• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.197-202
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• 2019

The cause of a pilonidal cyst is unclear, and treatment is still under debate. In Korea, the incidence of this disease is lower than that of Western countries, and it has often been misdiagnosed as a simple abscess. When pilonidal cysts are diagnosed, the principle of treatment is not to leave a residue, and a wide excision is needed to reduce the recurrence rate. This paper introduces a wide excision technique using Indigo-carmine dye to minimize the recurrence of a pilonidal cyst.

• The Journal of the Korea Contents Association
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• v.10 no.4
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• pp.247-256
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• 2010

This study, using questionnaires to target Servicemen were investigating. Study period of 2009 October to 24 was 20 days. All 600 questionnaires distributed affair, but 565 cases were collected. The purpose of the this study was serviceman investigate the actual conditions of utilization of private hospitals and awareness for the level of military hospital medical service as well as to the selection of future for the private hospitals is to finding. Results of the study are as follows: Outpatient utilization rate of each other the military hospital and private hospitals was 60.7% and 18.9%.(p<.000) The results of frequency study of the factors which affect the private hospital is satisfaction of medical workforce(58.9%), medical equipment and facilities(49.6%), etc. The choice of hospital were inpatient and outpatient both the selected by private hospitals. Had to prefer a private hospital were statistically significant (p<.005). In conclusion, to increase the preference of the military hospital is level of private hospital health care level of should be to developed. More support to financial should provide for medical workforce and setting of cutting edge medical equipment in the military hospital. Military hospital is should be competition with private hospital. Also should be improve the quality of military medical service.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.470-476
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• 2018

Facial motor evoked potential (FMEP) by multi-pulse transcranial electrical stimulation (mpTES) can complement free-running electromyography (EMG) and direct facial nerve stimulation to predict the functional integrity of the facial nerve during cerebello-pontine angle (CPA) tumor surgery. The purpose of this paper is to examine the standardized test methods and the usefulness of FMEP as a predictor of facial nerve function and to minimize the incidence of facial paralysis as an aftereffect of surgery. TES was delivered through electrode Mz (cathode) - M3/M4 (anode), and extracranially direct distal facial muscle excitation was excluded by the absence of single pulse response (SPR) and by longer onset latency (more than 10 ms). FMEP from the orbicularis oris (o.oris) and the mentalis muscle simultaneously can improve the accuracy and success rate compared with FMEP from the o.oris alone. Using the methods described, we can effectively predict facial nerve outcomes immediately after surgery with a reduction of more than 50% of FMEP amplitude as a warning criterion. In conclusion, along with free-running EMG and direct facial nerve stimulation, FMEP is a useful method to reduce the incidence of facial paralysis as a sequela during CPA tumor surgery.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.653-662
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• 2023

Purpose This study aimed to determine the incremental value of using a structured report (SR) for US examinations of the pediatric appendix. Materials and Methods Between January 2009 and June 2016, 1150 pediatric patients with suspected appendicitis who underwent US examinations of the appendix were included retrospectively. In November 2012, we developed a five-point scale SR for appendix US examinations. The patients were divided into two groups according to the form of the US report: free-text or SR. The primary clinical outcomes were compared between the two groups, including the rate of CT imaging following US examinations, the negative appendectomy rate (NAR), and the appendiceal perforation rate (PR). Results In total, 550 patients were included in the free-text group and 600 patients in the SR group. The rate of additional CT examinations decreased by 5.3% in the SR group (8.2%, p = 0.003), and the NAR decreased by 8.4% in the SR group (7.8%, p = 0.028). There was no statistical difference in the appendiceal PR (37.6% vs. 48.0%, p = 0.078). Conclusion The use of an SR to evaluate US examinations for suspected pediatric appendicitis results in lower CT use and fewer negative appendectomies without an increase in appendiceal PR.

