• Clinical and Experimental Reproductive Medicine
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• v.34 no.3
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• pp.189-196
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• 2007

Objectives: The purpose of this study is to investigate the clinical significance of age and basal serum FSH in predicting the outcomes of in vitro fertilization (IVF) in patients with poor-ovarian response. Methods: From January 2000 to December 2004, 85 second IVF cycles of 85 poor-ovarian response patients under the age of 42 with a back-ground of the first IVF cycles at our infertility center and 5 or less oocytes were retrieved and their basal serum FSH levels of 15$\sim$25 mIU/ml were enrolled in this study. Exclusion criteria were patients with a male factor for the etiology of infertility and undergoing genetic diagnosis of embryo such as PGD. Flare-up protocol was used for ovarian stimulation in all cases. Results: When we stratified the study groups by patient's age, the younger age group (age<35, n=35) showed significantly higher implantation rate (19.0% versus 4.0%, p<0.05) and higher ongoing pregnancy rate (100% versus 14.3%, p<0.05) than the older age group (age$\geq$35, n=50). And then, when we stratified the study populations by basal serum FSH level, the lower FSH group (basal serum FSH<20 mIU/ml, n=58) showed significantly higher number of retrieved oocytes (4.6$\pm$0.7 versus 2.2$\pm$0.5, p<0.05) and lower cancellation rate (19.0% versus 55.6%, p<0.05) than higher FSH group (basal serum FSH$\geq$20 mIU/ml, n=27). Conclusions: In conclusion, it was suggested that the patient's age could predict the IVF outcomes in respect to its potency of pregnancy and ongoing pregnancy. Serum basal FSH levels could predict more accurately the ovarian response of cycle, but not clinical outcomes.

• Health Policy and Management
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• v.31 no.2
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• pp.225-231
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• 2021

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007-2019), the Community Health Survey (CHS, 2008-2019), the Korea Health Panel Survey (KHP, 2011-2017), and the Korean Welfare Panel Study (KOWEPS, 2006-2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general. However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

• Journal of muscle and joint health
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• v.20 no.3
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• pp.214-224
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• 2013

Purpose: The purpose of this study was to identify the differences in preference for terminal care between hospitalized patients and nurses. Methods: A cross-sectional descriptive design was used in 79 patients and 107 nurses. The data were collected from August to October 2011, using the Preference for Care near the End of life Scale - Korean Version (PCEOL-K) with 5-point scale of 26 items. The reliability of the tool was Cronbach's ${\alpha}=.74$. Results: The mean score (SD) of PCEOL-K's sub-dimensions in nurses' priority was: (a) pain $3.70{\pm}0.63$, (b) spirituality $3.63{\pm}0.61$, (c) family $3.40{\pm}0.70$, (d) autonomous decision making $2.30{\pm}0.66$, and (e) decision making by healthcare professionals $2.14{\pm}0.64$. In patients' priority, the $M{\pm}SD$ score of each sub-dimension was: (a) pain $3.86{\pm}0.65$, (b) family $3.83{\pm}0.57$, (c) decision making by healthcare professionals $3.37{\pm}0.85$, (d) spirituality $3.01{\pm}0.80$, and (e) autonomous decision making $2.43{\pm}0.63$. Results indicated significant differences between nurses and patients regarding decision making by healthcare professionals (t=-11.28, p<.001), family (t=-4.66, p<.001), and spirituality (t=5.71, p<.001). Conclusion: The PCEOL-K of patients was higher than nurses'. A terminal care program for hospitalized patients at the end of life should be planned according to the results of PCEOL-K in nurses and patients.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.292-300
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• 2023

Backgrounds/Aims: Current literature presents limited data regarding outcomes following conversion at the time of minimally invasive pancreaticoduodenectomy (MI-PD). Methods: The National Cancer Database was queried for patients who underwent pancreaticoduodenectomy. Patients were stratified into three groups: MI-PD, converted to open pancreaticoduodenectomy (CO-PD), and open pancreaticoduodenectomy (O-PD). Multivariable modeling was applied to compare outcomes of MI-PD and CO-PD to those of O-PD. Results: Of 17,570 patients identified, 12.5%, 4.2%, and 83.4% underwent MI-PD, CO-PD, and O-PD, respectively. Robotic pancreaticoduodenectomy (R-PD) resulted in a higher lymph node yield (n = 23.2 ± 12.2) even when requiring conversion (n = 22.4 ± 13.2, p < 0.001). Margin positivity was higher in the CO-PD group (26.6%) than in the MI-PD group (21.3%) and the O-PD (22.6%) group (p = 0.017). Length of stay was shorter in the MI-PD group (laparoscopic pancreaticoduodenectomy 10.4 ± 8.6, R-PD 10.6 ± 8.8) and the robotic converted to open group (10.7 ± 6.4) than in the laparoscopic converted to open group (11.2 ± 9) and the O-PD group (11.5 ± 8.9) (p < 0.001). After adjusting for patient and tumor characteristics, both MI-PD (odds ratio = 1.40; p < 0.001) and CO-PD (odds ratio = 1.24; p = 0.020) were significantly associated with an increased likelihood of long-term survival. Conclusions: CO-PD does not negatively impact perioperative or oncologic outcomes.

