• Title/Summary/Keyword: Care system

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Isolation Frequency of Candida species from Clinical Specimens (임상검체에서 Candida spp.에 대한 분리빈도)

  • Shin, Hyun-Sung;Park, Youn-Bo;Shin, Du-Sik
    • The Korean Journal of Mycology
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    • v.38 no.2
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    • pp.146-151
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    • 2010
  • A total of 167,955 microorganisms were isolated from 366,661 clinical specimens. Among them, 6,517 strains of the Candida spp. were isolated from the department of laboratory medicine in "C" hospital from Jan. 1, 2005 to Dec. 31, 2009. All clinical specimens were reviewed by the medical records of patients with Candida by the method of retrospectiveness. From this, we got the some isolated pure cultured yeasts. We identified these yeast by the identification kit system of VITEKII and VITEKII-ID-YST card. The isolation frequencies of Candida spp. were as follows. 56.4%,of C. albicans, 17.7% C tropicalis, 10.7% C glabrata and 9.5% C parapsilosis. The isolated frequency of Candida spp. in 2009 was 1.9 times higher than that in 2005. The clinical materials showing over 10.0% isolation rate were in sputum (30.1%), random urine (25.0%), 15.8% blood (15.8%) and catheterized urine (13.5%) in Candida spp.. The clinical department of showing over 7.0% isolation rate were in pulmonary medicine (20.5%), renal medicine (11.0%), infection disease medicine (10.4%), critical care medicine (10.0%), hematooncology (9.6%), general surgery (7.5%) and gastrointestinal medicine (7.4%) in Candida spp.. In monthly analysis, Candida spp. were most friquency isolated in July (10.6%), but lowest one in February (6.1%). Candida spp. were most frequently isolated in patient of over 50 years old (16.7-40.1%) than those isolated from the patients under the age of 0-49 (1.3-7.5%).

Does Additional Aortic Procedure Carry a Higher Risk in Patients Undergoing Aortic Valve Replacement?

  • Kim, Tae-Hun;Park, Kay-Hyun;Yoo, Jae Suk;Lee, Jae Hang;Lim, Cheong
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.295-300
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    • 2012
  • Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: $11.0{\pm}7.8%$ in the complex AVR group and $12.3{\pm}8.0%$ in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass ($152.4{\pm}52.6$ minutes vs. $109.7{\pm}22.7$ minutes, p=0.001), the quantity of allogenic blood products did not differ ($13.4{\pm}14.7$ units vs. $13.9{\pm}11.2$ units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ${\geq}5$ units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ${\geq}24$ hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.

Job Competency in Ultrasonography of Korean Radiological Technologists (한국 방사선사의 초음파진단검사 직무역량에 관한 고찰)

  • Lim, Chang Seon;Kim, Chuk Bok;Namkung, Jang Sun;Jin, Gye Hwan
    • Journal of the Korean Society of Radiology
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    • v.13 no.6
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    • pp.857-864
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    • 2019
  • Many countries, including Canada, operate a sonographer license system separately from a radiological technologist license. However, in Korea, radiological technologists perform ultrasound imaging under the guidance of doctors. Therefore, in order to have the opportunity to provide a systematic education by analyzing the job competency of the radiological technologist's ultrasound imaging, based on the Canadian National Competency Profile (NCP) lists, this study measured the job content validity of the job competences and detailed competencies required for performing ultrasonography in Korea. From the results of comparing and analyzing the importance of the core competencies included in the Korean radiological technologist's job competencies and the degree of job performance, the average overall importance was 4.087, the average of overall performance was 3.640, showing that the importance was higher than the performance and that there was a statistically significant difference. In conclusion, 'A Communication', 'B Professional responsibilities', 'D Operation of equipment' and 'G Workplace health and safety' showed high job content validity. However, it is said that as 'C Patient assessment and care', 'E Critical thinking and problem solving', and 'H Image' showed low job content validity, it is necessary to seek ways to strengthen and complement these competencies.

Analysis on the utilization Pattern of a General Hospital - With Cases of General Hospital Inpatients in the Provincial Area - (종합병원 이용형태에 관한 분석 - 지방소재 종합병원 입원환자 중심 -)

  • Jung, Yong-Mo;Jun, Sun-Kyong;Lee, Yong-Chul
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.14-24
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    • 2009
  • This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

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A Study on the Service Quality Evaluation in Electronic Customs Clearance Making Use of Kano-IGA Integrated Approach (Kano-IGA 통합접근법을 이용한 전자통관 서비스 품질의 평가에 관한 연구)

  • Song, Sun-Yok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.54-61
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    • 2019
  • This paper reports a comparative review of the service quality attributes of Electronic Customs Clearance (UNI-PASS) by applying the Kano model, Timko's BW coefficients, and IGA model, as reported by Tontini et al. in terms of a service quality evaluation of electronic customs clearance as the comprehensive national customs administration information system. In addition, this study examined which quality attributes should be focused on to improve the service quality and enhance customer satisfaction using the electronic customs clearance service. The Kano, Timko, and IGA models were classified into the four common quality attributes: attractive quality, one-dimensional quality, must-be quality, and indifferent quality. Because the integrated approach was used, one-dimensional quality was included in the area for critical improvement, while the must-be quality was included in the area for intensive maintenance. In addition, the indifferent quality was included in the area of carefree, while the attractive quality was included in the area of competitive advantage.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

