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An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

Regional Variations in the Cesarean Section Rate and It's Determinants in Korea (제왕절개 분만율의 지역간 변이와 관련요인에 대한 연구)

  • Kim, Hye-Kyung;Lee, Jeon-Un;Park, Kang-Won;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.3 s.39
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    • pp.312-329
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    • 1992
  • The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.

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The Nature of the Tomb Form and the Group Tomb Complex of the Wooden Chamber Tombs with Stone Mound in the Early Silla Phase (신라 전기 적석목곽분의 묘형과 집단복합묘군의 성격)

  • Choi, Byung-Hyun
    • Korean Journal of Heritage: History & Science
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    • v.50 no.4
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    • pp.168-197
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    • 2017
  • This paper considers two aspects of the wooden chamber tombs with stone mound that were constructed in Wolseong North Burial Ground, in Gyeongju: tomb form and the group tomb complex. The basic unit of a wooden chamber tomb with stone mound consisted of a single round mound, covered with an additional earthen layer and surrounded by a circle of protective stones, within which a single wooden chamber was located. The form of a wooden chamber tomb with stone mound could therefore 1) be round, consisting of a single tomb unit, 2) consist of two or more attached tomb units, 3) or consist of multiple attached chambers in a single mound. The single tomb contained the burial of a single individual, and the attached tomb contained two or more individuals who were blood relations or connected by marriage. Multiple attached chambers tombs usually consisted of wooden chamber burials of the lowest rank, and have only been identified in the royal burial area of Wolseong North Burial Ground. At the Jjoksaem Area of Wolseong North Burial Ground, which is currently, under investigation, tombs have been found in small clusters along the slightly raised ground. This is likely the result of small groups of kin relations, upon selecting points along the slightly raised ground as their burial area, having constructed midsized and large single tombs and attached tombs along the axis of the slightly raised ground, which were then surrounded by smaller 'satellite' tombs. It is through this process that the tomb complex of the different groups came to be formed. The tombs of the royal burial area of Wolseong North Burial Ground, including the Daereungwon Tomb Complex, also formed group tomb complexes. Forming the centers of the group tomb complexes of the royal tomb area were huge individual round tombs where the Maripgan rulers were laid to rest or a gourd-shaped dual mound tomb, which was the final resting place of the king and his queen consort. These central tombs were surrounded by large and smaller tombs. Of the individuals that were buried in the group tomb complexes, there would have been individuals that were of equal status or social position, such as husbands and wives or blood relations, but it is unlikely that all of the buried individuals were related by blood, given the significant difference in the sizes of the tombs. It is likely that the individuals buried in the lower ranked tombs included in the group tomb complexes were 'dependents' of the deceased of the central tomb and his or her direct family who maintained a subservient relationship. Such tomb forms and group tomb complexes that can be observed amongst the wooden chamber tombs with stone mounds of Wolseong North Burial Ground provide insights into the nature of the social groups of the Silla center during the Maripgan Period. It is hoped that future studies undertaking a more detailed analysis of the data may make further contributions to unveiling the various aspects of Silla society.

A Study on Needs of the Families of Head Injury Patients (두부 손상환자 가족의 간호요구에 대한 연구)

  • Cho Gyoo-Yeong;Park Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.414-433
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    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

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Agricultural Policies and Geographical Specialization of Farming in England (영국의 농업정책이 지리적 전문화에 미친 영향 연구)

  • Kim, Ki-Hyuk
    • Journal of the Korean association of regional geographers
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    • v.5 no.1
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    • pp.101-120
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    • 1999
  • The purpose of this study is to analyze the impact of agricultural polices on the change of regional structure based on the specialization during the productivism period. Analysis are carried on through the comparison of distribution in 1950s and 1997. Since the 1950s, governmental policy has played a leading role in shaping the pattern of farming in Great Britain. The range of British measures have also been employed in an attempt to improve the efficiency of agriculture and raise farm income. Three fairly distinct phase can be identified in the developing relationship between government policies and British agriculture in the postwar period. In the 1st phase, The Agricultural Act of 1947 laid the foundations for agricultural productivism in Great Britain until membership of the EC. This was to be achieved through the system of price support and guaranteed prices and the means of a series of grants and subsidies. Guaranteed prices encouraged farmenrs to intensify production and specialize in either cereal farming or milk-beef enterprise. The former favoured eastern areas, whereas the latter favoured western areas. Various grants and subsidies were made available to farmers during this period, again as a way of increasing efficiency and farm incomes. Many policies, such as Calf Subsidy and the Ploughing Grant, Hill cow and Hill Sheep Schemes and the Hill Farming and Livestock Rearing Grant was provided. Some of these policies favoured western uplands, whilst the others was biased towards the Lake District. Concentration of farms occured especially in near the London Metropolitan Area and south part of Scotland. In the 2nd stage after the membership of EC, very high guaranteed price created a relatively risk-free environment, so farmers intensified production and levels of self-sufficiency for most agriculture risen considerably. As farmers were being paid high prices for as much as they could produce, the policy favoured areas of larger-scale farming in eastern Britain. As a result of increasing regional disparities in agriculture, the CAP became more geographically sensitive in 1975 with the setting up of the Less Favoured Areas(LFAs). But they are biased towards the larger farms, because such farms have more crops and/or livestock, but small farms with low incomes are in most need of support. Specialization of cereals such wheat and barely was occured, but these two cereal crops have experienced rather different trend since 1950s. Under the CAP, farmers have been paid higher guaranteed prices for wheat than for barely because of the relative shortage of wheat in the EC. And more barely were cultivated as feedstuffs for livestock by home-grown cereals. In the 1950s dairying was already declining in what was to become the arable areas of southern and eastern England. By the mid-1980s, the pastral core had maintained its dominance, but the pastoral periphery had easily surpassed arable England as the second most important dairying district. Pig farming had become increasingly concentrated in intensive units in the main cereal areas of eastern England. These results show that the measure of agricultural policy induced the concentration and specialization implicitly. Measures for increasing demand, reducing supply or raising farm incomes are favoured by large scale farming. And price support induced specialization of farming. And technology for specialization are diffused and induced geographical specialization. This is the process of change of regional structure through the specialization.

