• International conference on construction engineering and project management
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• 2007.03a
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• pp.837-847
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• 2007

The study focused on the evaluation of maintenance management strategies used in public hospital buildings in Lagos state. It also assessed the labour composition for maintenance operations. In achieving these objectives, opinions of maintenance officers of ten (10) different hospitals in different local government areas of the state were sampled through well structured questionnaires. The data collected were analyzed using descriptive and inferential statistics. From the analysis, the study revealed that majority of those public hospitals do not have specific budget for maintenance programmes, maintenance policies, maintenance log book and maintenance manual to guide the operatives. About 98% of them do not understand the type of maintenance strategy being used for their maintenance operations. 78% of the maintenance work are only executed when there is a breakdown or in response to user's request. For labour composition, the cleaning of interior and exterior of the building, inspection of building elements, repairs and replacements of building elements are mainly carried out by in-house staff, while the repair and replacement of equipment is by outsourcing. The study also revealed that using in- house staff, reduces costs and provides a higher security while outsourcing provides more flexibility in staffing reduces equipment expenditures and provide better access to special skills. The study recommended proactive measures to provide necessary training and support for maintenance staff and users of these facilities and a means of securing sufficient funds for maintenance programmes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.5077-5081
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• 2014

To clarify whether gastric cancer patients can benefit from laparoscopy-assisted surgery completed by junior surgeons under supervision of expert surgeons, data of 232 patients with gastric cancer underwent operation performed by inexperienced junior surgeons were reviewed. Of the 232 patients, 137 underwent laparoscopy-assisted resection and in 118 cases this approach was successful. All of these 118 patients were assigned to laparoscopic group in this study, 19 patients who were switched to open resection were excluded. All laparoscopic operations were performed under the supervision of expert laparoscopic surgeons. Some 95 patients receiving open resection were assigned to the open group. All open operations were completed independently by the same surgeons. Short-term outcomes including oncologic outcomes, operative time intra-operative blood loss, time to first flatus, time to first defecation, postoperative hospital stay and perioperative complication were compared between the two groups. The numbers of lymph nodes harvested in the laparoscopic and open groups were $21.1{\pm}9.6$ and $18.2{\pm}9.7$ (p=0.029). There was no significant difference in the length of margins. The mean operative time was $215.9{\pm}32.2$ min in laparoscopic group and $220.1{\pm}34.6min$ in the open group (p=0.866), and the mean blood loss in laparoscopic group was obviously less than that in open group ($200.9{\pm}197.0ml$ vs $291.1{\pm}191.4ml$; p=0.001). Time to first flatus in laparoscopic and open groups was $4.0{\pm}1.0$ days and $4.3{\pm}1.2$ days respectively and the difference was not significant (p=0.135). Similarly no statically significant difference was noted for time to first defecation ($4.7{\pm}1.6$ vs $4.8{\pm}1.6$, p=0.586). Eleven patients in the laparoscopic group and 19 in the open group suffered from peri-operative complications and the difference between the two groups was significant (9.3% vs 20.0%, p=0.026). The conversion rate for laparoscopic surgery was 13.9%. Patients with gastric cancer can benefit from laparoscopy-assisted operations completed by inexperienced junior surgeons under supervision of expert laparoscopic surgeons.

• Journal of the Korean Operations Research and Management Science Society
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• v.17 no.1
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• pp.41-41
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• 1992

In the real world situations that some jobs need be processed only on certain limited machines frequently occur due to the capacity restrictions of machines such as tools fixtures or material handling equipment. In this paper we consider n-job non-preemptive and m parallel machines scheduling problem having two machines group. The objective function is to minimize the sum of earliness and tardiness with different release times and due dates. The problem is formulated as a mixed integer programming problem. The problem is proved to be Np-complete. Thus a heuristic is developed to solve this problem. To illustrate its suitability and efficiency a proposed heuristic is compared with a genetic algorithm and tabu search for a large number of randomly generated test problems in ship engine assembly shop. Through the experimental results it is showed that the proposed algorithm yields good solutions efficiently.

