• Title/Summary/Keyword: non-hospital

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Factors Affecting the Reuse of Non-face-to-face Treatment by Non-face-to-face Treatment Patients in Tertiary General Hospital (상급종합병원 비대면 진료 재이용에 영향을 미치는 요인)

  • Sun-Young Min;Tae Hyun Kim;Sang Gyu Lee;Suk-Yong Jang
    • Korea Journal of Hospital Management
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    • v.28 no.4
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    • pp.1-22
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    • 2023
  • Purposes: The purpose of this study is to identify and analyze the factors that affect patients reusing non-face-to-face treatments at tertiary general hospitals. Methodology: We retrospectively analyzed a patient's reuse of non-face-to-face treatment from February 1, 2020, to December 31, 2021, at a tertiary general hospital in Seoul within one year of the first non-face-to-face treatment. A frequency analysis was conducted to identify the study subjects' demographic characteristics, treatment type characteristics, disease characteristics, and hospital use type characteristics. Also, across-analysis was conducted to verify the difference in non-face-to-face treatment reuse according to the characteristics a multiple logistic regression analysis was conducted to identify the factors affecting the reuse of non-face-to-face treatment by non-face-to-face treatment patients. Findings: The results of this study can be interpreted as indicating that the following groups are more likely tore use the non-face-to-face treatment: women, children, the elderly, Patients living far from the hospital, psychiatric patients, pediatric patients, medical benefits recipients, chronic patients, patients with mobility difficulties, and patients with high loyalty to hospitals. Practical Implications: When developing a non-face-to-face treatment system in the future, based on the results of this study, it is possible to target patients who prefer non-face-to-face treatment. And this study will be research material for vitalizing non-face-to-face treatment. In addition, the activation of the non-face-to-face treatment system will be an effective means for improving the quality of medical services and generating profits in hospitals in the future.

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Prescription and Non-prescription Drug Classification of Hospital Pharmacy Formulations (의료기관조제실제제의 전문$\cdot$일반의약품 분류)

  • Lee, Eui Kyoung;Ko, Reek Kyoung;Jhang, Won Ki
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.3
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    • pp.130-139
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    • 2000
  • This study is intended to set the criteria for the classification of prescription and non-prescription drugs, and classify hospital pharmacy formulations according to the criteria. 717 hospital pharmacy formulations were collected ken the Center for review and evaluation of health insurance, and national provincial offices. Hospital pharmacy formulations were evaluated based on the 'Guidelines on the Hospital Pharmacy Formulations (Notification No. 2000-46)'by the Ministry of Health and Welfare. Drug classification advisory committee was composed of twelve medical and pharmaceutical specialists, and suggested opinions on the drug classification. Among 717 formulations, 651 drugs $(90.8\%)$ satisfied the basic conditions for the hospital pharmacy formulations. 312 formulations $(43.5\%)$ were classified as drugs for the disinfection and tests. For the rest of them, 231 formulations were classified as prescription drugs whereas 108 drugs were as non-prescription drugs. 56 non-prescription drugs were included as hospital formulations, because there were no therapeutic alternatives. Iu sum 599 drugs $(83.5\%)$ were suggested as hospital pharmacy formulations. The study also recommends pharmaceutical companies to produce drugs of limited commercial value, and doctors to change their unique prescribing behavior in order to prevent the abuse of hospital pharmacy formulations.

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Non-Watertight Intermittent Dural Closure in Neurological Surgery (뇌수술의 비방수성 경막 봉합)

  • Cho, Yong Woon;Moon, Jae Gon;Hwang, Yong Soon;Park, In Suk;Jeon, Byung Chan;Kim, Han Kyu
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.640-643
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    • 2000
  • Objective : In neurosurgical practice, it has been generally accepted that when the dura is opened, it should be watertightly closed, and traditionally non-watertight closure has not been performed. We clinically tried non-watertight closure, analyzed the frequency of CSF leakage and evaluated the possible clinical application of non-watertight closure. Methods : After classifying our cases with supratentorial and infratentorial approach, we tried non-watertight and watertight closures and compared the results. We also analyzed the cases with or without dural graft. Results : In supratentorial approach, the rate of cerebrospinal fluid leakage noted in non-watertight closure was similar to that of watertight closure. In infratentorial approach, except microvascular decompression(MVD), the rate of cerebrospinal fluid leakage in non-watertight closure was higher than that of watertight closure. Dura graft application did not seemed to influence the cerebrospinal fluid leakage. Conclusion : Since the frequency of cerebrospinal fluid leakage was not higher in non-watertight closure than that of watertight closure, non-watertight closure can be applied in supratentorial approach. In infratentorial approach, non-watertight closure may be applied in surgery with relatively short dural incision, such as MVD. However, non-watertight closure doesn't seem to be appropriate in surgery that requires wide dural incision, such as skull base surgery.

