• 한국임상수의학회지
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• 제31권4호
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• pp.288-292
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• 2014

A critical assumption of the standard sample size calculation is that the response (outcome) for an individual patient is completely independent to that for any other patient. However, this assumption no longer holds when there is a lack of statistical independence across subjects seen in cluster randomized designs. In this setting, patients within a cluster are more likely to respond in a similar manner; patient outcomes may correlate strongly within clusters. Thus, direct use of standard sample size formulae for cluster design, ignoring the clustering effect, may result in sample size that are too small, resulting in a study that is under-powered for detecting the desired level of difference between groups. This paper revisit worked examples for sample size calculation provided in a previous paper using nomogram to easy to access. Then we present the concept of cluster design illustrated with worked examples, and introduce design effect that is a factor to inflate the standard sample size estimates.

• 간호행정학회지
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• 제4권1호
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• pp.229-246
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• 1998

This dissertation classifies sample patients by a measure of K-DRG to identify the most frequent group. and investigates the differences in the dependency of nursing by patient classification system in the SICU of Seoul National University Hospital in Korea. It also calculates the mean nursing care hours and costs per craniotomy patient, who is shown to be the most frequent patient group. The results of the research can be used as basic data for the development of relevant nursing cost system in the future. The results of the research are as follows: 1. Using data from 97 sample patients, as many as 26 groups are identified when the patients are classified by K-DRG. KDRG-001 (craniotomy) is found to be the most frequent group(43.30%). 2. The result from patient classification system grouping in craniotomy patients shows homogeneity in terms of dependency of nursing with 35 patients in the 4th group, 145 patients(74.36%) are in the 5th group. and 15 patients are in the 6th group among the total 195 sample patients. 3. The direct nursing care hours for the 4th, 5th, and 6th patient classification system groups are found to be 381 minuites. 483 minuites, and 519 minuites, respectively, which shows that the nursing care hours increases as the dependency of nursing is intensified. The indirect nursing care hours are found to be 454 minuites(7.57 hours). The total mean nursing care hours, which is the sum of the direct nursing care hours(467 min.: 7.78 hours) and the indirect nursing care hours (454 min.: 7.57 hours), is 921 minuites(15.35 hours) per patient a day. 4. The nursing care cost is calculated to be 123,297 won per patient a day. Considering the average duration in the ICU, we can find the total nursing care cost is 610,318 won.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.35-46
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• 2023

Purpose: Culture-based methods for microbiological diagnosis and antibiotic susceptibility tests have limitations in the management of orofacial infections. We aimed to profile pus microbiota and identify antibiotic resistance genes (ARGs) using a culture-independent approach. Materials and Methods: Genomic DNA samples extracted from the pus specimens of two patients with orofacial abscesses were subjected to shotgun sequencing on the NovaSeq system. Taxonomic profiling and prediction of ARGs were performed directly from the metagenomic raw reads. Result: Taxonomic profiling revealed obligate anaerobic polymicrobial communities associated with infections of odontogenic origins: the microbial community of Patient 1 consisted of one predominant species (Prevotella oris 74.6%) with 27 minor species, while the sample from Patient 2 contained 3 abundant species (Porphyromonas endodontalis 33.0%; P. oris 31.6%; and Prevotella koreensis 13.4%) with five minor species. A total of 150 and 136 putative ARGs were predicted in the metagenome of each pus sample. The coverage of most predicted ARGs was less than 10%, and only the CfxA2 gene identified in Patient 1 was covered 100%. ARG analysis of the seven assembled genome/metagenome datasets of P. oris revealed that strain C735 carried the CfxA2 gene. Conclusion: A metagenomics-based approach is useful to profile predominantly anaerobic polymicrobial communities but needs further verification for reliable ARG detection.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• 한국임상수의학회지
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• 제36권3호
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• pp.180-183
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• 2019

A 7-year-old, male Maltese dog with a body weight of 2.8 kg was presented with a history of hind limbs ataxia that progressed to tetraparesis over a one-month period. Based on physical and neurological examinations, tetraparesis with concomitant UMN signs, kyphosis and severe neck pain were identified. On MRI scan, we tentatively diagnosed this patient as a primary intramedullary spinal cord tumor. Therapy with lomustine plus hydroxyurea and prednisolone was initiated and the clinical signs rapidly improved. The patient was regularly checked by MRI scan and the range of the mass was gradually reduced to complete remission for 11 months. About 19 months after treatment, the patient showed anemia and hematochezia which suspected as adverse effects of chemotherapy. The condition was getting worse over 2 months and the patient suddenly expired 657 days after initial presentation. On histopathological examination, the spinal cord sample was identified as a neuronal atrophy without evidence of tumor cell.

