• 대한불안의학회지
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• 제14권2호
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• pp.80-87
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• 2018

Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

• 대한불안의학회지
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• 제17권2호
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• pp.49-58
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• 2021

Objective : The purpose of this study was to investigate the longitudinal trajectories of life satisfaction, loneliness, and depression and to identify the factors that influence these trajectories in North Korean Defectors (NKD). Methods : NKD (n=300) who registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea, were recruited into this study. Life satisfaction, loneliness, and depression were assessed with self-report questionnaires over a period of 4 years (7 waves of data). Latent growth modeling was conducted to assess the changes in life satisfaction, loneliness, and depression. Results : Findings from both unconditional and conditional models (with gender, South Korea settlement age, household income, marital status, and PTSD at wave 1) indicated a linear increase in loneliness and depression, and a linear decrease in life satisfaction over the 4-year period. In the conditional model, gender predicted the intercept of life satisfaction and depression. In addition, PTSD predicted the intercept of life satisfaction, loneliness, and depression and slope of depression. Conclusion : Our finding suggests that the mental health of NKD tends to deteriorate over time after settling in South Korea. Therefore, continuous support is necessary for their successful adaptation to the South Korean Society.

• Radiation Oncology Journal
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• 제30권4호
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• pp.173-181
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• 2012

Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

• Radiation Oncology Journal
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• 제37권2호
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• pp.110-116
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• 2019

Purpose: This study aimed to identify prognostic factors for locoregional recurrence (LRR) in pT3N0 rectal cancer patients who were treated with surgery alone and had negative resection margin including circumferential resection margin (CRM) for optimal indication of adjuvant radiotherapy. Materials and Methods: We reviewed patients with pT3N0 rectal cancer who were treated via upfront surgery and had no other adjuvant treatment from January 2003 to December 2012. In total, 122 patients who had negative resection margin including negative CRM were included in the analysis. Results: The median follow-up period after surgery was 60 months (range, 3 to 161 months). During this time, 6 patients (4.9%) experienced LRR at the anastomotic site (4 patients), and regional lymphatic area (2 patients). The estimated 5-year rates of overall survival, recurrence-free survival, and LRR-free survival were 96.7%, 84.6%, and 94.0%, respectively. Multivariate analysis showed that level of tumor ≤5 cm was a significant prognostic factor for LRR-free survival (LRRFS) (p = 0.04; hazard ratio = 7.08; 95% confidence interval, 1.06-47.30). Patients with level of tumor ≤5 cm had an estimated 5-year LRRFS of 66.8%, which was much higher than 2.3% in patients with level of tumor >5 cm. There was no significant factor for recurrence-free survival or overall survival. Conclusion: In T3N0 rectal cancer, adjuvant chemoradiotherapy should be recommended in patients with level of tumor ≤5 cm for better local control. However, in patients with pT3N0 disease, negative resection margin, and level of tumor >5 cm, adjuvant chemoradiotherapy should be carefully suggested.

• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.211-220
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• 1991

Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health Insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women. premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, Proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

• 한국기록관리학회지
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• 제23권1호
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• pp.127-132
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• 2023

공공기관이자 의료기관인 인천광역시의료원의 특성을 반영하는 부서인 인천광역시의료원 임상연구윤리심의위원회(이하 IRB)는 2013년 설치되었으며, 의료원에서 시행된 연구의 윤리성을 심의·검증함으로써 연구자와 연구대상자를 보호하고 지역책임의료기관 역할 수행에 기여하고 있다. IRB는 지금까지 총 80여 건의 인간대상연구 및 인체유래물연구 계획을 검토하였으며, 현재 의료원장 직속의 독립된 처리과로 존재하고 있다. 본 고에서는 IRB 관련 기록물의 등록 및 보존, 기록관리기준표 및 관련 규정, 문서고의 정비에 관하여 설명하고, 기록물 공개와 활용, 분류에 있어 한계 및 개선 사항을 제시하고자 한다.

