• Journal of Korean Society for Quality Management
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• v.39 no.3
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• pp.391-399
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• 2011

Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.684-687
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• 2002

Besides lung transplantation, pulmonary thromboembolectomy is the only effective therapeutic option for chronic thromboembolic pulmonary hypertension. It is however associated with a considerably high hospital mortality between 6.6 to 23%. Proper patient selection is critical when considering a patient for pulmonary thromboembolectomy. And It cannot be overemphasised that the key to the success of the operation is complete endarterectomy of the entire pulmonary arterial tree. We report that pulmonary thromboendarterectomy under total circulatory arrest was an effective and safe method in the surgical correction of the chronic thrornboernbolic pulmonary hypertension and enabled complete removal of superimposed peripheral organized thrombi in a good operative field.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.20-23
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• 2011

Penetrating injury and retained foreign substances in human body are the main causes of visiting to the emergency room. In hand, foreign substances are caused by trauma. The most common plant pieces, the glass fragments and metal fragments should occur in the order. Especially, it's hard to find fragments of plants and plastic materials because of their radiolucency. And although these fragments are removed, it's difficult to differentiated clearly whether residual foreign bodies are in human hand or not. This study reports the authors' experience in the treatment of a patient from whom he removed a residual tree thorn in the operating room. The thorn was found 4 weeks after the trauma by ultrasonography and then the patients' symptoms were improved.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.714-718
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• 1993

Tracheobronchopathia osteoplastica(TPO) is a rare disorder characterized by submucosal cartilaginous or bony projections into the tracheobronchial lumen with sparing of the posterior membranous portion of tracheobronchial tree. The etiology of TPO is still unknown. A 44-year-old male was admitted to Seoul Paik Hospital Inje University due to left chest pain for 10 days. On the past history he had sufferred from symptoms of bronchitis for several months. He showed radiologically massive pleural effusion in left lung field. Pleural biopsy revealed chronic pleuritis with hemorrhage. Bronchoscopic findings showed multiple intraluminal portruding nodule from just below the vocal cord to carina and both main bronchi. Pathology of bronchoscopic biopsy showed abnormal proliferation of atypical bony and carilagious nodules in the tracheal submucosa. We experianced a case of tracheobronchopathia osteoplastica involving the trachea and main bronchus in 44-year old male, associated with massive pleural effusion. This report is a case of TPO with review of literature.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.300-310
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• 2018

The purpose of this study is to compare the change of Well-Dying awareness and decision of university student before and after taking the course of death study. A questionnaire survey was conducted for university students 93 before education, 117 after education who participated in the Death Studies related lectures at Daejeon Metropolitan City for 15 weeks from August to December 2016. The general characteristics of survey are gender, age. grade, major, marriage condition, religion, family member living together and health status. Four items on the perception aspect of death, five items on the aspect of acceptance of death, seven items of death decision and twelve items for death education's interest and importance were configured as a reference scale. The statistical method carried out the chi-square test, the independent sample t-test, and the decision tree analysis. Based on the decision tree, At the time of preparation for death(cancer patient, terminal patient, etc.) and the elderly(65 years old or older), the education transition rate was 66.7%. But After education, 65.3% of the respondents were in adult, middle and high school, under elementary school, university, and graduate school, which showed a significant difference. Therefore we are looking for death education's effectiveness and setting directions for education's period and contents. the negative viewpoints and worries about the implementation of death education at elementary, middle and high schools and universities are resolved and the death education will positively affect the change of attitude of students.

• 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 Korean Academy of Nursing
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• v.39 no.4
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• pp.594-601
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• 2009

Purpose: The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS). Methods: A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records. Results: The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5$\leq$age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits. Conclusion: This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.97-102
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• 2004

Anomalous systemic arterial supply to the lung is a rare congenital anomaly. The lung supplied by the anomalus systemic artery has a normal bronchial tree, which is usually in the basal segment of the lung, especially in the left lung. Most of patients are asymptomatic, but the main clinical symptoms of this disease are hemoptysis and exertional dyspnea. CT is useful for the diagnosis and showed a retrocardiac nodular shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe. Surgery is indicated for all patients. Here we report a case of anomalous systemic arterial supply to normal basal segments of left lower lobe in a patient with hemoptysis with a review of the relevant literature.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.47-62
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• 2023

Purpose: We aimed to investigate the objective cutoff values of unstimulated flow rates (UFR) and stimulated salivary flow rates (SFR) in patients with xerostomia and to present an optimal machine learning model with a classification and regression tree (CART) for all ages. Materials and Methods: A total of 829 patients with oral diseases were enrolled (591 females; mean age, 59.29±16.40 years; 8~95 years old), 199 patients with xerostomia and 630 patients without xerostomia. Salivary and clinical characteristics were collected and analyzed. Result: Patients with xerostomia had significantly lower levels of UFR (0.29±0.22 vs. 0.41±0.24 ml/min) and SFR (1.12±0.55 vs. 1.39±0.94 ml/min) (P<0.001), respectively, compared to those with non-xerostomia. The presence of xerostomia had a significantly negative correlation with UFR (r=-0.603, P=0.002) and SFR (r=-0.301, P=0.017). In the diagnosis of xerostomia based on the CART algorithm, the presence of stomatitis, candidiasis, halitosis, psychiatric disorder, and hyperlipidemia were significant predictors for xerostomia, and the cutoff ranges for xerostomia for UFR and SFR were 0.03~0.18 ml/min and 0.85~1.6 ml/min, respectively. Conclusion: Xerostomia was correlated with decreases in UFR and SFR, and their cutoff values varied depending on the patient's underlying oral and systemic conditions.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1441-1476
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• 2021

The tracheobronchial tree is a system of airways that allows the passage of air to aerate the lungs and entire body. Several pathological conditions can affect this anatomical region. Multidetector CT (MDCT) helps identify and characterize various large airway diseases. Post-processing tools, such as virtual bronchoscopy and automatic lung analysis, can help enhance the performance of imaging studies. In this pictorial essay review, we provide imaging findings of various bronchial lesions manifested as wall thickening and endoluminal nodules on conventional MDCT and advanced image visualization and analysis.