• Health Policy and Management
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• v.29 no.1
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• pp.82-85
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• 2019

Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2017); the Community Health Survey (CHS 2008-2017); the Korea Health Panel Survey (KHP 2011-2015); and the Korean Welfare Panel Study (KOWEPS 2006-2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was -19.2%, -13.3%, -5.8%, and -13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.

• Journal of Home Health Care Nursing
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• v.24 no.1
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• pp.5-13
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• 2017

Purpose: This study aimed to identify the workload of home healthcare nurses and their job satisfaction. Methods: The research was conducted on 87 home healthcare nurses in nationwide medical institutions. Results: Number of visits was correlated with direct nursing hours. The monthly average number of visits was 108.84 ; the average number of patients was 45.66; the average daily working hours were $8.95{\pm}0.95$, of which $5.43{\pm}1.06 $ were indirect nursing hours, and $3.57{\pm}1.05$ were direct nursing hours. The average nursing time by severity condition was 22.25 minutes for group 1 patients, 28.04 minutes for group 2, 34.97 minutes for group 3, and 42.88 minutes for group 4. Of possible scores out of 5 for the job satisfaction of home healthcare nurses, their satisfaction was low for their welfare ($2.68{\pm}1.12$), workload ($2.90{\pm}0.88$), and enough time to work ($2.98{\pm}0.90$). Conclusion: The severity of patient's conditions influenced the workload of home healthcare nurses. Although workload did not correlate significantly with job satisfaction, it is necessary to devise a measure for manpower so that home healthcare nurses can secure sufficient nursing hours when they visit clients.

• The Journal of Information Systems
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• v.28 no.3
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• pp.159-202
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• 2019

Purpose The purpose of this study is to explain users' wearable healthcare device adoption using performance expectancy, effort expectancy, the hedonic motivation and price value of UTAUT2, and to identify the causal relationship between intention to use wearable healthcare device and innovation resistance formed by perceived risks. Design/methodology/approach The research model proposed in this study is based on UTAUT2(Extended Unified Theory of Acceptance and Use of Technology) and MIR(Model of Innovation Resistance). In specific, performance expectancy, effort expectancy, hedonic motivation and price value of UTAUT2 and innovation resistance formed by perceived risks of MIR are adopted in our research model. To validate the research model, we carry out the analysis of the survey data using Smart PLS 3.0 to test the hypotheses. Findings According to the empirical analysis results, this study confirms that the performance expectancy, effort expectancy, hedonic motivation, and price value have significant effects on the intention to use wearable healthcare devices. It also finds that perceived risk affects innovation resistance and in turn, innovation resistance affects the intention to use wearable healthcare devices.

• Journal of the Korea Convergence Society
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• v.9 no.8
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• pp.61-70
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• 2018

The purpose of this study was to identify the of patient safety related to perception of Hospital environment, Organizational culture, Reporting system and Factors Influencing on Perception of Medical Errors Report Related to Patient Safety of Healthcare Workers in a General Hospital. Healthcare Workers in a General Hospital in B City who signed on the written consent participated in this study between February 12 and 28, 2017. A total of 244 copies were collected and were analyzed using the SPSS 22.0 program. The result mean score perception of Hospital environment was 3.26(${\pm}0.31$)point on a scale of 0 to 5, and Organizational culture 3.74(${\pm}0.54$)point, Reporting system 3.64(${\pm}0.57$)point. Factors influencing on perception of medical errors report is sex(${\beta}=.137$, p=.023), Type of occupation(${\beta}=289$, p=.001), Department of Nursing(${\beta}=-.196$, p=.023), Hospital environment(${\beta}=.327$, p=<.001), Organizational culture(${\beta}=.288$, p=<.001). Therefore management and hospital management efforts should be made to establish a system that enables healthcare workers to report without fear of medical errors reporting, and appropriate staffing and open communication.

