• Journal of Trauma and Injury
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• v.24 no.2
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• pp.95-97
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• 2011

Purpose: We analyzed the medical costs for severely traumatized patients according to the severity and medical performance so that we could improve the financial balance of the trauma center. Methods: Retrospective analysis was performed on patients visiting SNUH Trauma Center from May 2011 to August 2011. Among a total of 55 severely traumatized patients, 31 patients whose medical bills were available and categorized were included in this study. The injury severity score (ISS) was calculated from the abbreviated injury score (AIS), which was updated in 2008,for each patient to assess the severity of injury. Major trauma was defined as an ISS above 15. Results:The 31 patients in this study included 20 males and 11 females. The average ISS was $33.23{\pm}16.65$ points. We categorize the patients into three groups according to ISS, 16-24: group 1, 25-40: group 2, and above 41: group 3. Total incomes, admission fees, surgery fees, and imaging test fees are shown in table 1. The costs seem to be higher costs in group 2, but this result has no statistical significance. Statistical significantly data are as follows: high radiologic test fees in group 1, short hospital stay in groups 1 and 2, and short ICU stay in group 1. The average hospital stay was 17 days, and the average emergency intensive care unit (EICU) stay was 7.5 days. Although the EICU stay was only 44% of the total hospital stay, the income from the EICU covers 79.4% of the total hospital income. Conclusion: From this study, we found several items that show relatively high medical income from severely traumatized patients visiting the SNUH Trauma Center. Most of the medical fees arise in the early phase of acute medicine usually in the ICU. Efforts to identify the items with high income and to minimize expenses will improve the financial structure of the Trauma Center,which is facing a budget crisis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.418-428
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• 2015

This study conducted influencing and mediated effect on stroke to lead correct health behavior of stroke patients and tried to provide preliminary data of stroke prevention. It used stage 4 and 5 data of a national health and nutrition examination survey, analysis method was frequency analysis, Chi-square test, multiple logistic regression and structural equation modeling. In case of male, factors affecting to stroke were age, job, self-related health, alcohol, hypertention and diabetes. In case of female, age, job, self-related health, stress level and hypertention affected to stroke. In tested results on whether or not mediated effect of preceding disease exists, 5.80 difference in ${\chi}^2$ between partial mediated modeling and full mediated modeling was statistically significant(p<0.01). Therefore, partial mediated modeling was adequate to this study. We need preventive health education for changing wrong health behaviors and policy that strengthens health care network. If someone has preceding disease, they need long-term diagnosis for health condition and continuous improvement in life style.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.9
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• pp.3983-3990
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• 2012

The hazardous effects of heavy alcohol intake and smoking to body systems have been identified by numerous studies, and there is many influencing factors on alcohol intake and smoking choices. The aim of this study is to identify the correlation between alcohol intake and digit ratio (2D:4D), as well as smoking and digit ratio (2D:4D) in university students. Participants were 121 male and 314 female university students. After filling in questionnaire related alcohol and smoking history, 2nd and 4th finger lengths were measured on both hands using vernier callipers with photocopy. This study showed 2D:4D of the males was 0.95, and that of the females was 0.96. There was a significant difference between male and female in digit ratio. The digit ratio according alcohol intake level significantly differed in only women's left hand. The digit ratio according smoking level significantly differed in only men's left hand. Moreover, The digit ratio was negatively associated with alcohol intake and smoking. The results of this study suggest that the digit ratio (2D:4D) affected with fetal testosterone concentration is negatively related to alcohol intake and smoking. Therefore, the digit ratio would be used in preventive program of alcohol intake and smoking of adolescent, or in antialcoholism /smoking cessation program as a biological basic data.

