• Title/Summary/Keyword: the length of stay

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A Study on Patterns of Sap Water Users of Acer mono (고로쇠나무 수액(樹液) 이용객(利用客)의 음용형태(飮用形態)에 관(關)한 연구(硏究))

  • An, Jong Man;Kim, Jun Sun;Kang, Hag Mo
    • Journal of Korean Society of Forest Science
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    • v.87 no.4
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    • pp.510-518
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    • 1998
  • This study was carried out to investigate the drinking patterns of sap water of Acer mono by on-the-spot visitors. The survey was done from late-February to mid-March in the 3 major sap water tapping regions, such as Piagol of Mt. Chiri in Kurey, Okryong of Mt. Baekun in Kwangyang, and Mt. Chokey in Sunchon, Chonnam. A total of 300 visitors over 20 years old, 100 visitors in each region, were interviewed personally to make up questionnaires, irrespective of sex. The purpose of drinking, the frequency of visit, the modes of traffic, the length of stay, drinking amount per person, one's opinions after drinking, drinking plans and patterns, and intention of drinking processed sap were investigated and examined. Wide range of age groups from twenties to sixties drank sap water. Visitors drank sap water in order to keep health, to promote mutual friendship, and so on. 44% of sap drinkers visited for the first time, and 71% visited by private automobiles holding the first place. 59.7% of visitors spent only a day, but 40.3% passed one or two nights to drink sap water. For drinking amount of sap water, $3-6{\ell}$ a was consumed by 31.3% of visitors, under $3{\ell}$ or $9-12{\ell}$ by 22.7% $6-9{\ell}$ by 12.7% and so forth. 74% of visitors felt sap water sweet and favorable, but were doubtful about the efficacy of sap water. 79.0% of visitors had a plan to drink sap water again next year, 40% of whom preferred a day's visit to overnight staying (29%) or 3 days' staying (6%). 45% answered to plan to drink sap water with having meals, and 43% with having meals and passing a night. More than half (54.3%) of the visitors were inclined not to drink processed sap water for the reasons of unreliable quality, unwillingness for process, change in quality, etc.

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Two-Layer Hand-Sewn Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy for Gastric Cancer

  • Norero, Enrique;Munoz, Rodrigo;Ceroni, Marco;Manzor, Manuel;Crovari, Fernando;Gabrielli, Mauricio
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.267-276
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    • 2017
  • Purpose: Different esophagojejunostomy (EJ) reconstruction methods are used after totally laparoscopic total gastrectomy (TLTG), and none is considered a standard technique. This report describes a 2-layer hand-sewn EJ technique during TLTG; we also evaluated postoperative morbidity associated with this technique. Materials and Methods: This retrospective cohort study included all consecutive patients who underwent TLTG for gastric cancer (GC) from 2012 to 2016 at 2 affiliated teaching hospitals. All participating surgeons performed standardized intracorporeal 2-layer hand-sewn EJ. Results: We included 51 patients who underwent TLTG for GC and standardized EJ anastomosis. Twenty-seven (53%) were male, and the median age was 60 (36-87) years. The average operative time was $337{\pm}71minutes$ and intraoperative bleeding was $160{\pm}107mL$. There were no open conversions related to EJ. Postoperative morbidity was observed in 9 (17.0%) patients. There was no postoperative mortality. EJ leakage was observed in 2 patients (3.8%) and 1 patient (1.9%) developed EJ stenosis. Patients with leakage were managed non-operatively and the patient with stenosis required endoscopic dilation. The median length of hospital stay was 8 (6-29) days. Conclusions: Two-layer hand-sewn EJ during TLTG for GC is a feasible and safe technique. This method avoids a laparotomy for reconstruction and the disadvantages associated with laparoscopic introduction of mechanical staplers for EJ, and provides an alternative for alimentary tract reconstruction after TLTG.

Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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Study of seismic performance of super long-span partially earth-anchored cable-stayed bridges

  • Zhang, Xin-Jun;Yu, Cong;Zhao, Jun-Jie
    • Structural Engineering and Mechanics
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    • v.72 no.1
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    • pp.99-111
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    • 2019
  • To investigate the seismic performance of long-span partially earth-anchored cable-stayed bridge, a super long-span partially earth-anchored cable-stayed bridge scheme with main span of 1400m is taken as example, structural response of the bridge under E1 seismic action is investigated numerically by the multimode seismic response spectrum and time-history analysis, seismic behavior and also the effect of structural geometric nonlinearity on the seismic responses of super long-span partially earth-anchored cable-stayed bridges are revealed. The seismic responses are also compared to those of a fully self-anchored cable-stayed bridge with the same main span. The effects of structural parameters including the earth-anchored girder length, the girder width, the girder depth, the tower height to span ratio, the inclination of earth-anchored cables, the installation of auxiliary piers in the side spans and the connection between tower and girder on the seismic responses of partially ground-anchored cable-stayed bridges are investigated, and their reasonable values are also discussed in combination with static performance and structural stability. The results show that the horizontal seismic excitation produces significant seismic responses of the girder and tower, the seismic responses of the towers are greater than those of the girder, and thus the tower becomes the key structural member of seismic design, and more attentions should be paid to seismic design of these sections including the tower bottom, the tower and girder at the junction of tower and girder, the girder at the auxiliary piers in side spans; structural geometric nonlinearity has significant influence on the seismic responses of the bridge, and thus the nonlinear time history analysis is proposed to predict the seismic responses of super long-span partially earth-anchored cable-stayed bridges; as compared to the fully self-anchored cable-stayed bridge with the same main span, several stay cables in the side spans are changed to be earth-anchored, structural stiffness and natural frequency are both increased, the seismic responses of the towers and the longitudinal displacement of the girder are significantly reduced, structural seismic performance is improved, and therefore the partially earth-anchored cable-stayed bridge provides an ideal structural solution for super long-span cable-stayed bridges with kilometer-scale main span; under the case that the ratio of earth-anchored girder length to span is about 0.3, the wider and higher girder is employed, the tower height-to-span ratio is about 0.2, the larger inclination is set for the earth-anchored cables, 1 to 2 auxiliary piers are installed in each of the side spans and the fully floating system is employed, better overall structural performance is achieved for long-span partially earth-anchored cable-stayed bridges.

Effects of Preoperative Psychological fare on Postoperative Recovery - An Exploratory Experiment - (수술 전 심리간호가 회복에 미치는 효과에 관한 실험적 연구)

  • 김조자
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.97-113
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    • 1971
  • The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.

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Transhiatal versus Transthoracic Esophagectomy for Esophageal Cancer (식도암의 식도열공을 통한 식도절제술과 개흉을 통한 식도절제술의 비교)

  • 박기성;박창원;최세영;이광숙;유영선;이재훈;금동윤
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.296-302
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    • 2002
  • The classic approach for esophagectomy is via the combined thoracic and abdominal approach. Controversy exists whether patients with esophageal carcinoma are best managed with Ivor-Lewis esophagectomy(ILO) as combined thoracic and abdominal approach or transhiatal esophagectomy(THO). The THO approach is known to be superior with respect to operative time, severity of leak, morbidity/mortality, and length of stay, but may represent an inferior cancer operation as a result of survival disadvantage due to inadequate mediastinal clearance compared with ILO. Accordingly, we reviewed the results of our esophageal resections to compare these outcome parameters for each operative approach. Material and Method: From January 1993 to July 2001, We performed a retrospective review of all esophagectomies performed at Keimyung University Dongsan ·Medical Center; 27 underwent THO, and 45 underwent ILO Result: The two groups were comparable in terms of age, sex, and stage of the disease. Mean tumor length and mean operative time were 3.81cm and 354 minutes for THO versus 5.31cm and 453 minutes for ILO, respectively (p<0.01 and p<0.001). Respiratory complications were 11.1% for THO versus 35.6% for ILO(p<0.05). Hospital mortality was 11.1% for THO versus 22.2% for ILO. There were no significant differences between THO and ILO with respect to other types of complications, amount of blood transfusion, leak and stricture rates, and hospital stay. Overall long-term survival at 5 years was 37%, respectively. Conclustion: There was no significant difference in long-term survival of patients of both operative approach. ILO had significant difference in respiratory complications associated with hospital mortality. Hence, THO is a valid alternative to ILO for well selected patients. And either approach appears to be acceptable depending on the surgeons, preferences and experiences.

