• 약학회지
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• 제49권6호
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• pp.449-458
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• 2005

There have been rapid changes in the pharmaceutical environment after the separation of Dispensing and Prescribing practice. In the early stage of this system, outpatients had few options to choose their pharmacies due to various obstacles. Under these circumstances, this study on the defection tendency of long-term care patients was performed through the analysis of outpatients who quit visiting a pharmacy nearby general hospital. PowerBuilder ver 9.0 program was used to extract significant data, and SPSS package was employed for statistic analysis. 3,308 outpatients who visited a pharmacy nearby hospital for a month (in January, 2004) were studied. Patients' sex, age and location of residence, the class of medical insurance, the characteristic type of medication (powder, split form, medication for external use/injection), waiting time, disease (department) were considered as variable factors. It turned out that the patient revisit ratio was 80.8$\%$ and the patient defection ratio was 32.4$\%$. As was expected, those factors mentioned above influenced on the revisit and defection ratio considerably. In terms of patient factors, it proved that there was no relationship among sex, location of residence, the class of medical insurance and revisit (defection) ratio. Only age factor influenced the ratio; the older, the higher revisit ratio and the less defection ratio. In respect of dispensing factors, there were obvious relationships among the factors and the ratio: bill (money they had to pay individually), waiting time, number of medications, splitting of tablets, unit price of drug and revisit (defection) ratio showed significant relationship. The result of this study revealed an aspect of outpatients' behavior and it could be used as a reference for better patient service and customer relationship management.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.20-28
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• 2016

Purpose: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. Methods: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. Results: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (${\geq}1.5cm$, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion. Conclusion: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.387-390
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• 2007

Objective : To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. Methods : One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma [n=56], meningioma [n=31], metastatic brain tumor [n=7], primary central nervous system lymphoma [n=4], and central neurocytoma [n=2]. Anti-epileptic drugs [AEDs] were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. Results : Thirty patients [30%] presented at least a single episode of seizure at the time of admission. Five of these patients [16.7%] developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients [8.6%] without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. Conclusion : Compared with patients without seizure, patients with seizure at the time of admission showed younger age [p=0.003], a higher portion of low-grade glioma [p=0.001], tumor location in the frontal and temporal lobes [p=0.003] and cortical involvement [p=0.017]. Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.242-247
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• 2020

Purpose: The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma. Methods: Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively. Results: Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common. Conclusions: Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.43-47
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• 2013

Purpose: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. Materials and Methods: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. Results: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. Conclusion: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.

• 한국임상보건과학회지
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• 제2권3호
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• pp.158-166
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• 2014

Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.114-119
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• 2018

Background: The ideal absorbable plating system should provide sufficient rigidity and then be absorbed within a timely manner. The Resorb-X has been recently developed as a plating system with a mixture ratio of 50:50 poly(D, L-lactide). Methods: We present seven of 121 patients who experienced delayed degradation with this absorbable plate. One hundred twenty-one patients with facial bone fracture underwent surgical treatment from March 2011 to March 2015, and rigid fixation was achieved with the Resorb-X. Results: Of 121 patients, seven (5.8%) developed complications at the surgical sites. Six of 102 cases underwent fixation of the infraorbital rim and one of 73 underwent fixation of the frontozygomatic buttress; the other sites of fixation did not develop delayed degradation. Foreign body granuloma developed at the earliest by postoperative 20 months and at the latest by postoperative 28 months (average, 23.5 months). Conclusion: We observed that the use of absorbable plates in incision sites or areas with thin skin can increase the possibility of delayed degradation. When performing surgery in these areas, the normal skin above the fixed location should be covered sufficiently.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.405-407
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• 2019

Due to the variety in the shape of dysmorphic cartilage, tragus reconstruction is one of the most challenging goals in otoplasty. The authors describe a method to reconstruct a prominent tragus in a simple way suitable for accounting for the size, shape, and location of the remaining ear. We present a case of tragus deformity in an 11-year-old female patient after a previous excision of pretragal skin tags. There was a small remnant of the deeply located dystopic cartilage in a horizontal orientation. The dystopic cartilage was used to reconstruct the tragus using a chondrocutaneous transposition flap. Only a small portion of the pre-existing cartilage was used to create a chondrocutaneous transposition flap that supplemented the portion of cartilage during tragus reconstruction. The result was a new tragus that showed acceptable improvement in shape, location, and projection. Patients with a small portion of pre-existing cartilage near the tragal wall may benefit from the use of this method for tragus reconstruction.

• 임상간호연구
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• 제23권1호
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• Korean Journal of Radiology
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• 제23권8호
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• pp.785-793
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• 2022

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.