• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.827-831
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• 2012

To determine the relationship between comorbidity and outcome after radical cystectomy in Chinese patients by using the Adult Comorbidity Evaluation (ACE)-27 index. Two-hundred-and-forty-six patients treated with radical cystectomy at the Second Xiangya Hospital of Central South University, Hunan Province, China between 2000 and 2010 were retrospectively analyzed. Medical records were reviewed for age, gender, delayed time of radical cystectomy, urinary diversion type, pelvic lymphadenectomy status, TNM stage, and pathological grade. Comorbidity information was assessed by the ACE-27 index. The outcome measurement was overall survival. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the association between comorbidity and outcome. The study population consisted of 215 (87.40%) males and 31 (12.60%) females with a mean age of $62{\pm}11$ years. Median duration of follow-up was $47{\pm}31$ months. A total of 151 (61.38%) patents died during follow-up. Of those, 118 (47.97%) had at least one comorbidity. According to the ACE-27 scores, 128 (52.03%) patients had no comorbidity, 79 (32.11%) had mild, 33 (13.41%) had moderate, and 6 (2.45%) had severe comorbidities. Multivariate analysis indicated that moderate (p=0.002) and severe (p<0.001) comorbidity was significantly associated with decreased overall survival. In addition, age ${\geq}70$ years (p=0.002), delayed time of radical cystectomy >12 weeks (p=0.044), pelvic lymphadenectomy status (p=0.014), and TNM stage >T3 (p<0.001) were determined to be independent risk factors of overall survival. Increasing severity of comorbidity statistically correlated with decreased overall survival after radical cystectomy.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.606-618
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• 2000

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.201-209
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• 2020

In this study, issues related to changes in base year, which have controversial effects on fees in service contracts, were reviewed. In this regard, sensitivity analysis was conducted on the effects of changes in base year on conversion factor by type. The benefits and disadvantages of each specific type of medical institution were examined. Main conclusions are as follows. First, changing the base year to be closer to the present time had a beneficial effect on the conversion factor of hospitals. Second, changing the base year to be closer to the current point of time had an adverse effect on the conversion factor of pharmacies and clinics and had a significant adverse effect on clinics. Third, assuming that a single conversion factor is collectively applied to all types, a favorable effect occurred in all cases when the base year was changed to be closer to the present time. Base year changes can bring about conflicts of interest between insurer and providers, and within providers. Therefore, changing the base year should be pursued upon mutual agreement on a reasonable basis for resource allocation. In addition, it is necessary to provide incentives for temporary compensation for the types of losses incurred.

• The Journal of Industrial Distribution & Business
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• v.9 no.6
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• pp.77-85
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• 2018

Purpose - The purpose of this study is to subdivide trade transaction-centered structure in a logistics/distribution industry system to apply blockchain, to establish and resolve with which types of technology, and to provide policy direction of government institution and technology to apply blockchain in this kind of industry. Research design, data, and methodology - This study was conducted with previous researches centered on cases applied in various industry sectors on the basis of blockchain technology. Results - General fields of blockchain application include digital contents distribution, IoT platform, e-Commerce, real-estate transaction, decentralized app. development(storage), certification service, smart contract, P2P network infrastructure, publication/storage of public documents, smart voting, money exchange, payment/settlement, banking security platform, actual asset storage, stock transaction and crowd funding. Blockchain is being applied in various fields home and abroad and its application cases can be explained in the banking industry, public sector, e-Commerce, medical industry, distribution and supply chain management, copyright protection. As examined in the blockchain application cases, it is expected to establish blockchain that can secure safety through distributed ledger in trade transaction because blockchain is established and applied in various sectors of industries home and abroad. Parties concerned of trade transaction can secure visibility even in interrupted specific section when they provide it as a base for distributed ledger application in trade and establish trade transaction model by applying blockchain. In case of interrupted specific section by using distributed ledger, blockchain model of trade transaction needs to be formed to make it possible for parties concerned involved in trade transaction to secure visibility and real-time tracking. Additionally, management should be possible from the time of contract until payment, freight transfer to buyers through land, air and maritime transportation. Conclusions - In order to boost blockchain-based logistics/distribution industry, the government, institutionally, needs to back up adding legal plan of shipping, logistics and distribution, reviewing standardization of electronic switching system and coming up with blockchain-based industrial road maps. In addition, the government, technologically, has to support R&D for integration with other high technology, standardization of distribution industry's blockchain technology and manpower training to expand technology development.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.539-544
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• 2017

Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.207-220
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• 2009

This study researched into literature materials in order to utilize basic data on job importance in dental coordinator, and analyzed questionnaire on job importance in dental coordinator for about 2 months from August and September in 2008 targeting dental hygienists and other manpower for dental hospitals & clinics where are located in D region and neighboring region. The following are the results: 1. Dental hospital & clinics where dental coordinators work were surveyed to be totally 66.9%. Dental coordinators were indicated to be 71.1% as for dental hospital$^{\circ}{\S}$clinic(women), and to be 28.4% as for a case with none. There was significant difference according to final academic degree and working place(P<.001). 2. License holders(women) for dental hygienist as dental coordinator accounted for 39.8%. The opposite case accounted for 60.2%. A case of doing duty of dental coordinator given not dental hygienist was indicated to be high. There was significant difference according to working place(p<.01). 3. The task importance on job that a dental coordinator directly performs was indicated to be averagely 3.24, thereby having been recognized to be important. 4. As for the recognition on job importance according to working-year number, it was indicated to have higher recognition on task importance in the more working-year number regarding customer management(p<.01), organization management(p<.05), and self-management(p<.01). 5. Given seeing difference in recognition on task importance according to medical institution, it was indicated to be 3.34 for dental clinic and 3.25 for dental hospital. Thus, the task importance was indicated to be slightly high in a person who works for dental clinic. There was no significant difference. In light of the above results, in order to educate dental coordinator who can successfully perform a role at dental hospital & clinic, a dental hygienist is required who is equipped with dental-clinic career rather than a person without a major. A professionally educational program for dental coordinator needs to be developed. Even in a dental coordinator's task, there is necessity for the curricular development and the specialized education.

• Journal of Korean society of Dental Hygiene
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• v.7 no.4
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• pp.535-551
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• 2007

Objectives: This study was conducted to know dental service and fear after research on reliability on dentists and satisfaction on dental hygienists. Methods: This study was conducted by the 325 persons who had the experience of visiting dental medical institution. Statistical analysis was conducted using the SPSS 12.0 with T-test, ANOVA and correlation. The obtained results were as follows: Results: 1. Internal consistency of Dental Beliefs Survey(DBS) and dental hygienists satisfaction questionnaire factors were 0.758~0.908(Cronbach' alpha). And the Cronbach' alpha's coefficients of the all subscales were more than 0.6. So high reliability and validity were identified. 2. As result of analysing fear from general feature, the men feel more fear than women and more fear was felt in the case of having worse teeth status. Fear was higher in case of visiting to dental clinic than in case of visiting dental clinic for precaution. And that was statistically related. 3. Dental fear was higher in the case of having the past pain experience, insufficient anesthesia experience, experience of seeing other persons pain and this was statistically related(P<0.01)(P<0.05). 4. Average of reliability on dentists was 37.9, person who has high reliability was 81.8%, person who has low reliability was 18.2%, average of satisfaction on dental hygienists was 31.5%(Satisfaction on dental hygienists was 51.1% and dissatisfaction on dental hygienists was 48.9%). 5. Higher dentists reliability and satisfaction on dental hygienists has lower fear considering general feature and dental clinic use behavior but person who has the dental clinic to go regularly has higher dentists reliability and satisfaction on dental hygienists where, however, fear was not low. 6. As result of analyzing correlation between dental service and dental clinic use behavior, satisfaction on dental hygienists was negatively related to reliability on dentists and fear. And, reliability on dentists was positively related to fear, pain experience in dental clinic, incomplete anesthesia experience, near person pain experience(experience on seeing person in pain), which were statistically related(p<0.01). Conclusions: In relation to general features and reliability on dentists and satisfaction on dental hygienists caused by dental clinic use behavior, dental fear was decreased when reliability and satisfaction are higher. Group with low dental fear had higher reliability on dentists and satisfaction on dental hygienists than group with high dental fear but only reliability on dentists was statistically related(p<0.05).

