• 국제학술발표논문집
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• The 2th International Conference on Construction Engineering and Project Management
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• pp.837-847
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• 2007

The study focused on the evaluation of maintenance management strategies used in public hospital buildings in Lagos state. It also assessed the labour composition for maintenance operations. In achieving these objectives, opinions of maintenance officers of ten (10) different hospitals in different local government areas of the state were sampled through well structured questionnaires. The data collected were analyzed using descriptive and inferential statistics. From the analysis, the study revealed that majority of those public hospitals do not have specific budget for maintenance programmes, maintenance policies, maintenance log book and maintenance manual to guide the operatives. About 98% of them do not understand the type of maintenance strategy being used for their maintenance operations. 78% of the maintenance work are only executed when there is a breakdown or in response to user's request. For labour composition, the cleaning of interior and exterior of the building, inspection of building elements, repairs and replacements of building elements are mainly carried out by in-house staff, while the repair and replacement of equipment is by outsourcing. The study also revealed that using in- house staff, reduces costs and provides a higher security while outsourcing provides more flexibility in staffing reduces equipment expenditures and provide better access to special skills. The study recommended proactive measures to provide necessary training and support for maintenance staff and users of these facilities and a means of securing sufficient funds for maintenance programmes.

• 디지털융복합연구
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• 제13권10호
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• pp.405-413
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• 2015

본 연구는 지방의료원의 경쟁 수준의 정도를 측정하여 재무성과와의 관련성 분석 후 효과적인 경영전략을 수립할 수 있는 기초자료를 제공하는데 있다. 조사기간은 지방의료원의 HHI(허핀달-허쉬만)지수와 경영성과를 알 수 있는 2010년부터 2012년까지 3년간을 평가기준으로 하였으며, 총 31개의 의료원을 조사대상으로 선정하였다. 결론을 보면, 집중시장일수록 재무성과가 높은 것으로 나타났으며, 지역 내 경쟁정도와 재무지표 간의 유의한 상관관계가 나타났다. 지방의료원은 지역 내 경쟁력과 공공성을 확보하기 위한 정책수립과 실행을 위해서는 지역 의료시장의 경쟁정도와 그에 따른 추이를 파악이 요구된다. 지방의료원이 타 의료기관관의 경쟁력의 우위를 선점하기 위해서는 의료서비스 제공의 향상과 자본 투자 등의 선별적인 전략이 고려되어야 할 것이다.

• 한국융합학회논문지
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• 제10권10호
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• pp.259-266
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• 2019

본 연구는 의료 환경의 변화로 병원의 경쟁력을 갖추기 위하여 병원의 행정전략에 대한 변화의 필요성이 있으며, 의료서비스 향상을 위해서 어떤 전략이 가장 중요한지 제시하여, 의료서비스 향상을 위한 병원 행정전략에 기초자료를 제공하고자 한다. 이를 위해서 병원행정 분야와 관련된 행정학 및 경영학 박사급 전문가 20명을 선정하였고, 자료분석방법은 AHP 방법으로 상대적 중요도를 측정하였다. 이에 대한 연구결과는 다음과 같다. 첫째, 측정영역에서 의료서비스 향상을 위한 병원 행정전략에 대한 상대적 중요도는 의료진 요인(1순위), 제반시설 요인(2순위), 직원서비스 요인(3순위), 접근편의 요인(4순위) 순으로 결과가 나타났다. 둘째, 복합가중치 분석 결과, 의료진 전문성(1순위), 의료진 다양성(2순위), 의료장비수준(3순위) 순으로 상대적 중요도가 측정되어 의료서비스 향상을 위한 병원 행정전략은 의료진의 전문성 확보, 의료진의 다양성, 그리고 의료장비 수준을 높이는 것이 가장 중요함을 알 수 있다. 이러한 결과가 의료서비스를 향상시키기 위한 병원의 행정전략 마련 시에 유용한 기초자료로 활용될 수 있을 것이며, 또한 향후 병원 행정전략 마련 시에 다각적인 요소들을 파악해야 할 것이다.