• Journal of the Korean Operations Research and Management Science Society
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• v.37 no.4
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• pp.211-223
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• 2012

This study purposed to evaluate the influences of rival hospitals on the number of patients who visited the a study territory hospital. Spatial analysis technique was used to measure the impact of rival hospitals in study region. Selected hospitals were all medical school affiliated hospitals which were located in Daejeon metropolitan city and Chungchungnamdo. Patient data was collected from the claims data of the study hospital, and the number of inpatient and outpatients who visited the study hospital between January and June in 2008 were calculated on the smallest administrative district, Eup, Myeon, and Dong, in study region. To control the differences of regional characteristics among Eup, Myeon, Dong, socio-economic variables (total population, number of people aged over 65, number of basic livelihood security recipients, distance from the study hospital to the centroid point of each Eup, Myeon, Dong, number of business, and number of employees) were included in analysis model. These variables were collected from the annual year book of city as well as county located in study region. Cluster analysis classified the study region into three groups by using the difference of between th actual number of inpatient/outpatient and the predicted number of inpatient/outpatient in Eup, Myeon, and Dong. Most areas around the rivalry hospitals were categorized into same group. Multiple regression analysis indicated that areas around rivalry hospitals had statistically significantly negative relationship with the number of inpatients and outpatients who visited the study hospital. As the buffer size was increased from 5Km to 10Km, the standardized regression coefficients were decreased. These study results confirmed that rivalry hospitals in region had negative impacts on the performance of hospitals. It suggests that hospitals will require not only to select their location to minimize the effects of rivalry hospitals, but also to establish their strategy to cope with the rivalry's threats in their region.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.47-53
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• 1997

Accidental ingestion of caustic substance is one of the common problems among children around the world. Acid intake accounts for a mere 5% of all reported cases of corrosive ingestion in the West. Because of the esophageal sparing effect of acid, clinically significant esophageal involvement after acid ingestion occurs in only 6 to 20 percent of the instances. Despite effort of prevention, 7% to 15% of children sustaining caustic esophageal burns develop esophageal strictures. If balloon dilatation or bougie dilatation fails to resolve the esophageal strictures, successful outcome following replacement by colon or stomach has been reported in children. But the complications and morbidity following these operations are still relatively high. Seven patients with corrosive-acid induced esophageal strictures who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from 1991 to 1995 were reviewed. Primary resection and anastomosis was performed in all of 7 patients. The stricture involved short segments of the esophagus at the level of the lower cervical and the upper thoracic vertebra. The operations were approached through a left cervical incision or a left thoracotomy. In one patient, operative repair of anastomotic leakage was done, and three patients required re-resection of anastomotic strictures postoperatively, and one patient required a third operation(reversed gastric tube) due to an anastomotic stricture. The other anastomotic leaks, strictures or pulmonary complications were resolved with conservative treatment. In conclusion, primary resection and anastomosis of the esophagus was performed successfully on the 6 of 7 children with acid induced corrosive esophageal strictures. This approach is physiologic, especially in children who should have a long life expectancy, and recommended for the treatment of short-segment acid induced corrosive esophageal strictures.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.1
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• pp.30-36
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• 1998

