• Journal of Trauma and Injury
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• v.32 no.3
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• pp.136-142
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• 2019

Purpose: Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV). Methods: This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows. Results: NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05). Conclusions: NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

• Quality Improvement in Health Care
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• v.8 no.2
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• pp.186-207
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• 2001

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2007.11a
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• pp.93-98
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• 2007

The air velocity flowing in inner combustion chamber of SCramjet is supersonic and the time of its stay is very short as a few milliseconds. Within this short time, fuel injection， air-fuel mixing, and combustion process should be accomplished. Several methods are suggested for mixing enhancement. Among these, cavity is selected to study for mixing characteristics. The numerical simulation is performed in the case of freestream Mach number of 2.5 and cavity located in front of fuel jet injection. 3 different sized cavities of the same length-height ratio were used in order to recognize the effect about cavity size. Also, the case without cavity was analyzed to find the effect of cavity. Used code compared with the result of experiment under identical conditions and it was verified. Through this comparison and verification, mixing enhancement by cavity size could be confirmed.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.645-654
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• 2002

Purposes : This study was conducted to examine nursing effects after using a new method of nasogastric tube feeding with recycled PETE bottle making use of gravity, and to compare with those of bolus method using syringe and pressure. Methods : The data collected from patients with nasogastric tube feeding more than a week at an internal medicine unit of C university hospital located in G-city from January 1st, 1998 through June 30th, 2000. For this nonequivalent control group posttest non-synchronized design, 28 patients were assigned to an experimental group and 35 patients to a control group. The homogeneity of two groups and the dependent variables were tested with use of $x^2-test$ and t-test. Results : The duration of hemostatic use was significantly shorter in the experimental group than control group(t=2.63, p=0.02). Also, the patients with PETE bottle feeding had a lower cost of material(t=3.51, p=0.01) and a lower rate of the time of direct nursing care(t=2.44, p=0.04) than those of control group. But, there was no significant difference between two groups in the length of hospital stay. Conclusion : This results indicates that nasogastric tube feeding with PETE bottle is superior to nasogastric tube feeding with syringe. This findings gave us an evidence to enhance nursing effectiveness in clinical setting.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7359-7366
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• 2013

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

• Journal of Gastric Cancer
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• v.10 no.2
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• pp.69-74
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• 2010

Purpose: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy. Materials and Methods: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler. Results: There were 12 female and 13 male patients with a mean age of $55.6{\pm}11.2$. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was $179.5{\pm}27.4$ minutes, the mean anastomotic time was $17.5{\pm}3.4$ minutes. The mean number of stapler cartridges was $5.6{\pm}0.8$. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was $6.7{\pm}1.0$ days except the complication case, and there was no case of conversion to open procedure and postoperative mortality. Conclusions: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.4
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• pp.1511-1519
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• 2010

The purpose of this study was to analyze regional medical utilization variation of hospital inpatients and to suggest policy for the allocation of medical service in Korea. We analyzed the relationship among medical service, city size, income level and regional medical utilization variation of hospital inpatients. The patient survey report of 2005 year in Ministry of Health and Welfare was used for this study. To adjust on the factor age and sex, we used direct standardization method. Findings of the research were summarized as follows ; First, standardization discharge rate on patient was different in the district. city type, and number of beds. Second, standardization length of stay of patient was different in region, city type, and number of beds.

• Archives of Plastic Surgery
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• v.51 no.3
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• pp.304-310
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• 2024

Background Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. This study aimed to assess impact of a psychiatric diagnosis on patients treated for HS. Methods Patients with HS were retrospectively identified at a single institution from 2010 to 2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. Results Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a preexisting psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1 ± 11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs. 1.5, p < 0.001), a higher median number of ED visits (1.0 vs. 0, p = 0.006), and a similar hospital length of stay (p = 0.456). The mean COST-FACIT score of the overall study population was 19.2 ± 10.7 (grade 1 financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, p = 0.092) and reported greater financial hardship (3.3 vs. 1.7, p < 0.001). On multivariate analysis, a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. Conclusion Preexisting psychiatric conditions in patients with HS are associated with increased health care utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.5-8
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• 2016

Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

• International Journal of Fluid Machinery and Systems
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• v.3 no.4
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• pp.315-323
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• 2010

This work investigates the influence of water compressibility on pressure pulsations induced by rotor-stator interaction (RSI) in hydraulic machinery, using the commercial CFD solver ANSYS-CFX. A pipe flow example with harmonic velocity excitation at the inlet plane is simulated using different grid densities and time step sizes. Results are compared with a validated code for hydraulic networks (SIMSEN). Subsequently, the solution procedure is applied to a simplified 2.5-dimensional pump-turbine configuration in prototype with different speeds of sound as well as in model scale with an adapted speed of sound. Pressure fluctuations are compared with numerical and experimental data based on prototype scale. The good agreement indicates that the scaling of acoustic effects with an adapted speed of sound works well. With respect to pressure fluctuation amplitudes along the centerline of runner channels, incompressible solutions exhibit a linear decrease while compressible solutions exhibit sinusoidal distributions with maximum values at half the channel length, coinciding with analytical solutions of one-dimensional acoustics. Furthermore, in compressible simulation the amplification of pressure fluctuations is observed from the inlet of stay vane channels to the spiral case wall. Finally, the procedure is applied to a three-dimensional pump configuration in model scale with adapted speed of sound. Normalized Pressure fluctuations are compared with results from prototype measurements. Compared to incompressible computations, compressible simulations provide similar pressure fluctuations in vaneless space, but pressure fluctuations in spiral case and penstock may be much higher.