The PNPLA3 rs738409 Variant but not MBOAT7 rs641738 is a Risk Factor for Nonalcoholic Fatty Liver Disease in Obese U.S. Children of Hispanic Ethnicity

  • Mansoor, Sana;Maheshwari, Anshu;Guglielmo, Matthew Di;Furuya, Katryn;Wang, Makala;Crowgey, Erin;Molle-Rios, Zarela;He, Zhaoping
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.5
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    • pp.455-469
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    • 2021
  • Purpose: The rs641738 C>T in membrane-bound O-acyltransferase domain-containing protein 7 (MBOAT7) is implicated, along with the rs738409 C>G polymorphism in patatin-like phospholipase domain-containing protein 3 (PNPLA3), in nonalcoholic fatty liver disease (NAFLD). The association of these polymorphisms and NAFLD are investigated in Hispanic children with obesity. Methods: Obese children with and without NAFLD were enrolled at a pediatric tertiary care health system and genotyped for MBOAT7 rs641738 C>T and PNPLA3 rs738409 C>G. NAFLD was characterized by the ultrasonographic presence of hepatic steatosis along with persistently elevated liver enzymes. Genetic variants and demographic and biochemical data were analyzed for the effects on NAFLD. Results: Among 126 enrolled subjects, 84 in the case group had NAFLD and 42 in the control group did not. The two groups had similar demographic distribution. NAFLD was associated with abnormal liver enzymes and elevated triglycerides and cholesterol (p<0.05). Children with NAFLD had higher percentage of PNPLA3 GG genotype at 70.2% versus 31.0% in non-NAFLD, and lower MBOAT7 TT genotype at 4.8% versus 16.7% in non-NAFLD (p<0.05). PNPLA3 rs738409 C>G had an additive effect in NAFLD; however, MBOAT7 rs641738 C>T had no effects alone or synergistically with PNPLA3 polymorphism. NAFLD risk increased 3.7-fold in subjects carrying PNPLA3 GG genotype and decreased in MBOAT7 TT genotype. Conclusion: In Hispanic children with obesity, PNPLA3 rs738409 C>G polymorphism increased the risk for NAFLD. The role of MBOAT7 rs641738 variant in NAFLD is less evident.

Appraisal of Guidelines for Research & Evaluation II Appraisal of Clinical Practice Guidelines for Traffic Injuries (Appraisal of Guidelines for Research & Evaluation (AGREE) II를 이용한 교통사고 상해증후군의 국내·외 기개발 임상진료지침의 평가)

  • Park, Kyeong-Won;Lee, Jun-Seok;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.129-143
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    • 2021
  • Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

Mediating Effect of Attitude toward Advertisement on the Relationship between COVID-19 Involvement and Behavioral Intention of Social Distancing in Loss versus Gain Advertising Context (손실과 이득 메시지 프레이밍 광고상황에서 COVID-19에 대한 관여와 사회적 거리두기 실천의도와의 관계에 영향을 미치는 광고태도의 매개효과)

  • Choi, Ja In;Choi, Ja Yun
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.467-477
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    • 2021
  • Purposes of this study were to identify the relationship among involvement in COVID-19 (IiC), attitude toward advertisement (AtA), and behavioral Intention to social distancing (BItSD), and to investigate the mediating effect of AtA in a loss versus gain advertising context. The participants were 379 adults who have been consecutively living in Korea since January 2020. The participants were randomly assigned to one of two advertisements using an online survey system. We found that IiC affects BItSD since Korean adults recognize the risks and seriousness of COVID-19 infection or transmission through IiC. Induced positive attitudes or emotions through involvement in the COVID-19 preventive behaviors including social distancing and vaccination are helpful to increase the BItSD. Thus, health care and information providers should give an accurate message, which induces a positive attitude, to recognize that our world is a risk of the COVID-19.

Liberalization of Telemedicine in Germany (독일 원격의료 합법화와 법개정 논의)

  • Kim, SooJeong
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.3-33
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    • 2020
  • Until recently the German and the South Korean medical associations reacted cautiously to the introduction of telemedicine between doctor and patient which is exclusively on the platform conducted. But the General Assembly of German Physicians voted to lift the ban on remote treatment with the amendment to Section 7 (4) MBO-Ä(Medical Association's Professional Code of Conduct) in 2018 and the situation has been fundamentally changed in Germany. From then until now 16 of 17 rural medical associations have changed their professional code to allow telemedicine. In addition the legislature started to prepare the basis for the introduction of the electronic health card (eGK) and the telematics infrastructure. So far, various laws such as Medicinal Products Act, Drug Advertisement Act and Social Code have been changed to support legalization of telemedicine and digitalization of health care. Unlike in Germany, the social circumstances such as excessive centralization of the big hospitals in Seoul and the resulting concern of small medical practices for profitability are the main obstacles to the introduction of telemedicine. However the German approach how to legalise the telemedicine and to prepare for legal and technical infrastructure is also interesting in South Korea. The discussions for and against the changes in the law and the telematics infrastructure attempted by the German government for several years indicate that not only lifting the ban on remote treatment, but also harmonization of all the related legal system could guarantee successful implementation of telemedicine.