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The Accuracy of Tuberculosis Notification Reports at a Private General Hospital after Enforcement of New Korean Tuberculosis Surveillance System (새로운 국가결핵감시체계 시행 후 한 민간종합병원에서 작성된 결핵정보관리보고서의 정확도 조사)

  • Kim, Cheol Hong;Koh, Won-Jung;Kwon, O Jung;Ahn, Young Mee;Lim, Seong Young;An, Chang Hyeok;Youn, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.178-190
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    • 2003
  • Background : The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. Materials and Methods : 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. Results : In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. Conclusion : Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.

The Role of Ballooning in Patients with Post-tuberculosis Bronchial Stenosis

  • Kwon, Yong Soo;Kim, Hojoong;Kang, Kyung Woo;Koh, Won Jung;Suh, Gee Young;Chung, Man Pyo;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.431-436
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    • 2009
  • Background: In order to access the role of ballooning in patients with post-tuberculosis bronchial stenosis (PTBS), medical records of patients who underwent the procedure were reviewed. Methods: Twenty-nine PTBS patients underwent balloon dilatation between May 1999 and November 2000 at Samsung Medical Center. The median age was 28 (range 16~62 year) and most patients were female (n=27, 93%). The mean number of ballooning procedures was 2.4 (range 1~8) and the interval between ballooning procedures was 76.2$\pm$69.7 days. Results: In general, the $FEV_1$ was improved after ballooning (from 66.2.$\pm$11.9% predicted to 73.5$\pm$13.0% predicted, p=0.0004). Among 29 patients who underwent ballooning, a clinically successful outcome was observed in 16 patients (55%). Comparison between the successful and unsuccessful groups showed that favorable factors for a successful outcome were a higher pre-9ballooning $FEV_1$ (71.1$\pm$8.1 vs. 60.2$\pm$13.3% predicted), higher post-9ballooning $FEV_1$ (89.2$\pm$7.8 vs. 63.4$\pm$9.2% predicted) and absence of left upper lobe collapse. The clinical outcome was unsuccessful in all eight patients with a pre-9ballooning $FEV_1$ $\leq$57% of predicted or with complete left upper lobe collapse. Conclusion: In conclusion, ballooning appears to be helpful in patients with PTBS, especially when the pre-ballooning $FEV_1$ >57% of predicted and there is no complete left upper lobe lung collapse.

Diagnostic Performance of Radial Probe Endobronchial Ultrasound without a Guide-Sheath and the Feasibility of Molecular Analysis

  • Moon, Seong Mi;Choe, Junsu;Jeong, Byeong-Ho;Um, Sang-Won;Kim, Hojoong;Kwon, O Jung;Lee, Kyungjong
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.319-327
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    • 2019
  • Background: Radial probe endobronchial ultrasound (R-EBUS), is effective for tissue diagnosis of lung lesions. We evaluated the diagnostic performance of R-EBUS both a guide-sheath and fluoroscopy and identified factors associated with accurate diagnosis. The feasibility of molecular and genetic testing, using specimens obtained by R-EBUS, was also investigated. Methods: The study retrospectively reviewed 211 patients undergoing R-EBUS without a guide-sheath and fluoroscopy, June 2016-May 2017. After excluding 27 patients of which the target lesion was not reached, 184 were finally included. Multivariate logistic regression was used, to identify factors associated with accurate diagnosis. Results: Among 184 patients, R-EBUS-guided biopsy diagnosed malignancy in 109 patients (59%). The remaining 75 patients (41%) with non-malignant results underwent additional work-ups, and 34 were diagnosed with malignancy. Based on final diagnosis, diagnostic accuracy was 80% (136/170), and sensitivity and specificity for malignancy were 76% (109/143) and 100% (27/27), respectively. In multivariate analysis, peripheral location (adjusted odds ratio [aOR], 3.925; 95% confidence interval [CI], 1.203-12.811; p=0.023), and central position of the probe (aOR, 2.435; 95% CI, 1.424-7.013; p=0.035), were associated with accurate diagnosis of malignancy. Molecular and genetic analyses were successful, in all but one case, with inadequate specimens. Conclusion: R-EBUS-guided biopsy without equipment, is effective for tissue diagnosis. Peripheral location and central position of the radial probe, were crucial for accurate diagnosis. Performance of molecular and genetic testing, using samples obtained by R-EBUS, was satisfactory.

The Art Therapy Experiences of Patients and Their Family Members in Hospice Palliative Care

  • Park, Sungeun;Song, Hyunjoo
    • Journal of Hospice and Palliative Care
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    • v.23 no.4
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    • pp.183-197
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    • 2020
  • Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

Development of oral brush and maintaining of oral hygiene (임상가를 위한 특집 3 - 구강솔의 발달과 구강위생관리의 고찰)

  • Park, Joon Bong
    • The Journal of the Korean dental association
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    • v.52 no.11
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    • pp.678-685
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    • 2014
  • The purpose of this article is reviewed the historical background and development of oral care devices in the ancient civilization. Through an evolutional process of oral care devices, the prevalence of periodontal diseases and dental caries has revealed decreasing tendency. Because of the changing the role of the toothbrush, the name of brush should be alter from toothbrush to oral brush. Recent we can apply toothbrush to tongue cleaner to diminish the oral breathe odor. Selection of the toothbrush for fittable for each and every person is the one of important point to maintain the oral hygiene. including check-up the oral hygiene status after toothbrush with disclosing solution. This review of literature suggest that the most important way to maintain the oral health shoul be included the selection of proper toothbrush for each person and confirmation of result of toothbrush in oral cavity after had learned tooth brush instruction from professional person.