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Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study

  • Azusa Kawasaki;Kunihiro Tsuji;Noriya Uedo;Takashi Kanesaka;Hideaki Miyamoto;Ryosuke Gushima;Yosuke Minoda;Eikichi Ihara;Ryosuke Amano;Kenshi Yao;Yoshihide Naito;Hiroyuki Aoyagi;Takehiro Iwasaki;Kunihisa Uchita;Hisatomi Arima;Hisashi Doyama
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.75-82
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    • 2023
  • Background/Aims: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy. Methods: This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions. Results: For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44-8.40; p<0.001). Conclusions: Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.

Comparison of Clinical Characteristics and Effects of Modified Jaw Thrust Maneuver During Drug-Induced Sleep Endoscopy (DISE) between Positional and Non-Positional Obstructive Sleep Apnea Patients

  • Moon, Ji Seung;Koo, Soo Kweon;Kim, Young Joong;Lee, Sang Hoon;Lee, Ho Byoung;Park, Geun Hyung;Lee, Sang Jun
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.190-197
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    • 2018
  • Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

Characteristics of Metachronous Remnant Gastric Cancer After Proximal Gastrectomy: A Retrospective Analysis

  • Kenichi Ishizu;Tsutomu Hayashi;Rei Ogawa;Masashi Nishino;Ryota Sakon;Takeyuki Wada;Sho Otsuki;Yukinori Yamagata ;Hitoshi Katai;Yoshiyuki Matsui;Takaki Yoshikawa
    • Journal of Gastric Cancer
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    • v.24 no.3
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    • pp.280-290
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    • 2024
  • Purpose: Despite annual endoscopy, patients with metachronous remnant gastric cancer (MRGC) following proximal gastrectomy (PG) are at times ineligible for endoscopic resection (ER). This study aimed to clarify the clinical risk factors for ER inapplicability. Materials and Methods: We reviewed the records of 203 patients who underwent PG for cT1 gastric cancer between 2006 and 2015. The remnant stomach was categorized as a pseudofornix, corpus, or antrum. Results: Thirty-two MRGCs were identified in the 29 patients. Twenty MRGCs were classified as ER (ER group, 62.5%), whereas 12 were not (non-ER group, 37.5%). MRGCs were located in the pseudo-fornix in 1, corpus in 5, and antrum in 14 in the ER group, and in the pseudofornix in 6, corpus in 4, and antrum in 2 in the non-ER group (P=0.019). Multivariate analysis revealed that the pseudo-fornix was an independent risk factor for non-ER (P=0.014). In the non-ER group, MRGCs at the pseudo-fornix (n=6) had more frequent undifferentiated-type histology (4/6 vs. 0/6), deeper (≥pT1b2; 6/6 vs. 2/6) and nodal metastasis (3/6 vs. 0/6) than non-pseudo-fornix lesions (n=6). We examined the visibility of the region developing MRGC on an annual follow-up endoscopy one year before MRGC detection. In seven lesions at the pseudofornix, visibility was only secured in two (28.6%) because of food residues. Of the 25 lesions in the non-pseudo-fornix, visibility was secured in 21 lesions (84%; P=0.010). Conclusions: Endoscopic visibility increases the chances of ER applicability. Special preparation is required to ensure the complete clearance of food residues in the pseudo-fornix.