• Quality Improvement in Health Care
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• v.12 no.1
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• pp.104-112
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• 2006

Background : The necessity of unify and standardize codes used at hospital has been emphasized since OCS (Order Communicating System) was adopted. Therefore, the purpose of this study were to standardize operation code by continuous training of the ICD-9-CM code that is used as standard code in OCS program at operating room. Method : In 400 operation data, operation code entered in OCS program at operating room was compared to operation name recorded in medical record. In addition, a matching rate between input data of operation code by medical record department and computing input data of operation code in 3,710 cases was compared for each department. User operation name and operation code were matched and major diagnosis by operation department and operation name were also matched. Results : User operation name was reflected in operation classification code in detail, and operation code entered on user was registered. Input rate and matching rate of operation code were gradually improved after improvement activity. In particular, a matching rate was high at ophthalmology where operation name is segmented. Plastic surgery and orthopedics with a lot of emergency operation and comprehensive operation name show low input rates. Conclusions : As the medical field makes progress in computerlization, awareness of information exchange and sharing becomes higher. Among codes to classified medical institution, codes related to surgical operation are all different by user of hospital and department. Computerlization and standardization is essential. And when efforts of standardization continue in alliance with individual hospital and institution, initiative of preparing medical policy data at a national level will be accelerated.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.885-888
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• 2010

현재 우리나라는 보건소 중심의 예방접종등록사업을 진행 중에 있다. 2004년부터 시작된 이 사업은 현재는 전국민을 대상으로 실시하고 있다. 예방접종등록사업은 피접종자들은 대체적으로 예방접종에 대한 적절한 시기를 판단할 수 있는 정보가 부족하기 때문에 예방접종과 관련된 정보들을 국가나 사회에서 적시에 피접종자들에게 제공해 줄 수 있다. 따라서 이에 대한 확인이 등록에 앞서 그 정확성을 확인 필요가 있다. 예방접종등록사업의 가장 기본적인 사업으로 진행된 것은 예방접종 수첩의 제공과 그 관리를 통한 예방접종 사업으로 지속적으로 전개되어 왔으며, 일반 국민과 개원의사들에서도 대중적으로 보급되어 있다. 국가 예방접종률의 산출 그리고 취학 어린이 예방접종력 증명서 제출 제도를 위하여 예방접종 수첩을 활용하는 방법이 현실적으로 유용할 수 있다. 따라서 예방접종 수첩의 예방접종력 정확성을 확인할 필요가 있다. 지역조사에서 접종기관으로 확인된 민간 의료기관 365곳 가운데 의료기관 이전 및 폐업으로 반송된 경우가 4건(1.1%)이었으며, 응답한 경우는 129곳으로 응답률은 35.3%였다. 조사된 의료기관 전체를 대상으로 확인된 1,201건에 대한 BCG 접종여부의 정확도는 69.5%였다. B형 간염의 정확도는 1차가 41.3%로 낮았으며, 2차와 3차는 각각 76.6%, 79.7%였다. DTaP의 정확도는 약 80%였으며, 정확도가 제일 높은 것은 DTaP 3차로 82.5%였으나 다른 것과 가장 낮은 정확도와 2% 정도 밖에 차이가 나지 않았다. 폴리오의 정확도는 약 80%였다. MMR의 정확도는 83.2%였다. 일본뇌염의 경우 약 80.0%였으며, 수두의 정확도는 74.9%로 다른 질병과 비교하여 낮은 수치를 보였다. 조사된 의료기관을 전체로 한 기타예방접종별 예방접종수첩의 접종여부의 정확도는 인플루엔자는 정확도는 74.1%였으며, 뇌수막염은 72.7%의 정확도를 보였다. A형 간염 1차의 정확도79.5%였으며, 폐렴구균 1차의 경우 73.2%로 나타났다. 국가필수예방접종별 예방접종수첩의 접종일자에 대한 정확도는 BCG 80.1%로 확인되었고, B형 간염 1차 89.7% 2차는 82.1% 3차는 79%로 B형 간염 중 가장 낮은 정확도를 보였다. DTaP는 1차와 2차는 약 87% 3차는 85.1% 4차는 83.5%로 확인이 되었다. 폴리오는 1차가88.1%로 가장 높은 정확도를 보였고 그 다음으로 2차가 86.2%, 3차가 84.8%로 확인되었다. MMR의 정확도는 84%였으며, 일본뇌염 1차의 정확도는 83.1%로 나타났다. 수두의 접종일자 정확도는 83.7% 이고, 인플루엔자의 정확도는 55.3%로 상대적으로 낮은 수치를 보였다. 기타예방접종별 접종일자 정확도의 조사 결과 뇌수막염 1차과 폐렴구균 1차는 약 90%로 상대적으로 높은 정확도를 보였고, A형 간염 1차는 88.4%의 정확도를 보였다.

