• 제목/요약/키워드: tertiary treatment level

검색결과 45건 처리시간 0.027초

의료 기관 구분에 따른 중독 환자의 사망률 - 건강보험심사평가원 자료 기반 (Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service)

  • 김소영;최상천;김혁훈;양희원;윤상규
    • 대한임상독성학회지
    • /
    • 제17권1호
    • /
    • pp.21-27
    • /
    • 2019
  • Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

일 상급종합병원 장기재원환자의 특성과 전원 결정 여부에 영향을 미치는 요인 (Characteristics of Long-term Care Patients at a Tertiary Referral Hospital and Factors Influencing the Decision of prolonged Care-giving)

  • 이미진
    • 가정∙방문간호학회지
    • /
    • 제31권1호
    • /
    • pp.56-65
    • /
    • 2024
  • Purpose: This study aimed to explore the association between demographic characteristics, hospitalization-related characteristics, and the severity of long-term hospitalization in a high-level general hospital, and to analyze the factors influencing decisions of all patients. Methods: General and clinical characteristics of the participants were analyzed using frequency, percentage, mean, and standard deviation. Differences in these characteristics, contingent upon whether a power source was requested, were analyzed using independent t-Test and Chi-squared tests. Logistic regression analysis was used to identify the factors related to the presence or absence of power requests. Results: The factors impacting the decision to refer a dependent variable include medical treatment (neurosurgery) (B=2.118, SE=0.960, p-value=.027, OR=8.314, 95% CI=1.267-54.551), infection isolation (CRE) (B=1.336, SE=0.666, p-value=.045, OR=3.804, 95% CI=1.032-14.021), and the utilization of tertiary antibiotics (B=3.076, SE=1.362, p-value= .024, OR=21.663, 95% CI=1.502-312.530). Conclusion: This study found a significant association between medical treatment (neurosurgery), infection isolation (CRE), and the use of tertiary antibiotics as dependent variables. These findings indicate that continuous monitoring can contribute to a reduction in long-term financial burdens.

2차처리장 방류수 정화 부들습지셀의 초기운영단계 질산성질소 제거 (Nitrate Removal of a Cattail Wetland Cell Purifying Effluent from a Secondary-Level Treatment Plant During Its Initial Operating Stage)

  • 양홍모
    • 한국환경농학회지
    • /
    • 제23권4호
    • /
    • pp.228-233
    • /
    • 2004
  • Nitrate removal was examined from May to October 2003 of a surface flow treatment wetland cell, which was a part of a treatment wetland system composed of four wetland cells and a distribution pond The system was established on rice paddy near the Kohung Estuarine Lake located in the southern part of the Korean Peninsula. Effluent from a secondary-level night soil treatment plant was funneled into the system. The investigated cell, 87 m in length and 14 m in width, was created in April 2003. An open water was designed at its center, which was equivalent to 10 percent of its total area. Cattails (Typha angustifolia) were transplanted from natural wetlands into the cell and their stems were cut at about 40cm height from their bottom ends. Average $25.0\;m^3/day$ of effluent from the treatment plant was funneled into the cell by gravity flow and average $24.1\;m^3/day$ of its treated effluent was discharged into the Sinyang Stream flowing into the lake. Its water depth was maintained about 0.2 m and its hydraulic detention time averaged 5.2 days. Average height of the cattail stems was 42.5 cm in May 2M3 and 117.7 cm in September 2003. The number of stems averaged $9.5\;stems/m^2$ in May 2003 and $16.4\;stems/m^2$ in September 2003. The growth of cattails was good. Temperature of influent and effluent averaged 25.9 and $26.7^{\circ}C$, respectively. $NO_3$-N loading rate of influent and effluent averaged 176.67 and $88.09\;mg/m^2\;day$, respectively. Removal of rf03-N averaged $89.58\;mg/m^2\;day$ and its removal rate by mass was about 50%. Considering its initial operating stage in which cattail rhizomes and litter layer on the bottom were not Idly established, the $NO_3$-N removal rate of the cell was rather good.

Preoperative Serum CEA and CA19-9 in Gastric Cancer - a Single Tertiary Hospital Study of 1,075 Cases

  • Zhou, Yang-Chun;Zhao, Hai-Jian;Shen, Li-Zong
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권7호
    • /
    • pp.2685-2691
    • /
    • 2015
  • To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.