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Complication and Failure Analysis of Endodontically Treated Teeth Restored with Post and Cores (포스트로 수복한 근관 치료된 치아의 임상적 상태에 대한 평가)

  • Yun, Mi-Jung;Kim, Mu-Hyon;Jeong, Chang-Mo;Huh, Jung-Bo;Jeon, Yeong-Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.359-370
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    • 2012
  • The endodontically treated tooth is generally restored with post and core, owing to the brittle and the loss of large amount of tooth structure. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 101 individuals (aged 30-89, 66 women and 35 men loaded with 125 fixed prostheses) who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between January 1990 to December 2005 were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $9.7{\pm}3.4$ years (mean), 11.1 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 3. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in anterio-posterior combination region (median:9.2 years). 4. Longevity of fixed prostheses made of base metal ceramic(median:12.0 years) and noble metal ceramic (median:11.3 years) is long (P<.05). 5. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 7. Dental caries, periapical disease, tooth fracture were frequent complications. In 51.9% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

A Short-Term Study of the Effects of UDCA on Gingival Inflammation in the Beagle Dog (우로수데옥시콜릭산이 치주질환 억제에 미치는 영향)

  • Park, Sang-Hyun;Han, Seoung-Min;Choi, Sang-Mook;Ku, Young;Rhyu, In-Chul;Han, Soo-Boo;Lee, Hak-Mo;Kim, Moon-Moo;Kim, Sang-Nyun;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.29 no.1
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    • pp.1-14
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    • 1999
  • Ursodeoxycholic acid(UDCA) is a hydrophilic gall bladder acid and has been used as a effective drug for liver disease related to in1munity. This drug inhibits secretions of IL-2, IL-4, and $IFN-{\gamma}$ from T-cells and production of immunoglobulin from B-cells. Also it has been reported that UDCA inhibits production of IL-1 related to the progression of periodontal disease and activation of collagenases. The purpose of the present study was to elucidate the effects of UDCA on inhibition of periodontal disease progression using clinical, microbiological and histometrical parameters. Twelve pure bred, 16 month-old-beagle dogs were used in the study. After ligature-induced periodontal diseases were formed, experimental drugs were applied twice a day and then the results of clinical, microbiological, and histometrical parameters were measured at baselie(initiation of experiment) , 4weeks and 8weeks. The gel with UDCA(concentration 0.5%, 5% 3 dogs in each) was applied to experimental group, chlorhexidine to positive control group(3dogs) and the gel without UDCA(base) to negative control group. After induction of general anesthesia, the maxillary 2nd, 3rd premolars and 1st molar and the mandibular 2nd, 3rd, 4th premolars and 1st molar were ligated in one side selected randomly and were not ligated in the opposite side. The plaque index(PI), gingival index(GI), pocket depth(PD) and gingival crevicular fluid(GCF) volum were measured clinically. The PI and GI were measured at 3 buccal points of all experimental teeth and the GCF was measured only at the 3rd premolar in the maxilla and the 4th premolar in the mandible. In the microbiological study, the samples extracted from the 3rd premolar of the maxilla and the 4th premolar of the mandible at the center of buccal surface were analyzed aerobics, anaerobics and Streptococcus colony forming units, After clinical and microbiological examination at 8weeks, the dogs were sacrificed by carotid artery perfusion. The samples were fixed and sectioned including interproximal area, and the distance from cementoenamel junction(CEJ) to alveolar crest was measured. The results were that PI, GI and PD increased until 4 weeks and decreased at 8 weeks in three groups but the differences between all the groups were not significant. The 0.5% UDCA in non-ligated group showed remarkable decrease of GCF. The experimental group applied 5% UDCA decreased the number of aerobics and anaerobics. The distance from CEJ to alveolar crest was greater in the negative control group on both ligated and non-ligated sides, but the differences were not significant stastically.