Squamous cell carcinoma is a neglected disease entity in orthopedic oncology. The purpose of this study was to analyze overall survival and the role of surgery on survival and to evaluate the significance of possible prognostic factors. From Oct, 1986 to Aug, 1996, 57 patients were enlisted and 42 patients ere eligible. Inclusion criteria included more than one year follow-up and no distant metastasis at the first visit. Staging and survival followed AJC classification and Kaplan-Meier plot. Stage II included 17 cases and stage III, 25 cases. Thirty-eight patients underwent operations, chemotherapy, and/or radiotherapy, and the remaining four had operations only. The chemotherapeutic regimen was adriamycin-cisplatin. The average follow-up period was 45 months. The ten-year actuarial survival rate of whole patients was 65.4%. Location of primary lesion, stage, pathologic grading, and intensity of chemotherapy in the same stage showed a significant difference in survival. Nine out of 42 patients had local recurrence. Seven patients had inadequate wide margins and two had intralesional margins. Average period of recurrence from operation was 13(4-35)months. The operation itself had no impact on survival but a surgical margin of no less than 3cm from the lesion was important for local control. Pathological grade and staging were significant variables for long term survival. Acral lesion had a significantly higher chance of regional and distant metastasis but actual survival showed no difference. In stage II, aggressive chemotherapy could delay or reduce the chance of regional or distant metastasis.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.4
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• pp.188-192
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• 2013

This study was conducted to develop the strategy for more effective internal marketing and promoting internal customer satisfaction by grasping the level of internal marketing operations targeting employees within hospital and empirically analyzing the effect of internal marketing operations on internal customer satisfaction. The findings reveal that there is a significant correlation between factors for internal marketing components and internal customer satisfaction. The average factor score for internal customer satisfaction is 3.230 out of 5, which is a little higher than normal levels. Counting down the five factors is as follows: internal communication, education and training, delegation of authority, welfare, compensation system, with compensation system shown as the lowest level and internal communication as the highest level. In addition, the result of multiple regression analysis conducted to inspect the effect of factors for internal marketing components on internal customer satisfaction indicates that among 5 factors, delegation of authority, education and training, and welfare have positive influences on internal customer satisfaction; whereas, compensation system has little effect on it.

• Journal of the Korean Operations Research and Management Science Society
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• v.37 no.4
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• pp.161-180
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• 2012

We develop some evaluation tool and indicators for the scores for medical equipment replacement in hospital. There has been no research for Korean hospitals although there are many for foreign medical institutions. In this paper, among many variables that were obtained from the previous studies, eleven variables are selected as indicators and tied as three groups. And then we obtain scores of medical equipments based on the weighted values of those indicators. We can make decisions whether we replace medical equipments or not by ranking the medical equipments based on the scores. This paper shows that we can make decisions to replace medical equipments very objectively and effectively using the evaluation tool and indicators we develop.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.128-133
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• 2000

Persistent cloaca in a female newborn is one of the most complex and challenging anorectal malformation. The incidence is about 10% of all anorectal anomalies. Treatment of cloacal malformations has evolved during the past 40 years. However, it still remains one of the most difficult operations. In 1997, Pena reported a new procedure called "Total urogenital mobilization". We have repaired 3 cases of cloacal anomaly using "Total urogenital mobilization". The operations were performed between age 15 and 28 months. The length of the common channels was 2.5 - 3.0 cm. Two cases had double vaginas and one of them also had double uterus. The operation time was 4-5 hours and no major complications occurred. Functional and cosmetic results were satisfactory.

• Proceedings of the Korean Society of Computer Information Conference
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• 2014.01a
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• pp.279-280
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• 2014

정보통신기술의 발달로 말미암아 병의원에서도 다양한 정보시스템의 도입이 활발하고, 초기에는 데이터의 전자적 관리 및 공유를 위한 시스템이 주를 이루었으나 점차 병의원 운영관리에 대한 직접적인 의사결정지원 기능이 강조되고 있다. 그러나 기존의 시스템들은 대부분 의료 전문가들의 지식에 기반하여 진료행위가 정해진 절차를 벗어나지 않도록 하는 데에만 초점을 맞추었고, 환자나 경영자 입장을 충분히 고려하지 못하였다. 이에 본 논문에서는 전문적 의료 지식 베이스가 아닌 병의원에서 수집된 데이터를 기반으로 다양한 참여자들에게 유용한 기능을 제공하기 위한 능동형 임상의사결정지원시스템의 개념과 구조에 대하여 논의하고자 한다.