생태적 축산폐수 처리 및 재활용 연못시스템의 폐수처리수준 (Treatment Level of a Pond System for Ecological Treatment and Recycling of Animal Excreta)

  • 양홍모;이종욱
    • 한국환경농학회지
    • /
    • 제17권1호
    • /
    • pp.70-75
    • /
    • 1998
  • 실험결과 최종처리수의 $BOD_5$를 30mg/l 이하로 유지하는 것이 충분히 가능하다. 최종처리수의 총질소와 총인은 축산폐수처리시설의 방류수 수질기준보다 월등히 낮다. 연못상층에서 조류(Algae)가 성장하면서 질소와 인을 흡수하기 때문이다. 연못시스템은 질소와 인을 동시에 제거하는 장점이 있다. 최종처리수의 평균 SS가 $30mg/{\ell}$ 보다 다소 높아 2차처리 수준의 방류수 수질기준을 충족시키지 못하는 경우가 발생할 수 있으나 연못상층의 조류(Algae) 성장에 원인이 있어 문제가 되지 않는다. 2차연못과 3차연못의 SS는 거의 조류가 차지하고 있다. 조류를 회수하여 사료로 사용하거나 처리수를 유기농업 관수로 이용하여 조류를 비료로 이용하는 재활용 방법이 바람직하다. 실험 연못시스템의 모델은 연못의 수, 연못의 종류, 각 연못의 크기, 유입폐수의 $BOD_5$ 부하량을 적절히 조절하면 액상폐수(뇨${\cdot}$오수)뿐아니라 분${\cdot}$${\cdot}$오수를 동시에 처리할 수 있다. 국내 여건에서는 중소규모 축산시설의 폐수를 처리하는데 연못시스템이 적합하며, 토지확보가 가능하면 대형 축산폐수 공동처리시설로 사용할 수 있다. 대부분 축산농가에 설치되어 있는 간이정화조와 산화구를 연못시스템으로 대치하여 이들의 낮은 처리효율의 문제점을 해결할 수 있다고 사료된다. 다른 처리기법에 비해 연못시스템은 관리운영에 적은 인력과 경비가 소요하여 노동력이 부족한 농촌지역에 적합하다.

  • PDF

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

  • Kyung-Chul, Moon;Yu-Kyeong, Yun
    • Journal of Trauma and Injury
    • /
    • 제35권4호
    • /
    • pp.261-267
    • /
    • 2022
  • Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

Inhibitory effects of Capsicum annuum L. water extracts on lipoprotein lipase activity in 3T3-L1 cells

  • Baek, Jongmi;Lee, Jaesung;Kim, Kyoungkon;Kim, Taewoo;Kim, Daejung;Kim, Cheonan;Tsutomu, Kanazawa;Ochir, Sarangowa;Lee, Kooyeon;Park, Cheol Ho;Lee, Yong-Jik;Choe, Myeon
    • Nutrition Research and Practice
    • /
    • 제7권2호
    • /
    • pp.96-102
    • /
    • 2013
  • Obesity, an intractable metabolic disease, currently has no medical treatment without side effects, so studies have been actively carried out to find natural compounds that have anti-obesity activity with minimum side effects. In this study, the anti-obesity effects of water extracts of seven Capsicum annuum L. varieties being Putgochu (Pca), Oyee gochu (Oca), Kwari putgochu (Kca), Green pepper (Gca), Yellow paprika (Yca), Red paprika (Rca) and Cheongyang gochu (Cca), were examined through the evaluation of lipoprotein lipase (LPL) mRNA expression level in 3T3-L1 cells (mouse pre-adipocytes). After capsaicin elimination by chloroform defatting, freeze-dried powder of Cca was treated to 3T3-L1 cells and anti-obesity effects were examined by determining the LPL mRNA level using the RT-PCR method. Of the primary fractions, only proven fractions underwent secondary and tertiary refractionating to determine anti-obesity effects. From seven different Capsicum annuum L., there was a significant decrease of the LPL mRNA expression level of 50.9% in Cca treatment compared to the control group. A significant decrease of the LPL mRNA expression level was shown in primary fractions (Fr) 5 (36.2% decrease) and 6 (30.5% decrease) of the Cca water extracts. Due to the impurities checked by UPLC chromatography, Fr 5 and 6 were refractionated to determine the LPL mRNA expression level. Treatment of Fr 6-6 (35.8% decrease) and Fr 5-6 (35.3% decrease) showed a significant decrease in the LPL mRNA expression level. When analyzed using UPLC, major compounds of Fr 6-6 and Fr 5-6 were very similar. Subsequently, we refractionated Fr 6-6 and Fr 5-6 to isolate the major peak for structure elucidation. Treatment of Fr 5-6-1 (26.6% decrease) and Fr 6-6-1 (29.7% decrease) showed a significant decrease in the LPL mRNA expression level. Consequently, the fractions may have a possibility to ameliorate obesity through the decrease of the LPL mRNA expression level.