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Influence of porcelain re-firing on the formation of surface bubble and on the change in shade of metal-ceramic crown exposed to artificial saliva (인공타액에 노출되었던 금속도재관의 재소성이 색조와 표면기포 형성에 미치는 영향에 관한 연구)

  • Park, Ji-Hyun;Yeo, In-Sung;Kim, Sung-Hun;Han, Jung-Suk;Lee, Jai-Bong;Yang, Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.2
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    • pp.161-167
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    • 2011
  • Purpose: The purpose of this study was to evaluate the influence of porcelain re-firing on the formation of surface bubble and on the change in shade of metal-ceramic crown exposed to artificial saliva. Materials and methods: Thirty disk-shaped specimens were made in 10 mm diameter with 0.5 mm metal core thickness and 1 mm ceramic thickness. A spectroradiometer was used to determine the CIE Lab coordinates. The number and size of surface bubble were observed with a stereomicroscope. After the exposure to artificial saliva for 7 days, re-firing was performed at glazing temperature. After re-firing, the CIE Lab were calculated, and the number and size of surface bubble were observed again. The change in shade was expressed with ${\Delta}E$. Statistical analysis was done with paired t-test for the change in the number of surface bubble and student t-test for the change in the size of surface bubble (${\alpha$}=0.05). Results: Shade difference was calculated 2.14 ${\Delta}E$ units. The mean number of surface bubble was $1.33{\pm}1.49$ before re-firing, $3.27{\pm}2.90$ after re-firing. After re-firing, the number of surface bubble was significantly increased (P<.05). The mean size of surface bubble was $81.97{\pm}32.03\;{\mu}m$ before re-firing, $142.94{\pm}47.40\;{\mu}m$ after re-firing. After re-firing, the size of surface bubble was significantly increased (P<.05). Conclusion: Shade change after re-firing was perceptible (${\Delta}E$ < 2.0) and clinically acceptable (${\Delta}E$ < 3.7). The number and size of surface bubble was significantly increased after re-firing. Further investigation to decrease the surface bubble on the extra oral repair of metal-ceramic crown, will be needed in future study.

Complication and Failure Analysis of Fixed Restorations (고정성 보철물과 연관된 합병증과 실패에 관한 조사)

  • Yun, Mi-Jung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.149-159
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    • 2011
  • Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complication of fixed prostheses was found in the mouth of patient. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 154 individuals (aged 22-82, 88 women and 66 men loaded with 578 unit of fixed prostheses, and 423 abutments) who visited the Department of Prosthodontics, Pusan National University Hospital, between January 2009 to December 2009 and removed old fixed prostheses were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $10.3{\pm}05.5$ years (mean), 10.0 years (median). 2. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was high in anterior-posterior combination region (mean:13.1, median:13.5) than anterior and posterior region. 3. Longevity of fixed prostheses made of metal was longest (mean:13.3, median:12.3). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 5. Condition of opposing dentition was found to have statistically significant influence on longevity of fixed prostheses (P>.05). The fixed prostheses lasted longest when opposed by complete denture (mean:17.1, median:19.7), removable partial denture, fixed prosthesis and natural dentition trailing behind (P<.05) 6. Periodontal disease (37.5%), dental caries (19.0%), defective margin (18.4%) were frequent complications. In 33.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

Comparison of the Legislation Applicable to Compare the use of Diagnostic Radiation Devices (진단용 방사선발생장치 이용에 적용되는 법제의 비교)

  • Ko, Jong-Kyung;Jeon, Yeo-Ryeong;Han, Eun-Ok;Cho, Pyong-Kon;Kim, Yong-Min
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.277-286
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    • 2015
  • Diagnostic radiation devices that is used in the country has reached to 78,000 units. When used for human subjects diagnostic purposes, it is subject to Medical Service Act, when used in diagnostic purposes in animal subjects, the subject to Veterinarians Act. When used for other purposes are subject to the Nuclear Safety Act. Even the same radiation devices varies the legislation that is applied depending on the intended use and object. Diversified been p rovisions a re necessary compared to t he analysis o f l egal content in o rder t o prevent confusion of the legislation is a matter to be applied. It is a qualitative study that Nuclear Safety Act, Medical Service Act and Veterinarians Act administrative procedures for the introduction of the applied diagnostic radiation devices, safety inspection, human resources management, area management and the content related to administrative punishment. The Nuclear Safety Act sub-provisions, the introduction of diagnostic radiation generating devices, there are many complex and complete requirements administrative procedures on the concept of a permit. Inspection of safety associated with the use, would be subject to periodic inspection auditing characteristics over the entire field of radiation safety management. It must receive court regular education for the safety administrator and workers. Unlike the reference of the radiation dose rate to specify the radiation controlled area there is a measurement obligation of radiation dose rate. Unlike the reference of the radiation dose rate to specify the radiation controlled area there is a measurement obligation of radiation dose rate. Quantitative difference of administrative punishment that is imposed when legislation violation has reached up to 10 times, over the entire field, the largest burden of radiation safety management at the time of application of the Nuclear Safety Act sub provisions. And it is applied differently depending on the purpose and the imaging target using the same diagnostic radiation devices. Depending on the use mainly under the current legal system, radiation can be lacking in fairness of the contents of the legislation for safety management, there is a risk of confusion. Alternatives such as centralized and standardization of legislation by diagnostic radiation devices use is expected to be necessary.