Aims and Background: To improve understanding of the relationship between schistosome-related enteropathy and colorectal carcinoma with particular focus on endoscopic findings and clinicopathological characteristics of colonic schistosomiasis. Materials and Methods: All cases of intestinal schistosomiasis diagnosed at West China Hospital, Chengdu, China, between October 2006 and October 2012 were included in this study. A total of 179 cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected for analysis and the demographics, symptoms, endoscopic findings and clinicopathological characteristics were retrospectively evaluated. Results: Of the 179 colonic schistosomiasis patients, 32 combined with colorectal cancer (CRC) were found, between the ages of 44 and 85 years (24 males, 75%). These 32 lesions were classified as 12 endophytic/ulcerative (37.5%), 10 exophytic/fungating (31.2%), 4 annular (12.5%), 3 giant polypus (9.4%), and 3 IIc (superficial depressed type) (9.4%). The segments of rectum and sigmoid colon were involved in 19 patients (59.4%) and 6 patients (18.8%), respectively. The histopathologic types were classified as follows: 30 welldifferentiated adenocarcinomas, one mucinous adenocarcinoma and one poorly differentiated adenocarcinoma. The pathological findings suggest colorectal malignancy with deposited schistosome ova. Conclusions: Chronic schistosomal infestation has a probable etiological role in promoting genesis of colorectal neoplasms.
Nam, Sun Mo;Jang, Donghwan;Wang, Kyu-Chang;Kim, Seung-Ki;Phi, Ji Hoon;Lee, Ji Yeoun;Cho, Won-Sang;Kim, Jeong Eun;Kang, Hyun-Seung
Journal of Korean Neurosurgical Society
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v.62
no.5
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pp.551-560
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2019
Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.
Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.
Objectives This study was conducted to characterize scoliosis patients visiting Korean medicine hospital and to analyze the demands and factors affecting discomfort. Methods This retrospective study analyzed 33 scoliosis patients who visited Korean medicine hospital from March, 2021 to October, 2021. The data analysis consisted of three factors: (1) demographic characteristics, (2) characteristics of demands on Korean medicine (reasons for choosing Korean medical treatment, preferred treatment methods, most uncomfortable part, treatment priorities) and (3) discomfort factors (treatment experiences, diagnosed age and Cobb's angle). Statistical analyses were performed and a p-value≤0.05 was considered to be statistically significant. Results 43.75% of the patients chose 'effectiveness' for the reason why they preferred Korean medicine treatment. 'Chuna treatment' was the most preferred treatment method. The patients chose 'lower back' for the most uncomfortable part and 'pain' for the highest priority of improvement. The Cobb's angle of included patients was 16.02±7.65° and it is not much differ to average of Cobb's angle in Korean. Discomfort was more severe in the patients with treatment-experienced than treatment-naive. The score of discomfort in appearance and psychological were higher in the patients diagnosed in childhood or adolescent period than who were diagnosed after adult. Classification based on Cobb's angle showed no statistical difference. Conclusions Not only Cobb's angle but also other clinical factors should be considered for effective treatment in scoliosis. Also, It is necessary to pay attention to adult scoliosis patients.
This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.
This study was conducted to analyze the medical charges of the elderly dementia inpatients, to identity their characteristics, and there by to evaluate feasibility of the per diem payment system for the patients. Data on medical charges of the patients were collected from the National Federation of Medical Insurance and sample hospitals from October through December 1997. The data were analysed in order to find the characteristics and test hypotheses postulated. The results are summarized as follows; Firstly, there was no difference statistically in between disease groups and between the dementia inpatients belonging to each disease group. Secondly, the amount of the non-insurance medical charges of the elderly dementia inpatients is considerably high compared to the insurance medical charges paid by the patient, which implies that some measures are to be prepared by the Government. Finally, medical charges per inpatient day of the dementia patients are not different statiscally by sex, by age group, and by disease group. This result supports the feasibility of the per diem payment system for the elderly dementia inpatients.
There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of cataract patient. In order to investigate the major factors affecting selection of medical facilities by cataract patient, 300 subjects of cataract patients who was operated at 5 various medical care facilities were selected. Questionnaires are given on March, 2000 and 273 questionnaires were collected. Two types of hospitals(Eye Hospital and University hospital) were combined and analyzed. The main results of this research is as following; 1. In general characteristics of the patients, the variables shown statistically a significant difference between Eye Hospital and University Hospital; The6 educational level and average income are significantly higher in University Hospital Patient. 2. University Hospitals were preferred by the factors of social relationship, social reputation. The critical factors in reference for Eye hospital were kindness, service speed and convenience. This study can be used as a baseline data for marketing planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the hospital consumer behavior will be needed.
Oh, Jae-Young;Lee, Jae-Hon;Han, Sang-Woo;Chee, Ik-Seung;Koo, Bon Hoon;Woo, Jong Min;Yang, Jong-Chul;Gim, Min-Sook;Lee, Sang Hyuk;Heo, Jung-Yoon;Yu, Bum-Hee
Anxiety and mood
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v.10
no.1
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pp.11-16
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2014
Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.
Recently, the hospitals in Korea has positively changed one way or another. Therefore hospital managers must focus on the nurses' role in terms of consumers' perception of overall image of hospitals and the degree of satisfaction of the consumers. To achieve the purposes, the questionnaire was developed and distributed to 280 people who had a direct experience with nursing services subjected hospitals in Seoul at the time of screening. Among them, 229 responses were turned out to be useful and used for final analysis. The measurement instrument for hospital nursing service quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry (1988). For data analysis, SPSS/PC and PC-MDS program were used. The results were as follows : 1) The perception map showed that the seven subjected hospitals were divided into three groups. It could be interpreted that the hospitals in the same group had a strong competitive relationships. Because the nursing services' scores of hospitals C and E were higher than those of other hospitals, they could be served as a benchmark for the other hospitals. 2) The marketing place of hospital nursing services was divided by four. Since service generally had a strong point in nearby service market segment. Aiming an nearby hospital nursing services market segment by the hospital nursing services department was regarded as a good repositioning strategy. 3) When consumers evaluated the quality of hospital nursing services, they were greatly affected by the hospitals' overall image or other characteristics. Therefore, for improving hospital's nursing services, hospital nursing services department requires a great deal of labor to improve hospitals' overall image or other characteristics.
Journal of The Korea Institute of Healthcare Architecture
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v.22
no.4
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pp.105-115
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2016
Purpose: This study is a case study of a small-mid sized hospital to promote a full-scale remodeling to ensure the quality and competitiveness of the medical services and trying to arrange the remodeling characteristics of small-mid sized hospital which is suffering from aging facilities as well as chronic congestion and lack of spaces. Methods: Research was conducted by consultation with hospital executives and each department operators, and on-site investigation, Results: The result of this study can be summarized into two points. The first one is that existing statistical value like area per bed, in the remodeling of the small-mid hospitals may not mean much. planners have to verify the necessary room space areas in close consultation with the department operators. And after confirming layout possibilities, they have to create the program. The second one is that remodeling planning can be a realistic plan with structural and installation diagnosis at the same time. If so, it is advisable to proceed architectural design from the beginning for cost and time savings. Implications: This results can be applied to small-mid hospitals to apply to the medical law revision and others.
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