• Title/Summary/Keyword: review standard

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A Ruptured Salmonella-Infected Abdominal Aortic Aneurysm of the Suprarenal Type -A case report- (신동맥 상방의 파열된 Salmonella 복부 대동맥류 - 1예 보고 -)

  • Moon, Jong-Hwan;Hong, You-Sun;Lim, Sang-Hyun;Jung, Joon-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.199-203
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    • 2010
  • Infected aortic aneurysms are rare, but the mortality of patients with infected aortic aneurysms remains high. Open surgical procedures are the standard of care for infected aneurysms of aorta, but the surgical results are often disappointing. The risk factors related to the high mortality include aneurysm rupture and a suprarenal aneurysm location. The classic method for treating infected aneurysms has been aneurysm resection, soft tissue debridement, remote arterial reconstruction out of the field of infection and antibiotics. Infected anuerysms located in the suprarenal aorta are highly lethal because of the need to reimplant the visceral or renal arteries and the graft related complications. We reported here on a case of suprarenal infected aortic aneurysm in a 55-years-old man. We also include a review of the relevant medical literature.

Analysis of Medical Use and Costs of Liver Transplant Patients Using National Patients Sample Data (환자표본자료를 이용한 간이식 환자의 의료이용 특성 및 의료비용 분석)

  • Kim, Hye-Lin
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.57-64
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    • 2018
  • Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

Development of Ex-post Cost Benefit criteria and Analysis Plan for an Urban Stream Restoration Project: The Case of Cheonggyecheon Restoration Project (도심 하천복원사업을 위한 사후 비용편익 항목 및 분석방안 제시: 청계천 복원사업을 사례로)

  • Lee, Miyeon;Jung, Insu
    • Journal of Environmental Policy
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    • v.11 no.3
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    • pp.67-96
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    • 2012
  • The Ministry of Environment in Korea has been promoting the urban stream restoration project for paved streams in cities as the restored Cheonggyecheon. As an elementary study for suggesting policy implications for the project, cost and benefit criteria for an ex-post analysis on the Cheonggyecheon project is suggested in this study. The ex-ante analysis were reviewed critically by focusing on the cost and benefit criteria. Ex-post analysis plan in this study is developed considering the standard guideline of pre-feasibility, the theory of cost-benefit analysis, and the review results. The costs for compensating lands, amending conflicts, researching rivers, and maintaining water quantity were also included. For the benefits, this study proposes to estimate the benefits with the assessment on naturalness of stream. The results are expected to contribute to increase the efficiency of the urban stream restoration project and evaluate the project to match better with the meaning of the river restoration.

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Evaluation on the Performance of Nursing in according to the Nursing grade of Hospitals (병원 간호등급에 따른 간호수행 정도)

  • Yun, Soon-Gil;Park, Jae-Yong;Kim, Key-Hoon;Han, Chang-Hyun
    • Korea Journal of Hospital Management
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    • v.15 no.3
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    • pp.1-16
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    • 2010
  • As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses' awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses' performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses' awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses' job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.

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A Review of Renal Dialysis Unit Environment for Infection Prevention - Focused on Evidence Based Design (감염 예방을 위한 인공신장실 의료 환경에 대한 고찰 - 근거 기반의 디자인 중심으로)

  • Han, Su Ha;Yoon, Hyungjin
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.49-57
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    • 2018
  • Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.

Review on the Management for Radioactive Effluent and Methodology for Setting of Derived Release Limits at Pressurized Heavy Water Reactors in Korea (중수로원전 방사성유출물 관리와 유도배출한계 설정방법에 대한 고찰)

  • Kim, Hee-Geun;Kong, Tae-Young;Jeong, Woo-Tae;Kim, Seok-Tae
    • Journal of Radiation Protection and Research
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    • v.35 no.4
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    • pp.172-177
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    • 2010
  • The radioactive effluents from pressurized heavy water reactors (PHWRs) are relatively larger than those from pressurized water reactors (PWRs). Futhermore, radioactive effluents from PHWRs are released continuously. Thus, the discharge of radioactive effluents is strictly controlled. To do this, radiation detectors are installed at stacks of reactor buildings to monitor the concentration of radioactive effluents in real-time. Derived release limits (DRLs) of annual discharge are also set up for each radionuclide and effluents are rigidly controlled not to exceed those limits. In this paper, the discharge process of radioactive effluents, the standard for establishment of DRL and its methodology, and currents status for PHWRs were reviewed.