A Study about Change of Body Weight and Body Composition during Early Puerperium (산욕 초기 산모의 체중 및 체성분 변화에 대한 연구)

  • Park, Jang-Kyung;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.4
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    • pp.95-108
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    • 2010
  • Purpose: This study was to investigate the correlation among body weight, body composition, delivery method, parity, weight gain during pregnancy and obesity before pregnancy of patients who received postpartum care in one oriental medicine hospital. Mothods: From September 1, 2009 to August 31, 2008, we included 34 postpartum patients who had body composition analysis when admission and discharge among 47 postpartum patients who were hospitalized and received postpartum care in $\bigcirc\bigcirc$ University $\bigcirc\bigcirc$ Hospital. We used SPSS 14.0 for window to test for statistical significance. Results: After postpartum care, body weight and BMI of mothers was significantly decreased and the weight loss was almost body water. Mothers who had cesarean section had relatively severe edema and mothers who had been overweight before pregnancy had high BMI, body fat and abdominal fat. After delivery, body fat percentage was increased highly and body weight retention lasted long in mothers who had gained over 12.5kg during pregnancy. Conclusion: Living habits including diet has a significant effect on weight change of mothers during early puerperium, therefore it is required to teach mothers about breast-feeding, diet, and exercise to help their weight return to normal.

Effects of a Face-to-face Self-management Program on Knowledge, Self-care Practice and Kidney Function in Patients with Chronic Kidney Disease before the Renal Replacement Therapy

  • Choi, Eun Sung;Lee, Jia
    • Journal of Korean Academy of Nursing
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    • v.42 no.7
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    • pp.1070-1078
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    • 2012
  • Purpose: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. Methods: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. Results: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. Conclusion: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

CT Findings of Perforation of the Stomach after Ingestion of Glacial Acetic Acid (빙초산 음독 후 발생한 위천공: CT 소견을 중심으로)

  • Kim, Hohyun;Yeom, Seok Ran;Cho, Hyun Min;Yeo, Kwang-Hee;Kim, Jae-Hun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.161-164
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    • 2018
  • The ingestion of corrosive substances often leads to severe morbidity and mortality. Acids produce coagulation necrosis with a lesser degree of penetration, whereas alkalis produce liquefactive necrosis with penetration. Acetic acid is a clear, colorless organic acid with a pungent, vinegar-like odor. The ingestion of highly concentrated acetic acid (glacial acetic acid) may cause a range of complications. On the other hand, perforation of the stomach is extremely rare but it has a high mortality rate. This paper reports a case of perforation of the stomach after the ingestion of glacial acetic acid with suicidal intent in an otherwise healthy 76-year-old woman.

Unplanned Extubation in Patients with Mechanical Ventilation: Experience in the Medical Intensive Care Unit of a Single Tertiary Hospital

  • Lee, Tae Won;Hong, Jeong Woo;Yoo, Jung-Wan;Ju, Sunmi;Lee, Seung Hun;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.336-340
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    • 2015
  • Background: Potentially harmful unplanned extubation (UE) may occur in patients on mechanical ventilation (MV) in an intensive care unit (ICU) setting. This study aimed to evaluate the clinical characteristics of UE and its impact on clinical outcomes in patients with MV in a medical ICU (MICU). Methods: We retrospectively evaluated MICU data prospectively collected between December 2011 and May 2014. Results: A total of 468 patients were admitted to the MICU, of whom 450 were on MV. Of the patients on MV, 30 (6.7%) experienced UE; 13 (43.3%) required reintubation after UE, whereas 17 (56.7%) did not require reintubation. Patients who required reintubation had a significantly longer MV duration and ICU stay than did those not requiring reintubation ($19.4{\pm}15.1days$ vs. $5.9{\pm}5.9days$ days and $18.1{\pm}14.2days$ vs. $7.1{\pm}6.5days$, respectively; p<0.05). In addition, mortality rate was significantly higher among patients requiring reintubation than among those not requiring reintubation (54.5% vs. 5.9%; p=0.007). These two groups of patients exhibited no significant differences, within 2 hours after UE, in the fraction of inspired oxygen, blood pressure, heart rate, respiratory rate, and pH. Conclusion: Although reintubation may not always be required in patients with UE, it is associated with a poor outcome after UE.

A Study on Service Quality and Customer Satisfaction in Nigerian Healthcare Sector

  • Potluri, Rajasekhara Mouly;Angiating, Gift
    • The Journal of Industrial Distribution & Business
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    • v.9 no.12
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    • pp.7-14
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    • 2018
  • Purpose - The core objective of the research is to explore the quality of services provided by the Nigerian health care sector that lead to know the satisfaction levels of the consumers. Research design, data, and methodology - After a meticulous literature review, the researchers administered a two part questionnaire to know the service gaps and satisfaction levels of the customers. The research carried out with a sample of 400 respondents but received only 150 responses from the residents around Adamawa state. The collected data was edited, coded, and analyzed with the SPSS latest version with the descriptive and inferential statistical tools. Results - Majority of the respondents expressed their discontentment over the responsiveness of the service providers when compared to tangibility and reliability quality variables. There is no relationship between the quality variable tangibility and overall satisfaction. Related to the overall satisfaction, 42 percent of respondents have neutral perspective indicated that they are either satisfied or dissatisfied as against the 43.3 percent of dissatisfied customers. Conclusions - This research proffers invaluable information to the entire Nigerian health-care sector to review their existing delivery of services to improve patient satisfaction. This research is first of its kind concentrated to know the quality of health-care services and customers overall satisfaction in Nigeria.