• Journal of Chest Surgery
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• 제55권1호
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• pp.37-43
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• 2022

Background: The surgical strategy for single-stage resection of primary colorectal cancer (CRC) and synchronous pulmonary metastases remains a matter of debate. Methods: Perioperative data of patients who underwent single-stage resection of primary CRC and synchronous pulmonary metastases were compared to those of patients who underwent 2-stage resections. The demographic data, number of metastases, type of pulmonary and colorectal resections, operation time, blood loss, postoperative complications, morbidities, mortality, medical costs, and length of hospital stay were analyzed. Results: Twenty-two patients underwent single-stage resection of primary CRC and pulmonary metastases, while 27 patients underwent 2-stage resection. Tumor size and the number of pulmonary metastases were not significantly different between the 2 groups. The extent of pulmonary metastasectomy and abdominal procedures were similar in both groups, as was the thoracic surgical approach (video-assisted thoracic surgery vs. thoracotomy). However, open laparotomy was performed more frequently in the 2-stage group than in the single-stage group (p=0.045), which also had a longer total anesthetic time (p=0.013). The operation time, medical costs, estimated blood loss, complication rates, and severity were similar in both groups, but the length of hospital stay was shorter in the single-stage group (p<0.001). Conclusion: Single-stage colorectal and pulmonary resection shortened the overall hospital stay, with no significant changes in operation time, medical costs, hospital mortality, and morbidity. Therefore, single-stage resection could be a good surgical strategy in selected patients.

• 한국병원경영학회지
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• 제28권4호
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• pp.33-46
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• 2023

Purpose: This study analyzed the research published in KCI-registered journals related to healthcare marketing for the last 27 years from 1995 to 2022 to identify academic research trends, the specificity of the healthcare field and to suggest future research directions. Methodology: A total of 213 articles were selected for this study, and a descriptive analysis of the period and journals was conducted, as well as the analysis of research topics and keywords from the perspective of marketing strategy factors and performance factors. Findings: A total of 213 articles related to healthcare marketing have been published in the last 27 years. The descriptive analysis showed a steady quantitative increase, but the STP field showed a decreasing trend, and many papers were mainly published in the Korean Journal of Hospital Management. According to the analysis of research topics and keywords, STP field will be hard to become an active research topic in the future, and even in the 7P field, only Product, People, and Process can be researched according to medical law regulations, and other factors such as PX & WOM, CRM, and the Internet fields are expected to be research topics. Implications: Through the analysis of research trends over the past 27 years, we were able to identify the specificity of the healthcare marketing field in Korea and suggest future research directions based on this.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1019-1022
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• 2016

Background: Diagnostic difficulties in hematological malignancies may lead to unacceptably prolonged help-seeking to diagnostic interval as well as increased complications and poor outcomes. Proactive consultation by a clinical pathologist (PCCP) may help clinical diagnosis and therapeutic strategy. Hence, the aim of this investigation was to evaluate the effect of PCCP on the help-seeking to diagnostic interval in hematological cancer cases. Materials and Methods: From January to November, 2015, abnormal results of hematological laboratory testing with added laboratory comment were selectively screened out, and patients with such abnormalities in hematological laboratory testing and accompanied laboratory comment with PCCP were enrolled. Results: A total of 125 aberrant results of hematological laboratory testing were given with accompanied laboratory comments with PCCP and 40.8% (n=51) of these patient-oriented comments had an effect on clinical diagnosis and therapeutic strategy. Twelve of the subjects belonged to newly diagnosed hematological malignancies with the assistance of PCCP, and the help-seeking to diagnostic interval was also shortened from 42 days to 26 days in chronic lymphoid leukemia (CLL), from 83 days to 11 days in multiple myeloma (MM), and from 128 days to 15 days in myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN). During the monitoring interval, neither complication events nor deaths were reported in the study group. Conclusions: It was seemingly that PCCP prevented diagnostic delay in hematological malignancies via shortening the help-seeking to diagnostic interval, particularly in CLL, MM and MDS/MPN cases. PCCP can be considered to play an essential role in prompt establishment of diagnosis in hematological malignancies for those who newly present.

• 한국경영과학회지
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• 제37권4호
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• pp.211-223
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• 2012

This study purposed to evaluate the influences of rival hospitals on the number of patients who visited the a study territory hospital. Spatial analysis technique was used to measure the impact of rival hospitals in study region. Selected hospitals were all medical school affiliated hospitals which were located in Daejeon metropolitan city and Chungchungnamdo. Patient data was collected from the claims data of the study hospital, and the number of inpatient and outpatients who visited the study hospital between January and June in 2008 were calculated on the smallest administrative district, Eup, Myeon, and Dong, in study region. To control the differences of regional characteristics among Eup, Myeon, Dong, socio-economic variables (total population, number of people aged over 65, number of basic livelihood security recipients, distance from the study hospital to the centroid point of each Eup, Myeon, Dong, number of business, and number of employees) were included in analysis model. These variables were collected from the annual year book of city as well as county located in study region. Cluster analysis classified the study region into three groups by using the difference of between th actual number of inpatient/outpatient and the predicted number of inpatient/outpatient in Eup, Myeon, and Dong. Most areas around the rivalry hospitals were categorized into same group. Multiple regression analysis indicated that areas around rivalry hospitals had statistically significantly negative relationship with the number of inpatients and outpatients who visited the study hospital. As the buffer size was increased from 5Km to 10Km, the standardized regression coefficients were decreased. These study results confirmed that rivalry hospitals in region had negative impacts on the performance of hospitals. It suggests that hospitals will require not only to select their location to minimize the effects of rivalry hospitals, but also to establish their strategy to cope with the rivalry's threats in their region.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1067-1072
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• 2013

