• Title/Summary/Keyword: benefit groups

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Long Term Impact of Laparoscopic Assisted Distal Gastrectomy on Quality of Life (복강경 보조 원위 위 절제 환자의 장기적인 '삶의 질' 평가)

  • Kim, Dong-Won;Kim, Yong-Jin;Kim, Min-Ju;Cho, Kyu-Seok;Kim, Hyeong-Su;Lee, Mun-Su;Kim, Jae-Jun;Lee, Min-Hyeok;Mun, Cheol
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.213-218
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    • 2007
  • Purpose: Laparoscopy-assisted distal gastrectomy (LADG) is gaining wider acceptance for the treatment of early gastric cancer. However, firm evidence supporting the long-term outcome after LADG for gastric cancer is unknown. This study compared long-term quality of life after LADG versus an open distal gastrectomy (ODG) for early gastric cancer. Methods: This study included 29 patients who underwent LADG and 57 patients who underwent ODG for the treatment of stage I gastric cancer. Quality of life was evaluated based on the Korean version of EORTC QLQ-C30 (version 3.0) and EORTC QLQ-STO22 one year after surgery. All patients underwent a Billroth II gastrectomy for stage I gastric cancer between January 2003 and December 2004. Results: A total of 86 (58%) out of 154 patients responded to the questionnaire. Demographic features showed no difference between the two groups of patients for age, sex, depth of invasion, lymph node metastasis except for tumor size and the number of retrieved lymph nodes. The mean score for global health status was not statistically different (LADG, $60.3{\pm}20.4$ vs ODG, $57{\pm}20.6$; P=0.413). The total score of 21 items related to stomach cancer (EORTC QLQ-STO22) also was not statistically different (LADG, $68.9{\pm}64.9$ vs ODG, $94.5{\pm}97.3$; P=0.340). Conclusion: Based on the results of the Korean version of EORTC QLQ-C 30 (version 3.0) and EORTC. QLQ-STO22, LADG does not seem to have any long-term benefit over ODG on 'quality of life'.

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A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs (첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구)

  • Park Yong-Sin;Cho Byung-Hee;Kim Ho;Lee Si-Baek
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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A STUDY ON MICROLEAKAGE OF PREVENTIVE RESIN RESTORATION (예방적 레진수복의 미세누출에 관한 연구)

  • Koo, Hyun-Jung;Lee, Sang-Hoon;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.504-511
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    • 2001
  • Preventive resin restoration, extended concept of occlusal pit and fissure sealing, is procedure composed of as follows. Cavity preparation is limited to areas of initial caries The cavity is then restored with composite resin, while other sound pits and fissures are sealed with pit and fissure sealant. If pit and assure sealant with which microrestoration is possible is used, it may be of great benefit to both patient and operator in case of difficult-to-control children s treatment. However study on preventive resin restoration using this kind of materials have been scarce. The purpose of this study was to compare the microleakage of four different modes of preventive resin restoration. Restoration using only composite resin was compared together Fifty-five bicuspids were prepared with small class I cavity preparation on the occlusal surface, divided into the following groups and restored accordingly. Group 1 : Cavity was restored with Z-100 composite resin Group 2 : Cavity was restored with Z-100 composite resin. Pits and fissures were then sealed with Teethmate F-1 Group 3 : Cavity was restored with Z-100 composite resin Pits and fissures were then sealed with Ultraseal XT-plus Group 4 : Cavity and pits and fissures were restored with Ultraseal XT-plus altogrether Group 5 : Cavity was restored with Ultraseal XT-plus. Pits and fissures were then sealed with the same material. After restoration, the samples were thermocycled 500 times between $5^{\circ}C$ and $55^{\circ}C$ with a dwell time of 30 seconds. After thermocycling, the samples were dipped into 1% methylene blue solution for 24 hours, then rinsed with tap water. The teeth were then embedded in resin and cut buccolingually along the tooth axis and observed with a stereomicroscope to determine the degree of microleakage. The results were as follows : 1. Group 4 showed the greatest microleakage, while group 3, showed the least. The mean microleakage decreased in the following order:4>1>5>2>3. 2. There was no stastically significant difference between group 1 and group 5(p>0.05). However, group 1 showed significantly greater microleakage compared to group 2 and 3(p<0.05) Group 1 showed significantly less microleakage compared to group 4(p<0.05). 3. Group 2 showed no statistically significant difference compared to group 3(p>0.05). However group 2 showed significantly less microleakage compared to group 4 and 5(p<0.05) 4. Group 3 showed significantly less microleakage compared to group 4 and 5(p<0.05). 5. Group 5 showed significantly less microleakage than group 4(p<0.05).