• Perspectives in Nursing Science
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• 제10권2호
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• pp.133-140
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• 2013

Purpose: This study aimed to investigate the perspective of consumers in healthcare services regarding patient safety. Methods: The study was a descriptive study using a self-reported questionnaire. The questionnaire was based on the Senior Empowerment and Advocacy in Patient Safety (SEAPS) questionnaire, which was designed to assess patient safety health beliefs. The survey was conducted online and a convenient sample of 302 adults participated in total. The reliability of the measurement (Cronbach's ${\alpha}$) was 0.758 in attitude (ATT), 0.546 in out-come efficacy (OE), 0.757 in self-efficacy (SE), and 0.703 in behaviors (BEH). Results: The average patient safety awareness score of the healthcare service consumers was 2.72 (ATT), 2.91 (OE), 2.87 (SE), and 2.27 (BEH). Our analysis indicated that there were no differences in ATT, BEH, or SE by gender, age, or education level. However, in OE and the total score of the four subscales, there were significant differences by age and gender. Correlations were identified between BEH and SE (r=0.409, p<.01), BEH and OE (r=0.202, p<.01), ATT and SE (r=0.358, p<.01), and OE and SE (r=0.241, p<.01). Conclusion: This study measured consumer perspectives concerning patient safety. The findings demonstrate the need for developing a measurement tool to assess consumer's perception of patient safety, considering Korean healthcare system and cultural context.

• Genomics & Informatics
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• 제11권1호
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• pp.34-37
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• 2013

This study evaluated the effects of somatic mutations and single nucleotide polymorphisms (SNPs) on disease progression and tried to verify the two-hit theory in cancer pathogenesis. To address this issue, SNP analysis was performed using the UCSC hg19 program in 10 acute myeloid leukemia patients (samples, G1 to G10), and somatic mutations were identified in the same tumor sample using SomaticSniper and VarScan2. SNPs in KRAS were detected in 4 out of 10 different individuals, and those of DNMT3A were detected in 5 of the same patient cohort. In 2 patients, both KRAS and DNMT3A were detected simultaneously. A somatic mutation in IDH2 was detected in these 2 patients. One of the patients had an additional mutation in FLT3, while the other patient had an NPM1 mutation. The patient with an FLT3 mutation relapsed shortly after attaining remission, while the other patient with the NPM1 mutation did not suffer a relapse. Our results indicate that SNPs with additional somatic mutations affect the prognosis of AML.

• 임상간호연구
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• 제19권1호
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• pp.115-127
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• 2013

Purpose: This study aimed to describe how nurses in neurological intensive care units (ICU) perceive their roles about patient transfer and liaison. Methods: A cross-sectional survey was conducted using a questionnaire developed for the study. Data were collected from a convenience sample of 115 nurses working in the neurological intensive care units ofsix university hospitals. Data were analyzed using SPSS software (version 15.0). Results: Staff nurses were mainly in charge of patient transfer, and the awareness about its importance was significantly related with the burden about the practice of patient transfer (p<.001). Patient liaison was mainly conducted by staff nurses as well. Liaison practice wassuggested to be started from the ICU at the time of transfer; the suggested time for completion of liaison service and evaluation was when patients were adjusted to the transferred ward. Preparing job descriptions and increasing nursing staffing for patient liasion service were strongly recommended. Conclusion: The results suggest that the ICU nurses' burden in relation to patient transfer is commensurate with their awareness about itsimportance. To improve the continuity of care from ICU to transferred ward, it isrequired to reduce the burden about patient transfer and improve perceptions about patient liaison.

• 한국의류학회지
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• 제31권7호
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• pp.1097-1106
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• 2007

The purpose of this study is for development textile design and making fabric actually for dementia patients hospital clothing using symbol which has social care meaning. For achievement the aim, process and research methods were as follows. First the symbol design was developed. Second the symbol was applied as textile design for dementia patients hospital clothing. Symbol design was under processed with a letter 'Alzheimer' and meanings as like 'love', 'happiness' 'care' 'hope' and 12 design samples were developed by CAD and photoshop. Total 15 evaluation members chose 2 design samples. The 2 design sample were practically arrangement 7 textile design pattern with ground different colors. And finally 3 design pattern and 3 colorway were selected and add white ground. Totally 7 textile design was printed on 100% cotton, 20 yarn count, 1/2 twill. Therefore this new textile design for dementia patient's hospital clothing can be used in medical clinically and the symbol can be use for daily care item for the patients more comfort and high quality in their lives in hospital.

• 한국임상약학회지
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• 제28권1호
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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.