• Journal of Korean Biological Nursing Science
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• v.4 no.2
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• pp.113-125
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• 2002

This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.321-325
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• 2016

Dose creep is one of clinical errors that arises from the tester's inexperience or carelessness, and according to Task Group #116 of American Association of Physicists in Medicine, its continued occurrence is being reported in the digital method. At this point, the demand for an automatic exposure control device that minimizes the dose creep phenomenon and can improve reproducibility is increasing. In this study is to consider the automatic exposure control device sensor that can is not only easy to produce, but also reduce the dose creep phenomenon by conducting a research on high-efficient semiconductor sensor. As a result, the Intrinsic-type and PIN-type sensors have excellent optical property compared to Ref sensor, would have less shading effect, and have relatively low sensitivity, but would provide accurate feedback signals to automatic exposure control device with its consistent tendency according to exposure condition changes.

• Journal of the Korean Society of Radiology
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• v.1 no.2
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• pp.13-22
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• 2007

The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

• Journal of Life Science
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• v.20 no.9
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• pp.1299-1305
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• 2010

Cardiac troponin-I (cTnI), creatine kinase-MB (CK-MB), and C-reactive protein (CRP) are routine cardiac markers for the diagnosis of cardiovascular disease. Recently, brain natriuretic peptide (BNP) has garnered attention as a marker of heart failure. This study was retrospectively designed to investigate the relationships between preoperative BNP, other cardiac markers levels and perioperative parameters in seventy-four adult patients that underwent off-pump coronary artery bypass grafting (OPCAB) and to assess its usefulness for predicting postoperative outcomes. Preoperative levels of BNP, cTnI, CK-MB, and CRP had significantly positive or negative correlations with echocadiographic parameters. There were significantly positive relationships between BNP, cTnI, CK-MB, and CRP concentration. Postoperative mechanical ventilation time had a positive correlation to preoperative levels of cTnI, CK-MB, and CRP, while ICU-staying period had a positive correlation with BNP, cTnI and CK-MB. These results reveal that a preoperative level of BNP is a good predictor and that its combination with cTnI, CK-MB, and CRP might be useful for diagnosis and comprehensive risk stratification of patients with coronary heart diseases, as well as prognosis of perioperative outcomes in OPCAB patients.

• Journal of Life Science
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• v.20 no.10
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• pp.1458-1467
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• 2010

The present study was retrospectively designed to define whether preoperative levels of leukocytes and D-dimer are potentially useful factors in predicting perioperative outcomes of coronary heart disease (CHD). There was no relationship between preoperative leukocyte counts (Pre-OP leukocyte) and preoperative D-dimer levels (Pre-OP D-dimer). Pre-OP leukocyte counts each had positive correlation with cardiac troponin-I, creatine kinase-MB or C-reactive protein (cardiac markers) levels at preoperative and postoperative periods. Pre-OP D-dimer levels were positively associated with each cardiac marker at the same periods. Pre-OP leukocyte counts positively related with aspartate aminotransferase and alanine aminotransferase (liver markers), whereas Pre-OP D-dimer level positively or negatively correlated with bilirubin (liver marker), creatinine (renal marker) or glucose levels at preoperative and/or postoperative periods. Pre-OP leukocyte and Pre-OP D-dimer were inversely associated with Pre-OP high density lipoprotein cholesterol levels or left ventricular ejection fraction. Pre-OP leukocyte counts each had positive correlation operation duration and postoperative mechanical ventilation-time (PMVT), whereas Pre-OP D-dimer levels had positive relationship with PMVT, intensive care unit-staying period and hospitalization. The retrospective data suggest that Pre-OP leukocyte and Pre-OP D-dimer levels may be clinically useful factors for predicting perioperative outcomes in patients with CHD.