. The results are summarized as follows: 1. School administrators' attitudes toward school health education 1) As for view of health education, those who believed that health is the means of education was 36.2%. 2) In methods of school health, those who want regular health education was 75% ; irregular health education 25%. 3) As for attitudes of those chose irregular health education as teaching methods : (1) In teaching hours, the morning and afternoon class meetings was highest 50.8% of whole. (2) In teaching staffs, home room teacher was 51.9% ; school nurse 34.8%. (3) In frequency of irregular health education, 1-2 times a week was 38%, 1-2 times a month 32.6%, 1-2 times a semester 11.8%. (4) As for teaching methods of irregular health education, practice through the health function showed higher frequency than other methods 4) As for attitudes of those chose regular health education as teaching methods : (1) Most of respondents had opinion that regular health education should be carried out by the subject of physical education in both elemetary and secondary schools. (2) Opinion that school nurse should be in charge of regular health education was a little higher than other ones. (3) More than a half of the whole thought that 1-2 hours a month was suitable for carrying out regular health education. (4) Therr-fourth of those who wanted regular health education chose the using of audiovisual material as a teching method. (5) Curriculum recommended first by respondents for the school health education were personal habits and health, prevention and control of disease, mental and emotional health etc. (6) As for impedimental factors in the development of school health education, it was shown as following order : the lack of professional health education instructors, the lack of budget and administrative support, the lack of instructional materials and instruments etc.
Kang, Ha Ra;Kim, Sung Yoon;Cha, Hyo Hyun;An, Young Min;Park, In Ah;Kang, Hae Ji;Eun, Byung Wook
Pediatric Infection and Vaccine
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v.22
no.1
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pp.1-6
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2015
Purpose: This study investigated an outbreak of mumps affecting students in a high school (S high school) in Seoul, with an evaluation of the diagnostic utility of the mumps polymerase chain reaction (PCR) assay. Methods: S high school students that presented to health care providers with mumps symptoms between April 2013 and July 2013 were surveyed for the monthly distribution of symptom onset and their grade level. Mumps PCR assays were performed using buccal swabs from some of these students. Results: During the survey period, 77 students presented with suspected cases of mumps. The monthly distribution of symptom onset was as follows: one in April, 17 in May, 54 in June, and five in July. With regard to grade level, 26 students were in their first year, 28 were in their second year, and 23 were in their third year. Of the 18 students tested with PCR assays, five had positive results. Samples were collected within 3 days of symptom onset in 15 of the 18 students, and positive PCR results were obtained in five of these 15 students. The PCR results of the remaining three students from whom samples were collected more than 3 days after the onset of symptoms were negative (P=0.24). Conclusions: We evaluated the epidemiological aspects of an outbreak of mumps in a high school. Mumps PCR might be epidemiologically useful if performed within 3 days of the onset of symptoms in suspected cases.
Equine coital exanthema caused by equine herpesvirus type 3 (EHV-3) is a venereal disease which seriously drops horse reproduction rates. Here, we isolated EHV-3 from infected horses and investigated their biological characteristics. Initial cytopathic effects such as rounding of cells were detected 48 hours post infection of the virus into RK-13 cells. The infected cells were going to detach from the surface of culture flasks 72 hours post infection. The type of isolated viruses from swabbed samples was EHV-3 by PCR analysis. Glycoprotein G (gG) of isolated EHV-3 has a 99.25 percent similarity rate to that of EHV-3 334/74 control strain. The isolated EHV-3 was named Georo strain. Georo strain consisted of four major proteins including 145 kD, 60 kD, 45 kD and 40 kD, as shown by SDS-PAGE analysis. We hope the newly isolated Georo strain of EHV-3 can be used for studying various aspects of Korean equine coital exanthema.
Background: College students are recommended as the target groups for catch-up human papillomavirus (HPV) vaccination. Systematical exploration of awareness, acceptability, and decision-making factors of HPV vaccination among Chinese college students has been limited. Materials and Methods: A multi-center survey was conducted in mainland China between November 2011 and May 2012. College students aged 18-22 years were stratified by their grade, gender, and major for sampling. Socio-demographic and HPV-related information such as knowledge, perceptions, acceptability, and attitudes were collected through a questionnaire. Results: A total of 3,497 undergraduates completed the questionnaire, among which 1,686 were males. The acceptability of the HPV vaccine was high (70.8%). Undergraduates from high-level universities, at lower grade, or with greater prior knowledge of HPV vaccines showed higher acceptability of HPV vaccination ($p_{trend}$ <0.001). Additionally, undergraduates with vaccination experience outside the National Expanded Program on Immunization (OR=1.29; 95%CI: 1.10-1.51) or fear of HPV-related diseases (OR=2.79; 95%CI: 2.28-3.41) were more willing to accept HPV vaccination. General knowledge of HPV vaccine was low among undergraduates, and safety was a major concern (71.05%). The majority of students wished to pay less than 300RMB for HPV vaccine and chose the Chinese Center for Disease Control and Prevention as the most appropriate venue for vaccination. Conclusions: Although most undergraduates demonstrate positive attitudes towards HPV vaccination, challenges pertaining to introduction exist in China. Corresponding proactive education and governmental subsidy to do so are urgently needed by this age-group population. Suggestions and potential strategies indicated may help shape the future HPV vaccination program in China.
Ultrasonography is non-invasive and can give useful clues in the diagnosis of cervical lymphadenopathy, However, differential diagnosis is difficult in some situations even combined with color Doppler imaging. The present study was conducted to evaluate the clinical value of real time elastography in patients with unexplained cervical lymphadenopathy using a quantitative method. From May 2011 to February 2012, 39 enlarged lymph nodes from 39 patients with unexplained cervical lymphadenopathy were assessed. All the patients were examined by both B-mode ultrasound, color Doppler flow imaging and elastography. The method of analyzing elasto-graphic data was the calculation of the 10 parametres ("mean", "sd", "area%", "com", "kur", "ske", "con", "ent", "idm", "asm") offered by the software integrated into the Hitachi system. The findings were then correlated with the definitive tissue diagnosis obtained by lymph node dissection or biopsy. Final histology revealed 10 cases of metastatic lymph nodes, 11 cases of lymphoma, 12 cases of tuberculosis and 6 cases of nonspecific lymphadenitis. The significant distinguishing features for conventional ultrasound were the maximum short diameter (p=0.007) and absent of echogenic hilum (p=0.0293). The diagnostic accuracy was 43.6% (17/39 cases) and there were 17 patients with equivocal diagnosis. For elastography, "mean" (p=0.003), "area%" (p=0.009), "kurt" (p=0.0291), "skew" (p=0.014) and "cont" (p=0.012) demonstrated significant differences between groups. With 9 of the 17 patients with previous equivocal diagnoses (52.9%) definite and correct diagnoses could be obtained. The diagnostic accuracy for conventional ultrasound combined elastography was 69.2% (27/39 cases). There were differences in the diagnostic sensitivity of the two methods (p=0.0224). Ultrasound combined with elastography demonstrated higher rates of conclusive and accurate diagnoses in patients with unexplained cervical lymphadenopathy than conventional ultrasound. The quantitative program showed good correlation with the pathology of different lymph node diseases.
Objectives: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. Methods: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. Results: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually na$\ddot{i}$ve women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. Conclusions: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.
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