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Total Gastrectomy with Distal Pancreatico-splenectomy for Treating Locally Advanced Gastric Cancer (진행 위암에서의 위 전절제술에 동반된 원위부 췌-비장 절제)

  • Lee, Sung-Ho;Kim, Wook;Song, Kyo-Young;Kim, Jin-Jo;Chin, Hyung-Min;Park, Jo-Hyun;Jeon, Hae-Myung;Park, Seung-Man;Ahn, Chang-Jun;Lee, Jun-Hyun
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.74-81
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    • 2007
  • Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

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Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.1-9
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    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

Study on Gastroesophageal Reflux according to Feeding Types (수유 종류에 따른 위식도 역류의 빈도)

  • Yun, Seok-Kang;Park, Jae-Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.1-9
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    • 2001
  • Purpose: Gastroesophgeal reflux (GER) is defined as involuntary movement of gastric contents into esophagus. Relaxation of lower esophageal sphincter caused by immature anatomical development in newborn and young infants produces GER frequently. We wanted to know whether the frequency of GER is influenced by feeding types and position or not. We studied in 16 subjects according to feeding types (breast feeding group: BFG-7, formula feeding group: FFG-9) who admitted to the Soonchunhyang university hospital for recurrent regurgitation with 24 hr esophageal pH monitoring from August 1996 to July 1999. Methods: We compared two groups by number of reflux episode, reflux rate, longest episode, numbers of episodes lasting >5 minutes, longest episode in upright position and longest episode in supine position. We used Mann-Whitney test for statistical analysis. Results: 1) The subjects were 7 infants in BFG and 9 infants in FFG, 16 in total, and mean age was 2.1, and 2.6 months for BFG and FFG, respectively. 2) The reflux numbers were $244{\pm}151/day$, $275{\pm}155/day$ for BFG and FFG, respectively. 3) The reflux rate was $14{\pm}15%$ for BFG and $28{\pm}22%$ for FFG. It was lower in BFG. 4) The longest episode was $20{\pm}28$ minutes for BFG and $58{\pm}66$ minutes for FFG. It was significantly longer in FFG. 5) The numbers of episodes lasting >5 minutes were $5{\pm}6$ for BFG and $9{\pm}3$ for FFG. 6) The longest episode in upright position was $10{\pm}8$ minutes for BFG and $40{\pm}47$ minutes for FFG. It was significantly shorter in BFG. 7) The longest episode in supine position was $18{\pm}29$ minutes for BFG and $52{\pm}66$ minutes for FFG. It was significantly shorter in BFG. Conclusion: Breast feeding is strongly recommended to reduce the regurgitation in infancy. It is an another benefit of breast feeding.

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The Comparative Study on Health Promoting Behaviors by Shift Pattern of Duties of Women Workers in workplace (산업장 여성근로자의 근무형태에 따른 건강증진행위 비교)

