• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1993년도 제45차 추계 학술대회 연제집
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• pp.151-152
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• 1993

• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.487-496
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• 1995

This study was performed for the comparison of the therapeutic efficiency between 6-month (2HERZ/4HER) and 9-month (9HER) short-course chemotherapy under the programe conditions for pulmonary tuberculosis in terms of sputum AFB negative conversion rate, remedial interruption rate and cost effectiveness analysis. Two hundreds and ninty three patients treated with 9HER and 641 treated with 2HERZ/4HER had been discharged from 22 health centers in Seoul from May 1, 1993 to April 30, 1994. Seven hundreds and seventeen was subsequently analysed excluding 217 patients due to remedial interruption. The results : 1. Bacteriological negative conversion rate in 9HER regimen and 2HERZ/4HER regimen was 97.8% and 96.4% respectively(p>0.05). But the early treatment period, negative conversion rate in 2HERZ/4HER regimen was very higher than in 9HER regimen(p<0.01). 2. Remedial interruption rate for 9HER regimen and 2HERZ/4HER regimen was 34.1% and 13.6% respectively. The primary reason for the interruption was transfering to other clinics and this interruption was high within 3months. 3. Cost effectiveness for 2HERZ/4HER regimen was higher than 9HER regimen. The difference cost effectiveness ratio was 2.33 at the first sputum test and 1.69 at the last sputum test.

• 대한골관절종양학회지
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• 제1권2호
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• pp.226-232
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• 1995

Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

• 한국의료질향상학회지
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• 제2권2호
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.223-228
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• 2008

Purpose: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. Methods: We made newly innovated equipment with 50 cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. Results: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. Conclusion: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.303-310
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• 2019

Background Prosthetic hands with a myoelectric interface have recently received interest within the broader category of hand prostheses, but their high cost is a major barrier to use. Modern three-dimensional (3D) printing technology has enabled more widespread development and cost-effectiveness in the field of prostheses. The objective of the present study was to evaluate the clinical impact of a low-cost 3D-printed myoelectric-interface prosthetic hand on patients' daily life. Methods A prospective review of all upper-arm transradial amputation amputees who used 3D-printed myoelectric interface prostheses (Mark V) between January 2016 and August 2017 was conducted. The functional outcomes of prosthesis usage over a 3-month follow-up period were measured using a validated method (Orthotics Prosthetics User Survey-Upper Extremity Functional Status [OPUS-UEFS]). In addition, the correlation between the length of the amputated radius and changes in OPUS-UEFS scores was analyzed. Results Ten patients were included in the study. After use of the 3D-printed myoelectric single electromyography channel prosthesis for 3 months, the average OPUS-UEFS score significantly increased from 45.50 to 60.10. The Spearman correlation coefficient (r) of the correlation between radius length and OPUS-UEFS at the 3rd month of prosthetic use was 0.815. Conclusions This low-cost 3D-printed myoelectric-interface prosthetic hand with a single reliable myoelectrical signal shows the potential to positively impact amputees' quality of life through daily usage. The emergence of a low-cost 3D-printed myoelectric prosthesis could lead to new market trends, with such a device gaining popularity via reduced production costs and increased market demand.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.1-4
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• 2008

Immunizations are among the most cost-effective and widely used public health interventions. This is a report a revision of recommendation of immunization for children by Korean Pediatric Society. Immunization. Vaccines were divided into 4 groups. 1) Vaccines that are recommended to all infants and children (BCG, hepatitis B vaccine, DTaP, Td, Polio vaccine, Japanese encephalitis vaccine, MMR, varicella vaccine, influenza vaccine [6-23 months of age], H. influenzae type b vaccine), 2) those that can be administered to all infants and children, but decision of administration is made by parents (pneumococcal conjugate vaccine, hepatitis A vaccine, influenza vaccine [healthy children ${\geq}24$ months of age], rotavirus vaccine, human papilloma virus vaccine), 3) those that should be given to high risk group (pneumococcal polysaccharide vaccine [high risk patients ${\geq}24$ months of age], influenza vaccine [high risk patients ${\geq}24$ months of age], typhoid vaccine), and 4) those administered for control of outbreaks or prevention of emerging infectious diseases. Immunization schedule recommended by Korean Pediatric Society in 2008 is presented.

• 한국융합학회논문지
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• 제9권8호
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• pp.77-85
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• 2018

본 연구는 일 지역 내 요양병원의 경도인지장애환자의 일반적 특성, 입원 및 진료특성을 분석하여 경도인지장애 환자에 대한 효율적 관리에 필요한 자료를 제공하고자 시행하였다. 연구대상은 2016년 일 지역에 소재하는 요양병원에서 경도인지장애(F067)를 주진단으로 하는 입원환자 303명의 명세서 건이다. 본 연구결과, 재원일수는 계절별로는 ADL 6~12점, ADL 13~20점 그룹 모두 겨울이 가장 긴 것으로 나타났다. 진료결과는 ADL 6~12점, ADL 13~20점 그룹 모두 퇴원일 때 재원일수가 긴 것으로 나타났다. 총 진료비는 계절별로는 ADL 6~12점, ADL 13~20점 그룹에서 겨울이 높았다. 환자 분류군는 ADL 4~5점 그룹에서는 인지장애군의 진료비가 가장 높았고, ADL 6~12점, ADL 13~20점 그룹 모두 문제행동군이 가장 높은 것으로 나타났다. 이와 같은 결과 경도인지장애에 대한 조기발견과 치료는 잠재적인 치매환자 발생과 그에 따른 사회적 비용 감소에 효과적인 방안이자 대단히 중요한 과제임을 알 수 있다.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.51-57
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• 2018

Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

• 센서학회지
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• 제25권3호
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• pp.196-201
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• 2016

Rehabilitation exercises are the treatments designed to help patients who are in the process of recovery from injury or illness to restore their body functions back to the original status. However, many patients suffering from chronic diseases have found difficulties visiting hospitals for the rehabilitation program due to lack of transportation, cost of the program, their own busy schedules, etc. Also, the program usually contains a few medical check-ups which can cause patients to feel uncomfortable. In this paper, we develop a remote rehabilitation system with bio-signals by a stereo camera. A Kinect stereo camera manufactured by Microsoft corporation was used to recognize the body movement of a patient by using its infrared(IR) camera. Also, we detect the chest area of a user from the skeleton data and process to gain respiratory status. ROI coordinates are created on a user's face to detect photoplethysmography(PPG) signals to calculate heart rate values from its color sensor. Finally, rehabilitation exercises and bio-signal detecting features are combined into a Windows application for the cost effective and high performance remote rehabilitation system.