• Science of Emotion and Sensibility
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• v.9 no.2
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• pp.141-150
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• 2006

Since the late 1990s, 'smart clothing' has been developed in a various way to meet the need of users and to help people more friendly interact with computers through its various designs. Recently, various applications of smart clothing concept have been presented by researchers. Among the various applications, smart clothing with a health care system is most likely to gain the highest demand rate in the market. Among them, smart clothing for check-up of health status with its sensors is expected to sell better than other types of smart clothing on the market. Under this circumstance, research and development for this field have been accelerated furthermore. This research institution has invented biometric sensors suitable for the smart clothing, and has developed a design to diagnose various diseases such as cardiac disorder and respiratory diseases. The newly developed smart clothing in this study looks similar to the previous inventions, but people can feel more comfortable in it with its fabric interaction built in it. When people wear it, the health status of the wearers is diagnosed and its signals are transmitted to the connected computer so the result can be easily monitored in real time. This smart clothing is a new kind of clothing as a supporting system for preventing various cardiac disorder and respiratory diseases using its biometric sensor built-in, and is also an archetype to show how smart clothing can work on the market.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.127-136
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• 2009

Purpose: It is known that aspiration pneumonitis is associated with high mortality and morbidity following overdose. However, until now, few domestic studies on this subject have been conducted. The main aim of this study is to investigate the risk factors associated with aspiration pneumonitis in intubated patients following overdose. Methods: Among 654 adult overdosed patients who visited our institution from Jan. 2006 to June 2008, we enrolled 70 intubated patients within 24 hours after their overdose, and we reviewed the medical records to collect the data. This data was processed by univariate analysis, followed by multiple logistic regression analysis. P values <0.05 were deemed statistically significant. Results: In our study, a high incidence of pneumonitis was seen in the patients with an older age, a lower GCS and a high poisoning severity score or a high comorbidity score (p<0.05). Compared with the non-pneumonitis group, the pneumonitis group had a higher incidence of intubation (6% vs 61.8%, respectively, p<0.05). The main cause of intubation was a decreased mentality (68.6%). Older age, a high comorbidity score, irrigation without airway protection, relative hypoxemia and hyperkalemia were the risk factors of aspiration pneumonitis in the intubated overdosed patients (p<0.05). Among these factors, age, a high potassium level and airway protection might be significant predictors of aspiration penumonitis (p<0.05). Conclusion: Older age, a high potassium level and irrigation without proper airway protection may be the significant factors that can predict aspiration pneumonitis in patients who are intubated within 24 hours after overdose, although the further investigations on this are needed.

• Advances in pediatric surgery
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• v.8 no.2
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• pp.126-132
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• 2002

Inguinal hernia is a major surgical disease in pediatric surgery, occurring in 3.5% to 5% of all mature newborns and 9% to 11% of all premature babies. The objective of this study is to analyze the predisposing factors in association with recurrences of inguinal hernias in infants and children. In the period from January 1995 to September 2001, 1,575 infants and children who had primary inguinal hernias or recurrent inguinal hernias operated on at the Department of Pediatric Surgery at Seoul National University Hospital were evaluated retrospectively. We evaluated the data by medical records and by telephone interview. The sex, age, location of hernia, comorbidity, prematurity, incarceration, interval to operation after incarceration, postoperative complications were analyzed as predisposing factors in associated with hernia recurrence. Operative findings of recurrent inguinal hernia were reviewed. The data were statistically analyzed with Pearson Chi-Square test and Fisher-exact test. A total of eighteen (1.14%) out of 1,575 patients underwent an operation due to recurrent inguinal hernia. In 5 (27.8%) out of 18 recurred patients, institution of the primary herniorrhaphy was our hospital and in the other 13 (72.2%) was outside hospital. No impact on the development of recurrences was seen for sex, age, interval to operation after incarceration, and postoperative complications. The significant predisposing factors of recurrent inguinal hernias were left inguinal hernias (p=0.002), comorbidity (p=0.002), prematurity (p=0.006), incarceration (p=0.017) and technical error of first herniorrhaphy. We expect that knowledge for predisposing factors of recurrent inguinal hernias and experienced skill of pediatric surgeons will decrease recurrence rate in primary inguinal hernia.