• The Korean Journal of Medicine
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• v.94 no.1
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• pp.96-106
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• 2019

Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI. Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI. Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001). Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.405-406
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• 2009

Introduction : 최근 의료기관 내 진료비 정산으로 인한 전산화사업이 적극 추진되면서 각 의료기관은 생성된 자료의 목적과는 무관하게 대량의 자료를 지니고 있으면서도 병원경영과 관련하게 자료를 활용하고 있지 못하다．Objectives : 병원 입원환자의 데이터를 분석하여 입원환자의 이탈요인을 파악하여 이탈을 방지하고 지속적인 의료서비스를 제공할 수 있도록 하고자 한다. Method : 본 연구는 일개병원을 퇴원환자를 대상으로 2006년 1월 1일~2007년 12월 31일 동안의 퇴원환자 데이터를 기반으로 연구되었다. 퇴원환자 38,359명의 병원데이터 베이스를 기반으로 동일 연구기간 외래 누적데이터 375,659건의 외래환자 데이터와 비교하여 퇴원환자 중 재입원 예약 및 외래진료 예약 부도여부를 비교하는 후향적 연구를 수행하였다. 2008년 1월 1일 기준 재입원 예약 및 외래진료 예약부도 발생여부를 기준으로 계속진료환자 그릅과 이탈환자그룹을 생성하였다. 중복을 제거한 총 대상은 3,503명이였다. Discussion :본 연구에서 얻어진 결과를 기초로 퇴원환자의 이탈률이 높은 환자그룹을 집중 관리하여 이탈을 방지하고 관심을 갖고 향후 잠재적 이탈 고객을 다시 유입할 수 있는 많은 방안들이 마련되어야 할 것이다.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.387-391
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• 2002

Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.

• Journal of Hospice and Palliative Care
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• v.21 no.1
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• pp.23-32
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• 2018

Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

• Proceedings of the Korean Information Science Society Conference
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• 2006.10b
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• pp.526-530
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• 2006

논문은 CT영상에서 영역 확장 기법을 이용하여 인간의 장기 중 뇌와 간을 자동으로 추출할 수 있는 방법을 제안한다. 이는 뇌와 간이 CT영상에서 비교적 넓은 영역을 차지하고 있다는 사실에 기인하였으며, CT영상에서 특정 장기 영역을 추출하기 위해서 크게 초기 탐색 영역 결정 단계와 최종 장기 영역 단계로 나누어진다. 초기 탐색 영역은 CT영상 내에서 추출하고자 하는 장기 영역과 관계없는 부분을 제거하고 특정 장기 영역만을 남겨 관심 장기 영역의 검출률을 높이는 작업이다. 본 논문에서는 CT영상에서 비교적 높은 Gray Level을 가지고 있는 뼈영역인 두개골과 척추의 위치를 기반으로 하여 초기 탐색 영역을 결정하는 방법을 사용하였다. 특정 장기 영역의 추출은 ATID(Automatic Threshold Intensity Decision)를 이용한 이진화 단계, 모폴로지의 Opening 기법을 이용한 잡음제거 단계, Region Growing 기법을 이용한 특정 영역 추출 단계를 이용하는 과정을 거친다. 본 논문에서는 Region Growing 기법을 거친 다음 각각의 그룹 중에서 크기가 가장 큰 부분을 최종 특정 장기 영역으로 결정하였다. 본 논문에서 제안한 알고리즘은 국립전남대학교 부속병원에서 수집된 각각 뇌영상 100장과 간영상 100장을 사용하여 실험하였고, 제안된 알고리즘을 통해 관심 장기 영역을 추출했을 경우 약 91%이상의 높은 추출률을 보였다.

• Journal of Convergence for Information Technology
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• v.10 no.8
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• pp.187-193
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• 2020

This study analyzed how risk factors in management affect the management of working capital in general hospitals in Korea. The data used accounting information for three years (2016~2017 and 2018) of 271 general hospitals using the medical institution accounting information disclosure system. The independent variables were the working capital level and the cash conversion cycle, The dependent variables were operational risk and market risk, Control variables were selected as components of working capital(cash, accounts receivable, inventory assets, accounts payable). According to the study, the lower the operational risk, the higher the level of working capital hospitals in Korea. Working capital decisions were confirmed to be attributable to operating risks, cash, inventory assets and accounts payable. And the lower the market risk (Operating Margin), the higher the cash conversion cycle. Therefore, it is necessary to review appropriate management measures of operational risks, cash, inventory assets and accounts payable identified as operating capital determinants so that medical institutions can also have economic response capabilities in consideration of the specificity of their operations.