• Journal of Genetic Medicine
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• v.4 no.2
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• pp.160-166
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• 2007

Purpose : The ${\beta}$-adrenoceptors are pharmacologically classified into ${\beta}_1$-, ${\beta}_2$- and ${\beta}_3$-adrenoceptor. The gene of each subtype has polymorphisms related to their function (${\beta}_1$-adrenoceptor: Ser49Gly, ${\beta}_2$-adrenoceptor: Gln27Glu, ${\beta}_3$-adrenoceptor: Trp64Arg). The objectives of this study were to analyse the allelic and genotypic distribution of the representative polymorphism of ${\beta}$-adrenoceptors in preeclampsia and to investigate whether combined genotype of ${\beta}$-adrenoceptors may be associated with preeclampsia. Methods : Blood samples were collected from a Korean population (159 preeclamptic pregnancies and 168 normotensive pregnancies). The ${\beta}_1$-, ${\beta}_2$- and ${\beta}_3$-adrenoceptor genotypes was determined using polymerase chain reaction-restriction fragment length polymorphism. Results : There were no differences in allelic and genotypic distribution of ${\beta}_1$- and ${\beta}_2$-adrenoceptor polymorphisms between the two groups. However, the Arg allele of ${\beta}_3$-adrenoceptor polymorphism were more frequent in preecalmpsia than in controls (P<0.05, OR=1.57, 95% CI=1.01-2.46). Moreover, prevalence of genotype carrying heterozygote of ${\beta}_3$-adrenoceptor polymorphism was increased in preeclampsia compared with controls (P<0.05, OR 1.76, 95% CI 1.06-2.92). When combination of the three polymorphisms were evaluated, pregnancies with the particular combined genotype that is consisted of heterozygote of ${\beta}_1$-, ${\beta}_3$-adrenoceptor and wild homozygote of ${\beta}_2$-adrenoceptor (Ser/Gly, Gln/Gln, Trp/Arg), showed a significant increase in the risk of preeclampsia (P<0.05, OR=3.01, 95% CI 1.12-8.08). Conclusion : A particular combined genotype (Ser/Gly, Gln/Gln, Trp/Arg) of - adrenoceptors was associated with the risk of preeclampsia.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.340-346
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• 2012

Background: Amphotericin B is a mainstay in the treatment of many systemic fungal infections due to its wide antifungal spectrum and low incidence of resistance. However, the use of amphotericin B is limited by its nephrotoxicity. Objectives: The objective of this study was to evaluate the incidence and risk factors of renal adverse drug reactions (ADRs) of conventional amphotericin B (Fungizone$^{(R)}$). In addition, we compared the changes of serum creatinine (SCr) between patients who remained conventional amphotericin B and patients who were switched to liposomal amphotericin B after occurrence of renal adverse reactions. Methods: Adult hospitalized patients who reported renal adverse reactions caused by conventional amphotericin B from January 2011 to July 2012 at pharmacovigilance center in Yonsei University Healthcare System included in this study. ADRs scored as 'doubtful' in Naranjo probability ADR scale were excluded. We retrospectively analyzed patients' basic clinical characteristics, concurrent diseases or nephrotoxic drugs in order to find variables that can correlate with occurrence of renal ADRs. Changes in SCr were compared between conventional amphotericin B group and liposomal amphotericin B group. Results: A total of 231 ADRs after administration of conventional amphotericin B in 75 patients were reported to pharmacovigilance center and assessed their severities as 'possible', 'probable', or 'definite'. Renal adverse reaction was the most common ADR with incidence rate of 42% (96 of 231 ADRs). Mean change in SCr from baseline was 0.26 mg/dL (change % 37.8) and statistically significant (p=0.000). Simple correlations analysis revealed that the number of concurrent diseases and number of nephrotoxic drugs were positively correlated with changes in SCr, but these results were not statistically significant. Among 43 patients who remained amphotericin B after occurrence of renal ADRs, 27 patients was administered conventional amphotericin B and 16 patients changed to liposomal amphotericin B. Mean change in SCr in amphotericin B group was 0.23 mg/dL (32.75%), whereas mean change in SCr in liposomal amphotericin B group were -0.28 mg/dL (19.38%) and difference between two groups was statistically significant (p=0.003). The numbers of patient with SCr elevation more than 30% were 9 (33.3%) in amphotericin B group and 2 (12.5%) in liposomal amphotericin B group (Odd Ratio=3.50, 95% Confidence Interval 0.65-18.85; p=0.130). Conclusion: An analysis of ADRs due to amphotericin B administration revealed significant mean changes in SCr from baseline. Switching to liposomal amphotericin B showed significant decrease in SCr compared with conventional amphotericin B.