• Korean Journal of Digital Imaging in Medicine
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• v.12 no.2
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• pp.97-101
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• 2010

This experimental study is carried out one of the General Hospital in Kyungbok providence. Abdomen Phantom being located Anterior-posterior(AP) position on portable bed, and the portable X-ray generating device was placed the phantom at $-90^{\circ}$ direction. The experiment were set 65 kVp, 10 mAs, $10{\times}10\;cm^2$, 100 cm(FOD) for the measurement. Digital proportional counting tube survey meter was used for measuring the space scatter dose. Measurement points of horizontal distribution was set up at $30^{\circ}$ interval by increasing 50 cm radius of upside, downside, left and right. Vertical distribution of measurement points were set up for the vertical plane with a radius of at $30^{\circ}$ intervals with 50cm increments. It is concluded that longer distance from the soure of X-ray significantly decrease radiation dose to the patient and use of the radiation protection device should be applied in clinical practice to reduce dose to the patient.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.619-627
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• 2017

Objectives: The purpose of this case study is to report the effect of oriental medicine on pressure ulcers. Methods: We treated a patient with a pressure ulcer with acupuncture, Jaungo, and Gamisipjeon-tang. We started with herbal medicine only, and then added the acupuncture treatment after one month. We treated the sore for a total of 4 months. We measured the size and depth of the ulcer and graded it with a National Pressure Ulcer Advisory Panel (NPUAP) score once every two weeks. Results & Conclusions: Even though the wound was not cured completely, the total size of the pressure ulcer was reduced and the NPUAP stage was improved from 4 to 3. Therefore, Korean medicine could be an effective treatment for improving pressure ulcers.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.864-867
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• 2006

Percutaneous suture closure device is known as relatively safe and convenient tool, which can decrease not only bed rest period of patient but also time consuming effort of manual compression of doctor after femoral artery puncture. However[C1], there are also some reports on complication of its use. We report a 62-year-old male patient who had femoral artery endarteritis[0] with pseudoaneurysm as a complication of percutaneous suture closure device after percutaneous coronary angiography[C2]. He was treated successfully by appropriate antibiotics and vessel reconstruction using autologous saphenous vein patch.

• Health Policy and Management
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• v.10 no.4
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• pp.75-98
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• 2000

This study applied Data Envelopment Analysis(DEA) and Ratio Analysis and Regression Analysis to a set of Korean Public Corporation Medical Centers to evaluate their relative human resource efficiencies. The output measure used in this study was based on health insurance system which was used in both in-patient departments and out-patient departments. Inputs included working time of the doctors, nurses, technicians, and managerial department staff. Based on the data provided on the inputs and outputs, the analysis showed 23 of the 34 hospitals to be relatively inefficient. Each hospital with an efficiency rating of less than 1 was considered relatively inefficient. In addition, managerial strategies based on dual variables were constructed to indicate the manner In which inefficient hospitals may be made efficient. A subsequent analysis of t-test revealed that the bed occupancy rate, medical revenue per 100beds, value added revenue per staff, medical revenue per staff were statistically significant. The results of this study suggest the DEA is a promising tool for evaluating relative human resource efficiency in hospitals which have multiple inputs and outputs and where the efficient production function is not specifiable with any precision. But it is considered that efficiency evaluations may be most effective]y accomplished by Incorporating a combination of methodologies such as ratio analysis and regression analysis.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.14-23
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• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.489-493
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• 1994

Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.6
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• pp.2958-2965
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• 2013

Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.96-108
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• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• The Journal of the Korea Contents Association
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• v.13 no.8
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• pp.314-323
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• 2013

This study analyzed the relationship between the level of hospital caseloads and length of stay for the delivery patients. The differences of hospital caseloads were measured by the Internal Herfindahl Index, which measured the concentration of delivery patient in a hospital. And the structure variables of hospitals such as the number of bed, the number of treatment, and the number of doctors and nurses per 100 beds were included as control variables. And average length of stay of delivery patients was used as the dependent variable. Concentration status of delivery patients was measured in two models: (1) first model represents the concentration level of delivery patient in all hospital patients, (2) second model represents the concentration level of delivery patient in all obstetrics and gynecology patients. In regression analysis, patient concentration index was not statistically significant in explaining the variation of average length of stay in two models. But the number of delivery patients and number of beds were statistically significant. The number of delivery patient variable showed negative regression coefficient with average length of stay and the number of beds showed positive coefficient with average length of stay. This study result indicated that the volume of delivery patients in a hospital will play a significant role in reducing the length of stay of delivery patients. Patient volume could contribute in improving the efficiency of patient care in a hospital.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.