Status of meat alternatives and their potential role in the future meat market - A review

  • Lee, Hyun Jung;Yong, Hae In;Kim, Minsu;Choi, Yun-Sang;Jo, Cheorun
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.10
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    • pp.1533-1543
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    • 2020
  • Plant-based meat analogues, edible insects, and cultured meat are promising major meat alternatives that can be used as protein sources in the future. It is also believed that the importance of meat alternatives will continue to increase because of concerns on limited sustainability of the traditional meat production system. The meat alternatives are expected to have different roles based on their different benefits and limitations. Plant-based meat analogues and edible insects can replace traditional meat as a good protein source from the perspective of nutritional value. Furthermore, plant-based meat can be made available to a wide range of consumers (e.g., as vegetarian or halal food products). However, despite ongoing technical developments, their palatability, including appearance, flavor, and texture, is still different from the consumers' standard established from livestock-based traditional meat. Meanwhile, cultured meat is the only method to produce actual animal muscle-based meat; therefore, the final product is more meat-like compared to other meat analogues. However, technical difficulties, especially in mass production and cost, remain before it can be commercialized. Nevertheless, these meat alternatives can be a part of our future protein sources while maintaining a complementary relationship with traditional meat.

Immunosignature: Serum Antibody Profiling for Cancer Diagnostics

  • Chapoval, Andrei I;Legutki, J Bart;Stafford, Philip;Trebukhov, Andrey V;Johnston, Stephen A;Shoikhet, Yakov N;Lazarev, Alexander F
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4833-4837
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    • 2015
  • Biomarkers for preclinical diagnosis of cancer are valuable tools for detection of malignant tumors at early stages in groups at risk and screening healthy people, as well as monitoring disease recurrence after treatment of cancer. However the complexity of the body's response to the pathological processes makes it virtually impossible to evaluate this response to the development of the disease using a single biomarker that is present in the serum at low concentrations. An alternative approach to standard biomarker analysis is called immunosignature. Instead of going after biomarkers themselves this approach rely on the analysis of the humoral immune response to molecular changes associated with the development of pathological processes. It is known that antibodies are produced in response to proteins expressed during cancer development. Accordingly, the changes in antibody repertoire associated with tumor growth can serve as biomarkers of cancer. Immunosignature is a highly sensitive method for antibody repertoire analysis utilizing high density peptide microarrays. In the present review we discuss modern methods for antibody detection, as well as describe the principles and applications of immunosignature in research and clinical practice.

Progress and Challenges in Chemotherapy for Loco-Regionally Advanced Nasopharyngeal Carcinoma

  • Liang, Zhong-Guo;Chen, Ze-Tan;Li, Ling;Qu, Song;Zhu, Xiao-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4825-4832
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    • 2015
  • Incidence rates of nasopharyngeal carcinoma are high in Indonesia, Singapore and South-Eastern China. Chemoradiotherapy has been the standard regimen for locally advanced nasopharyngeal carcinoma according to guidelines from the National Comprehensive Cancer Network. Recently, advances in the management of nasopharyngeal carcinoma have transferred into better treatment outcomes. Most phase III clinical trials support the addition of concurrent chemotherapy to radiotherapy for the initial treatment of these patients. Studies evaluating effects and toxicity of concurrent chemotherapy with different regimens have been reported. However, the status of adding adjuvant chemotherapy or induction chemotherapy remains controversial. Recent studies have shown that adjuvant chemotherapy with two or three cycles may improve survival for nasopharyngeal carcinoma with stage N2-3 disease or with persistently detectable plasma EBV DNA after radiotherapy. This review examines the pertinent issues and latest studies concerning the management of loco-regionally advanced NPC, regarding concurrent chemotherapy, adjuvant chemotherapy, and induction chemotherapy in decades.

Nursing Activities on Continuous Renal Replacement Therapy in the Intensive Care Units (중환자실 내 지속적 신대체 요법과 관련된 간호업무 분석)

  • Yun, Seonyoung;Lee, Young Ock;Kang, Jiyeon;Yun, Mi-Jeong;Won, Youn-Hui;Lee, Mi-Young
    • Journal of Korean Critical Care Nursing
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    • v.6 no.2
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    • pp.65-77
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    • 2013
  • Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.

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