• 한국병원경영학회지
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• 제12권2호
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• pp.43-68
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• 2007

The administration of a regional public hospitals are expending from profit preference to publicity preference. The weight rate for a profitability and publicity of performance assessment has changed from 84:16 which was resulted by the assessment executed firstly in 1989 to 39:61 as resulted in 2004, the final assessment execution in 2005. Regional public hospitals are exerting and promoting a magnification in public sector to raise up the public-score. With comparison between publicity scores and profitability scores in original scores basis excluding weight rate, the publicity scores ranked higher than profitability scores although the latter was higher by 2002. However, for the administration performance of the regional public hospitals, the deficits increased 11 times from \92.6billion deficits with \460.3billion cost increased by 457% although income as \367.7billion increased by 394% comparing the last 2004 year to the first 1989 year for profit & loss statement of a regional public hospitals. There was analysis for the relation in yearly basis partitioning publicity and profitability for the assessment scores of the to regional public hospitals confirm the accumulated deficits of the hospitals like this attribute to the extension of public sector. The result showed that there was distinct plus relationship from 1999 although a minus relationship in general until 1997 except 1992 and there is a more plus relationship as approaching 2004. That is, it is hard to tell that the accumulated deficits increase of regional government medical center attributed to extension of public sector. On the contrary, the analysis showed the extension of public sector has a mutual relationship with uplift of profitability Meanwhile, it showed that operation cost rate and labor cost are the factors which influence a revenue & expenditure rate among the profitability index according to the results of relation analysis for the representative index of profitability and that of publicity.

• 보건행정학회지
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• 제26권4호
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• pp.373-381
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• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.

• Journal of Chest Surgery
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• 제44권1호
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• pp.32-38
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• 2011

Background: Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to evaluate the feasibility of VATS lobectomy for pathologic stage I NSCLC. Material and Methods: Between December 2003 and December 2007, 529 patients with pathologic stage I NSCLC underwent lobectomies (373 thoracotomy, 156 VATS). Patients in both groups were selected after being matched by age, gender and pathologic stage using propensity score method, to create two comparable groups: thoracotomy and VATS groups, and the overall survival, recurrence-free survival, complication and length of hospitalization were compared between these two groups. Results: After the patients were matched by age, gender and pathologic stage, 272 patients remained eligible for analysis, 136 in each group (mean age of 59.5 years; 70 men, 66 women; 80 stage IA, 56 stage IB). There was no statistical difference in other preoperative clinical characteristics between the two groups. No hospital mortality was observed in both groups. Overall 3-year survival rate was 97.4% in thoracotomy group and 96.6% in VATS groups (p=0.76). During the follow-up, 20 patients (14.7%) developed recurrence in thoracotomy group, including loco-regional recurrence in 7, distant metastasis in 13. In VATS group, 13 patients (9.6%) developed recurrence, including loco-regional recurrence in 4, distant metastasis in 9. Three-year recurrence-free survival rate was 81.8% in thoracotomy group and 85.3% in VATS groups (p=0.43). There was no significant difference in postoperative complications between thoracotomy and VATS groups (30 cases in 22 patients vs. 19 cases in 17 patients, p=0.65, odds ratio=1.19). The mean hospital stay of VATS group was 2 days shorter than that of thoracotomy group ($8.8{\pm}6.5$ days vs. $6.3{\pm}3.3$ days, p<0.05). Conclusion: VATS lobectomy for pathologic stage I lung cancer is a feasible operation with shorter hospitalization, while surgical outcome is comparable to thoracotomy lobectomy.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.29-39
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• 2013

Purpose: As emergency medical service fund is further expanded due to amendment of the law on emergency medical services in 2008, Korean government has prepared to intervene in a comprehensive manner to strengthen a trauma treatment system. As a result, it announced a master plan to establish a serious trauma treatment center in 16 areas across the nation. Therefore, this study has attempted to investigate the current status of the serious trauma treatment centers and suggest the goal and improvement plan of future serious trauma treatment centers. Methods: As of 2011, Korea operates 23 emergency cerebrovascular service centers, 23 emergency heart disease centers and 35 severe trauma treatment centers across the country. 12 emergency medical service centers have been chosen among the serious trauma treatment centers. Then, top six (6) centers chosen at Emergency Medical Institute Assessment 2011 by Ministry of Health and Welfare have been selected, and floor layout and spatial allocation by usage have been reviewed and analyzed. Results: Consequently, this study has investigated the spatial components, circulation layout and spatial allocation of a serious trauma treatment. For construction planning in consideration of the fundamental objectives and goal of emergency medical services, it is essential to allot spaces and select exact spatial components. It appears that it is necessary to design spaces for emergency medical services and come up with construction planning through appropriate spatial allocation.