Hiwi, a human homologue of the Piwi family, plays an important role in stem cell self-renewal and is overexpressed in various human tumors. This study aimed to determine whether an RNA interference-based strategy to suppress Hiwi expression could inhibit tumor growth in a xenograft mouse model. A rare population of $SSC^{lo}\;Alde^{br}$ cells was isolated and identified as lung cancer stem cells in our previous study. Plasmids containing U6 promoter-driven shRNAs against Hiwi or control plasmids were successfully established. The xenograft tumor model was generated by subcutaneously inoculating with lung cancer stem cell $SSC^{lo}\;Alde^{br}$ cells. After the tumor size reached about 8 mm in diameter, shRNA plasmids were injected into the mice via the tail vein three times a week for two weeks, then xenograft tumor growth was assessed. In nude mice, intravenously delivery of Hiwi shRNA plasmids significantly inhibited tumor growth compared to treatment with control scrambled shRNA plasmids or the vehicle PBS. No mice died during the experiment and no adverse events were observed in mice administered the plasmids. Moreover, delivery of Hiwi shRNA plasmids resulted in a significant suppressed expression of Hiwi and ALDH-1 in xenograft tumor samples, based on immunohistochemical analysis. Thus, shRNA-mediated Hiwi gene silencing in lung cancer stem cells by an effective in vivo gene delivery strategy appeared to be an effective therapeutic approach for lung cancer, and may provide some useful clues for RNAi gene therapy in solid cancers.

• Molecules and Cells
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• 제42권9호
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• pp.661-671
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• 2019

Adipose tissue-derived mesenchymal stem cells (ADSCs) are promising for regenerating degenerated intervertebral discs (IVDs), but the low efficiency of nucleus pulposus (NP)-specific differentiation limits their clinical applications. The Sonic hedgehog (Shh) signaling pathway is important in NP-specific differentiation of ADSCs, and Smoothened Agonist (SAG) is a highly specific and effective agonist of Shh signaling. In this study, we proposed a new differentiation strategy with the use of the small molecule SAG. The NP-specific differentiation and extracellular matrix (ECM) synthesis of ADSCs were measured in vitro, and the regenerative effects of SAG pretreated ADSCs in degenerated IVDs were verified in vivo. The results showed that the combination of SAG and transforming growth factor-${\beta}3$ ($TGF-{\beta}3$) is able to increase the ECM synthesis of ADSCs. In addition, the gene and protein expression levels of NP-specific markers were increased by treatment with SAG and $TGF-{\beta}3$. Furthermore, SAG pretreated ADSCs can also improve the disc height, water content, ECM content, and structure of degenerated IVDs in vivo. Our new differentiation scheme has high efficiency in inducing NP-specific differentiation of ADSCs and is promising for stem cell-based treatment of degenerated IVDs.

• 생물정신의학
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• 제13권4호
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• pp.252-259
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• 2006

Sexual dysfunction is a relatively common adverse effect in the use of antidepressants. The sexual side effects may result in a lack of compliance with the prescribed antidepressants. The author reviewed the prevalence and updated treatment for the antidepressant-induced adverse effects focusing on sexual dysfunction. The incidence of sexual dysfunction is reported to exceed more than 50% especially with SSRIs. In order to obtain a quantified baseline and as an ongoing evaluation tool, clinicians may use some of the established questionnaires and validated instruments such as the Arizona Sexual Experience scale and Changes in Sexual Functioning Questionnaire. Clinicians should be aware that delayed ejaculation and orgasm, symptoms most frequently associated with antidepressants, are not usually associated with depression itself. Although many antidotes have been proposed, few have been subjected to double-blind trials. Some evidences have suggested that bupropion and buspiron may be the effective antidotes for SSRI induced sexual dysfunction. Additional trials will be requied to define what role, if any, bupropion and buspiron might have in the treatment of SSRI-induced sexual side effects. The available evidence is rather limited, with only small number of trials assessing each strategy. While further randomized data is awaited, for men with antidepressant induced erectile dysfunction, the addition of sidenafil or tadalafil may appear to be an effective strategy.