  • Jang, Hee Jung;Park, Kyung Min
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.22-41
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    • 1999
  • This study intended to analyze the health promoting behaviors, compare their factors according to the shift pattern of duties of women workers who were working in the industrial workplace and present basic data in planning systematic and effective programs of health promotion for three-shift system and day-duty. Using Quota Sampling, 219 women workers were selected as subjects from 5 workshops which had 50 settled workers up to 300 and 10 factories which had more than 300 located in Taegu and Kyung-Book Province. Data were collected by means of questionnaire from September 12 to September 30, 1998. As the instruments of the study were used Health Promotion Lifestyle Profile(HPLP) which was adapted and adjusted by Seo, Y. O. for health promoting behavior, the one developed by Moon, J. S. (1990) for health-belief, the one developed by Sherer et al.(1982) and then adapted by Oh, H. S. for self-efficacy, and the one developed by Park, J. W. (1985) for social support. The analysis of data were performed with Cronbach's ${\chi}^2$-test, t-test, ANCOVA, Kendal tau, Pearson correlation, Stepwise Multiple Regression test using SPSS program. The results of the study are as follows : 1. There was a significant difference in age(${\chi}^2=32.46$, p=0.000), career (${\chi}^2=18.47$, p=0.000), working day(t=-3.18, p=0.000) by the shift pattern of duties in terms of socio-demographic characteristics. 2. There was a statistically significant difference between the two groups on the health promoting behaviors (t=2,52, p=0.012). The score of three-shift group on health promoting behaviors was 2.27, showing that it was lower by .13 than that of day-duty group(2.40). 3. ANCOVA involving age, career and working day as covariables, which had revealed significant difference before, showed that health promoting behaviors by the shift patterns of duties was significantly different(F=4.88, p=0.028). 4. In consideration of variables that have an influence on health promoting behavior by the shift pattern of duties, social support occupied 19.4% of health promoting behavior in the three-shift group and 22.5% including the sense of self-efficacy. In the day-duty group, social support occupied 34.4% of health promoting behavior. 5. The score of three-shift group(2.94) was significantly lower than that of day-duty group(3.12) in the perceived benefit of health-belief(t= -3.29, p=0.001), while the score of three-shift group (2.48) was significantly higher than that of day-duty group(2.24) in the perceived barrier (t=4.22, p=0.000). In the sense of self-efficacy(t=-4.20, p=0.000), the score of three-shift group(3.24) was significantly lower than that of day-duty group(3.53) while in social support(t=-4.56, p=0.000) the one of three-shift group(2.64) was significantly lower than that of day-duty group(2.88). The suggestions are as follows on the basis of the results of this study : 1. It is required to develop health promoting program that takes the shift pattern of duties of women workers into consideration. In addition, there are special demands on developing nursing strategies for health promoting behavior of three-shift workers. 2. It is required to develop specific strategies for social support which is the most significant factor to the health promoting behavior for women workers. 3. It is necessary to develop some programs for improving the sense of self-efficacy, social support, and health-belief of three-shift workers. To achieve these tasks, industrial nurses should play an active role and improve the ability of self-health care of women workers.

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Effects on Dental Caries of Chilren's Deciduous Teeth in Relation to their Mothers' Socioeconomic Factors and their Oral Health Beliefs (모친의 사회경제적 요인과 구강건강신념의 유치우식증에 미치는 영향)

  • Kang, Eun-Ju;Jang, Sun-Hi
    • Journal of dental hygiene science
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    • v.1 no.1
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    • pp.28-38
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    • 2001
  • The aim of this study was to analyze the dental caries of chilren's deciduous teeth in relation to their mothers' socioeconomic factors and their oral health beliefs to increase the effect on children's oral health. One hundred seventy four children and their mothers were selected for the study. The children were 5 and 6 years old in children house in Kun-san, Korea. Research was conducted by oral examination, their mothers' socioeconomic factors and dental health belief model. The finding of analysis can be summaried as follows; In regard to the caries in deciduous teeth status, the five-year-old boy children's dft index was 3.39 and that of the girls of the same age was 2.76. The dft index of the boys of six was 3.86 and that of the girls of the same age was 3.27. The five-year-old boy children had the highest df rate(81.8%), and their dt rate was more than their ft rate. But for the six-year-old girl children, ft rate was higher than dt rate. For the five years old, the boy children's ft rate was significantly higher than that of the girls(p<0.05). Concerning the caries in deciduous teeth states by socioeconomic factors, their oral health status was significantly different according to mother employment and householder age. The df rate of the preschoolers with working mothers(84.7%) was significantly higher than that of those with nonworking mothers(66.7%)(p<0.05). The dft index of the group whose households were over forty was highest with 4.07, followed by the children of the households aged 35 to 39 with 3.83, those of the households aged 25 to 29 with 3.33, and those of the households aged 30 to 34 with 2.15. The difference between the groups was significant(p<0.05). As to the difference of maternal dental health beliefs by maternal socioeconomic factors, households educational background and whether to live with parents or parents-in-law under the same roof made a significant difference to maternal oral health beliefs. The mothers whose households were college graduates or better-educated were stronger in oral health susceptibility and seriousness(p<0.01, p<0.05). The salience was recognized more by those who lived with parents or parents-in-law than by the others who didn't(p<0.05). The dft index of the preschoolers was related to maternal dental health beliefs. That was lower when their mothers perceived dental health benefit better.