Seismic Performance Evaluation of Acceleration-sensitive Medical and Mechanical Equipments in General Hospitals (가속도에 민감한 종합병원 의료 및 기계설비의 내진성능 평가)

  • Kim, Taewan;Kim, Seung Re;Chu, Yurim;Bhandari, Diwas
    • Journal of the Earthquake Engineering Society of Korea
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    • v.22 no.4
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    • pp.235-244
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    • 2018
  • The main function of the general hospital building is to provide medical facilities and service. However, damage to the non-structural elements such as architectural, medical, mechanical and other components will interrupt those functions after the earthquake. Especially, it is considered that, damage to the non-structural elements is a serious event because it is directly associated with the lives of patients. Therefore, this study evaluated whether the certain non-structural elements of general hospital building has the seismic performance to provide hospital medical services after the earthquake. The evaluation is conducted by selecting the non-structural elements used in general hospital which are sensitive to acceleration, such as cooling towers, air handler, MRI and CT. As a result, the non-structural elements located on the upper floor without suitable support method did not meet the performance objective. Therefore, adequate anchorage against the seismic event is required for such non-structural elements that are acceleration-sensitives.

Incidence and Clinical Outcomes of Non-endometrioid Carcinoma of Endometrium: Siriraj Hospital Experience

  • Jaishuen, Atthapon;Kunakornporamat, Kate;Viriyapak, Boonlert;Benjapibal, Mongkol;Chaopotong, Pattama;Petsuksiri, Janjira;Therasakvichya, Suwanit
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2905-2909
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    • 2014
  • Background: To study the incidence of non-endometrioid carcinoma of endometrium and compare the clinical characteristics and treatment outcomes with endometrioid carcinoma patients. Materials and Methods: This study included 236 patients with endometrial carcinoma at Siriraj Hospital whom were diagnosed and treated from 2003 through 2006. The clinical characteristics, pathological features, treatment and clinical outcomes were collected from the medical records. The 5-year survival was calculated according to 2009 FIGO staging. Results: Non-endometrioid carcinoma of endometrium accounted for 10.2% of all endometrial carcinomas (24/236 patients). The 5-year survival rate was significantly lower in the non-endometrioid group compared to the endometrioid group (77.3% vs 96%, p<0.001) and clinical data pointed to greater malignancy. Conclusions: Non-endometrioid carcinoma of endometrium is relative rare but is more aggressive, has more distant metastasis at diagnosis with a worse survival rate than endometrioid carcinoma. Only patients in stage IA with no residual disease on a hysterectomy specimen may not need adjuvant treatment.

Potential Predictors of Sensitivity to Pemetrexed as First-line Chemotherapy for Patients with Advanced Non-Squamous NSCLCs

  • Lu, Yan-Yan;Huang, Xin-En;Xu, Lin;Liu, De-Gan;Cao, Jie;Wu, Xue-Yan;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2005-2008
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    • 2013
  • Background: Pemetrexed (PEM) is effective in first-line treatment for patients with non-squamous non-small cell lung cancer (NSCLC). However there are currently no definitive determinants to certify which patients could benefit from PEM. To improve the efficacy of PEM combined with platinum as first-line therapy for advanced non-squamous NSCLC, we conducted this retrospective study to detect potential determinants of this regimen. Methods: We recruited 109 patients with advanced non-squamous NSCLC who received PEM with a platinum as first-line therapy from June 2006 to February 2013 in Jiangsu Cancer Hospital. Multiple variables (age, sex, smoking, degree of cell differentiation, hemoglobin, platinum drugs combined, positions of metastasis) were selected. Logistic regression analysis was used to analyse relationships between these variables and tumor response. Result: In univariate analysis, we found that age and platinum significantly influenced the results of PEM therapy (P<0.05). In multivariable analysis, no factors were independently significant. Conclusion: Our analysis did not suggest that the age, sex, metastasis of liver or other organs, hemoglobin, smoking history and pathological differentiation are associated with the response of PEM. We should conduct further analyses with larger sample size to reconfirm this issue.

The treatment of Non-obstructive Azoospermia (비폐쇄성 무정자증의 치료)

  • Seo, Ju-Tae;Park, Yong-Seog;Kim, Jong-Hyun;Lee, You-Sik;Jun, Jin-Hyun;Lee, Ho-Joon;Son, Il-Pyo;Kang, Inn-Soo;Jun, Jong-Young
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.1
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    • pp.95-99
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    • 1997
  • Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) or testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.

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