Comparison of Moxifloxacin Monotherapy versus Cephalosporin-Azithromycin Combination Therapies for the Treatment of Community Acquired Pneumonia (원외획득폐렴 환자 치료에서 Moxifloxacin 단독요법과 Cephalosporin-Azithromycin 병용요법의 비교)

  • Cheong, Eun-Jin;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.75-81
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    • 2005
  • Community acquired pneumonia (CAP) remains a prevalent and potentially life threatening illness. American Thoracic Society and Infectious Disease Society America recommend combination therapies with ${\beta}-lactam$ plus a macrolide or a fluoroquinolone monotherapy for the empirical treatment of CAP. The aim of this study was to compare moxifloxacin monotherapy with cephalosporin plus azithromycin combination therapies. From January 2004 to March 2005, 18 patients in the moxifloxacin group(MG) and 21 patients in the cefuroxime or ceftriaxone plus azithromycin group(CAG) with CAP were retrospectively reviewed with regard to clinical, laboratory and microbiological data. Each patient was stratified into mild (risk class I-II), moderate (risk class III) and severe (risk class VI, V) group according to and PSI (Pneumonia Severity Index) score. Each group was compared for microbiological eradication, clinical assessment, the length of hospital stay. As results, Total 39 patients with CAP were reviewed. The appropriateness of admission was 83.3% in MC vs. 76.2% in CAC. The mean length of the hospital day was for 8.31 days vs. 7.39 days, days switching parenteral to oral antibiotics in 5.19 days vs. 5.28 days, clinical improvement in 2.43 days vs. 2.61 days in MG vs. CAC. Radiological improvement required 3.75 days vs 3.63 days in MG vs. CAG and bacteriological eradication rate at discharge was the same in the both groups. Mortality rate was 11.1% (2 of 18) vs 14.3% (3 of 21) in MG vs. CAG (p=0.77). Drug cost of the mean 5 hospital days requiring parenteral antibiotics was the most inexpensive in moxifloxacin group for the 147,045 won, and ceftriaxone 1g-azithromycin group for the 170,285 won, cefuroxime bid-azithromycin group for the 207,800 won, ceftriaxone 2g-azithromycin group far the 220,570 won, cefuroxime tid-azithromycin group for the 251,700 won. There was no significant statistical difference in clinical, bacterial, radiological cure and hospital days, and switch to oral days. In conclusion, that i.v. moxifloxacin monotherapy was as effective as azithromycin plus cefuroxime or ceftriaxone combination therapies fur the treatment of CAP. In drug cost analysis, moxifloxacin is less expensive than CAG.

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Predicting Acculturation for Chinese International Students in Korea: The Role of Social Support through SNS (SNS 이용 동기와 사회적 지지가 문화적응에 미치는 영향 - 국내 거주 중국인 유학생의 문화적응을 중심으로)

  • Moon, Shin-Il;Jia, Liao;Lee, Hyunjoo;Kim, Kitae
    • The Journal of the Korea Contents Association
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    • v.21 no.1
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    • pp.722-732
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    • 2021
  • A recent rapid growth in the number of Chinese international students in Korea has generated interest in the key factors to affect their acculturation in domestic culture. In accordance with the growing interest, the present study aims to empirically test and analyze the effects of demographics (gender, age, the length of stay, the length of Korean language education and the level of Korean language skills), SNS use patterns (personal network sizes and hours of use for Korean and Chinese SNS, and motivations of Korean or Chinese SNS uses), and social support through Korean and Chinese SNS on acculturation for Chinese international students in Korea. A total of 322 Chinese international students in Korea participated in the online survey. Results showed that use of Chinese SNS for entertainment had an negative impact on the acculturation, while the use of Korean SNS had an overall positive impact. Finally, this study suggests that the practitioners regarding the issue of acculturation for international students in Korea should focus more on specific guidelines to help their appropriate SNS uses rather than on to prevent their SNS addiction problems.