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Evaluation Criteria and Preferred Image of Jeans Products based on Benefit Segmentation (진 제품 구매자의 추구혜택에 따른 평가기준 및 선호 이미지)

  • Park, Na-Ri;Park, Jae-Ok
    • Journal of the Korean Society of Clothing and Textiles
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    • v.31 no.6 s.165
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    • pp.974-984
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    • 2007
  • The purpose of this study was to find differences in evaluation criteria and to find differences in preferred images based on benefits segmented groups of jeans products consumers. Male and female Korean university students participated in the study. Quota sampling method was used to collect the data based on gender and a residential area of the respondents. Data from 492 questionnaires were used in the analysis. Factor analysis, Cronbach's alpha coefficient, cluster analysis, one-way ANOVA, and post-hoc test were conducted. As a result, respondents who seek multi-benefits considered aesthetic criteria(e.g., color, style, design, fit) and quality performance criteria(e.g., durability, ease of care, contractibility, flexibility) more importantly when evaluating and purchasing jeans products. Respondents who seek brand name considered extrinsic criteria(e.g., brand reputation, status symbol, country of origin, fashionability) more importantly than respondents who seek economic efciency. Respondents who seek multi-benefits such as attractiveness, fashion, individuality, and utility tend to prefer all the images: individual image, active image, sexual image, sophisticated image, and simple image when wearing jeans products. Respondents who seek fashion are likely to prefer individual image, and respondents who seek brand name more prefer both individual image and polished image. Mean while, respondents who seek economical efficiency less prefer sexual image and polished image.

Development of Analytic Hierarchy Process or Solving Dependence Relation between Multicriteria (다기준 평가항목간 중복도를 반영한 AHP 기법 개발)

  • 송기한;홍상연;정성봉;전경수
    • Journal of Korean Society of Transportation
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    • v.20 no.7
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    • pp.15-22
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    • 2002
  • Transportation project appraisal should be precise in order to increase the social welfare and efficiency, and it has been evaluated by only a single criterion analysis such as benefit/cost analysis. However, this method cannot assess some qualitative items, and cannot get a proper solution for the clash of interests among various groups. Therefore, the multi-criteria analysis, which can control these problems, is needed, and then Saaty has developed one of these methods, AHP(Analytic Hierarchy Process) method. In AHP, the project is evaluated through weighted score of the criteria and the alternatives, which is surveyed by a questionnaire of specialists. It is based on some strict suppositions such as reciprocal comparison, homogeneity, expectation, independence relationship between multi-criteria, but supposing that each criterion has independence relation with others is too difficult in two reasons. First, in real situation, there cannot be perfect independence relationship between standards. Second, individuals, even though they are specialists of that area, do not feel the degree of independence relation as same as others. This paper develops a modified AHP method for solving this dependence relationship between multi-criteria. First of all. in this method, the degree of dependence relationship between multi-criteria that the specialist feels is surveyed and included to the weighted score of multi-criteria This study supposes three methods to implement this idea. The first model products the degree of dependence relationship in the first step for calculating the weighted score, and the others adjust the result of weighted score from the basic AHP method to the dependence relationship. One of the second methods distributes the cross weighted score to each standard by constant ratio, and the other splits them using Fuzzy measure such as Bel and Pl. Finally, in order to validate these methods, this paper applies them to evaluate the alternatives which can control public resentments against Korean rail path in a city area.