ANION INDUCED BLUE TO PURPLE TRANSITION IN BACTERIORHODOPSIN

  • Singh, Anil K.;Kapil, Mrunalini M.
    • Journal of Photoscience
    • /
    • 제3권2호
    • /
    • pp.71-76
    • /
    • 1996
  • Anil K. Singh, Mrunalini M. Kapil, Department of Chemistry, Indian Institute of Technology Bombay - 400076, INDIA Purple membrane (PM, $\lambda$$_{max}$ 570 nm) of H. halobium on treatment with sulphuric acid changes its colour to blue ($\lambda$$_{max}$ 608 nm). The purple chromophore can be regenerated from the blue chromophore by exogeneous addition of anions such as CI$^-$ and HPO$_4^{2-}$. Chloride ion is found to be more effective than the dibasic phosphate ion in regenerating the purple chromophore. Nevertheless, one thing common to the anion regeneration is that both CI$^-$ and HPO$_4^{2-}$ show marked pH effect. At pH 1.0 the efficiency of regeneration of the purple chromophore is greater than at pH 2.0, for the same anion concentration. Fluorescence and circular dichroic studies indicate that the proteins do not undergo drastic changes at the secondary' or tertiary structure level and the native structure is preserved during this transition. However, chromophoric-site interactions between retinal and the apoprotein are affected during this colour transition. A molecular mechanism is advanced for this transition.

  • PDF

Psychosocial Adjustment in Korean Colorectal Cancer Survivors

  • Sun, Hyejin;Lee, Jia
    • 대한간호학회지
    • /
    • 제48권5호
    • /
    • pp.545-553
    • /
    • 2018
  • Purpose: The increasing survival rate of colorectal cancer demands various nursing interventions and continuous care for patients to adapt to their psychosocial daily lives. The purpose of this study was to identify factors associated with psychosocial adjustment in colorectal cancer survivors. Methods: A cross-sectional descriptive study with face-to-face interviews was conducted of 156 colorectal cancer survivors after surgery visiting an outpatient cancer clinic at a tertiary hospital in S city, Korea. Posttraumatic growth, health-promoting behavior, length of treatment, difficulty in activities of daily living, and having a stoma were entered into the linear regression model. Results: The strongest factor influencing the level of psychosocial adjustment was health-promoting behavior (${\beta}=.33$, p<.001), followed by difficulty in activities of daily living (${\beta}=-.24$, p=.001), posttraumatic growth (${\beta}=.20$, p=.004), and having a stoma (${\beta}=-.19$, p=.004). Conclusion: Nursing interventions for psychosocial adjustment in colorectal cancer survivors need to include the contents for posttraumatic growth, as well as health-promoting behavior, and activities of daily living.

50대 폐경 여성의 대사증후군 위험인자 분석 (Analysis of Metabolic Syndrome Risk Factors among the Menopausal Women in Her Fifties)

  • 심혜선;김희승;김주현
    • Journal of Korean Biological Nursing Science
    • /
    • 제12권1호
    • /
    • pp.58-62
    • /
    • 2010
  • Purpose: The purpose of this study was to assess the difference of metabolic syndrome (MS) risk factors according to the MS diagnosis in the age of fifties women. Methods: Forty-two subjects (non metabolic syndrome 30, metabolic syndrome 12) were recruited from the health promotion center of a tertiary care hospital in an urban city. MS was defined by third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (ATP III), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. Results: The prevalence of MS by definition of NCEP-ATP III and Asia-Pacific criteria in waist circumference was 28.6% in the age of fifties women. The educational level and the median HDL-cholesterol were significantly lower in the MS patient group than in the Non-MS group. The median of weight, triglyceride, and fasting glucose were significantly higher in the MS patient group than in the Non-MS group. Conclusion: These results indicate that the nursing care should be focused on weight, triglyceride, HDL-cholesterol, and fasting glucose of the MS patients in the fifties women.