Clinical Analysis of 89 Patients with Severe Acute Ischemic Stroke from 3rd Intensive Care Unit(East-West Integrated Intensive Care Uint) of Kyung Hee Medical Center (경희의료원 제3 중환자실(동서협진중환자실)에 입원한 89명의 중증 급성기 뇌경색 환자에 대한 임상적 고찰)

  • Heo, Hong;So, Hyung-Jin;Im, Ju-Hyuk;Cho, In-Young;Lee, Hae-Yong;Min, Kyoung-Yoon;Ryu, Jae-Hwan;Lee, Beom-Jun
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.863-871
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    • 2007
  • Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

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Clinical Aspects of Bacteremia in Medical and Surgical Intensive Care Units (내과 및 외과계 중환자실 환자 균혈증의 임상적 고찰)

  • Kim, Eun-Ok;Lim, Chae-Man;Lee, Jae-Kyoon;Mung, Sung-Jae;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo;Pai, Chik-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.535-547
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    • 1995
  • Background: Intensive care units(ICUs) probably represent the single largest identifiable source of infection within the hospital. Although there are several studies on ICU infections in respect to their bacteriology or mortality rate for individual types of ICU, few studies have compared ICU infections between different types of ICU. The aim of this study was to identify clinical differences in bacteremia between medical ICU(MICU) and surgical ICU(SICU) patients. Methods: 256 patients with bacteremia were retrospectively evaluated. Medical records were reviewed to obtain the clinical and bacteriologic informations. Results: 1) The mean age of the patients with bacteremia of MICU($58.6{\pm}17.2\;yr$) was greater than that of all MICU patients($54.3{\pm}17.1\;yr$)(p<0.01), but there was no significant difference in SICU patients(patients with bacteremia of SICU: $56.3{\pm}18.6\;yr$, all SICU patients: $62.0{\pm}16.8$)(p>0.05). ICU stay was longer(MICU patients: $23.4{\pm}40.8$ day, SICU patients: $30.3{\pm}26.8$ day) than the mean stay of all patients($6.8{\pm}15.5$ day)(p<0.05, respectively). Bacteremia of both ICU patients developed past the average day of ICU stay(all MICU patients: 7.9 day, all SICU patients: 6.0 day, MICU bacteremia: 19th day, SICU bacteremia: 17th day of ICU stay)(p<0.05, respectively). 2) There were no significant differences in mean age, sex, and length of stay of both ICU patients with bacteremia. 3) Use of antibiotics or steroid, use of percutaneous devices and invasive procedures before development of bacteremia were more frequent in SICU patients than in MICU patients(prior antibiotics use: MICU 45%, SICU 63%, p<0.05; steroid use: MICU 14%, SICU 36%, p<0.01; use of percutaneous devices: MICU 19%, SICU 39%, p<0.01; invasive procedures: MICU 19%, SICU 61 %, p<0.01). 4) The prevalence of community acquired infections was significantly higher in MICU patients than in SICU patients(MICU 42%, SICU 9%)(p<0.01), whereas SICU patients showed higher prevalence of ICU-acquired infection than MICU patients(MICU 48%, SICU 78%)(p<0.01). 5) There were no differences in causative organisms, primary sites of infection and time interval to bacteremia between both ICUs. 6) There were no significant differences in outcome according to pathogenic organisms or primary sites of infection. 7) The mortality rate was higher in patients with bacteremia than without bacteremia(MICU mortality rate: patients with bacteremia 72.5%, patients without bacteremia 36.0%, p<0.01; SICU mortality rate: patients with bacteremia 40.3%, patients without bacteremia 8.5%, p<0.05), and the mortality rate of MICU bacteremia was significantly higher compared with that of SICU bacteremia(MICU 72.5%, SICU 40.3%)(p<0.01). Conclusion: ICU patients with bacteremia stayed longer before the development of bacteremia, and showed higher mortality than the overall ICU population. The incidence of bacteremia was higher in MICU patients than SICU patients. MICU patients with bacteremia showed higher prevalence of liver diseases and acute respiratory failure, community-acquired bacteremia and greater mortality rate than SICU patients with bacteremia. SICU patients with bacteremia, on the other hand, showed higher prevalence of trauma, prior use of immunosuppressive agents, invasive procedures, and ICU-acquired bacteremia, and lower mortality rate than MICU patients with bacteremia.

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