• Title/Summary/Keyword: Hospitalized

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Evaluation of Patients서 Satisfaction with Foodservice of Mid-size Hospitals in Busan Area (부산지역 중소병원 급식서비스에 대한 환자만족도 평가)

  • 김영선;류은순
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.7
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    • pp.1153-1163
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    • 2003
  • The purpose of this study was to evaluate the patients' satisfaction with the quality of hospital food service in Busan area. For the purpose, questionnaires were distributed to 271 hospitalized patients in 4 hospitals (three hospitals for self-operated foodservice, one for contracted foodservice) within 130 beds. The average scores were -0.99/5.00 for quality satisfaction of meal characteristics, -0.68/5.00 for service characteristics, and -0.37/5.00 for nutrition characteristics. The items of low scores in quality satisfaction were treatment of complaints, nutrition of meals, provision of nutritional information, the seasoning of the meals, selective menu, and sanitation of the meals. At the expectation and perception grid, high expectation and high perception items were cleanliness of employees' clothes, cleanliness of dish, employees' courtesy, exactness of meal time, and sanitation of the meals. High expectation and low perception items were treatment of complaints and nutrition. The patients with little appetite showed significantly (p<0.01) lower average scores in meal, service, and nutrition characteristics than those with much appetite. The self-operated foodservice operation had significantly (p<0.01) higher average scores in meal, service, and nutrition characteristics than those of the contracted foodservice operation. The patients hoped to improve the taste of cooked rice and side dish, quantity of the side dish, variety of menu, and sanitation of the meals.

Preliminary Result in Patients with Primary Hepatoma Treated by Stereotactic Radiotherapy (원발성 간암에 대한 정위방사선치료의 예비결과)

  • Kang Ki Mun;Choi Ihl Bohng;Kim In Ah;Choi Byung Ock;Kang Young Nam;Chai Gyu Young;Han Sung Tae;Chung Gyu Won
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.34-39
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    • 2001
  • Purpose : It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. Materials and Methods : From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of $ 44\~66$ year old (median : 59) and the tumor size of $10\~825\;cc$ (median : 185 cc). SRT was given to them $3\~5$ fractions a week (5 Gy/fraction, $90\%$ isodose line) for $2\~3$ weeks. Median dose of SRT was 50 Gy and the range was $30\~50\;Gy$. Results : Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression $(7.7\%)$, 7 partial regression $(53.8\%)$, 4 minimal regression $(30.8\%)$, 1 stable disease $(7.7\%)$. The positive responses more than partial remission were 8 patients $(61.5\%)$ after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been $92.3\%$ decreased. There was no severe complication except dyspepsia $84.6\%$, mild nausea $69.2\%$, transient decreased of hepatic function $15.4\%$ and fever $7.7\%$. Conclusion : SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

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Gastric Dilatation and Volvulus in Shih-tzu (시츄에서 발견된 위확대염전)

  • Moon, Joon Ho;Kim, Hyun Ah;Ryu, Minok;Jang, Min;Ji, Seoyeon;Lee, Inhyung;Yoon, Junghee;Choi, Mincheol;Youn, Hwayoung;Lee, Byeong Chun;Jang, Goo
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.255-258
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    • 2015
  • Gastric dilatation and volvulus (GDV) is an acute and life-threatening disease most commonly affecting large- and giant-breed dogs. However a 17-year-old Shih-tzu (4 kg, spayed female) was hospitalized for acute GDV. Repeated unproductive retching, lethargy, and excessively enlarged abdomen were observed. Physical examination indicated that the patient had suffered from hypothermia ($36.5^{\circ}C$), tachycardia (240 bpm), slowed capillary refill time (> 2 sec.), and pale mucous membrane. Grade III murmur with normal lung sound was auscultated. Abdominal palpation revealed that tympanic regions existed in both the left and right sides. Systolic blood pressure decreased gradually from 220 to 40 mmHg within 4 hours. In blood analysis, slight azotemia was observed by blood urea nitrogen (BUN; 29.1 mg/dl) and creatinine (1.6 mg/dl). Blood lactate concentration (8.13 mmol/l) was severely elevated. Additionally, dilatation and volvulus of the stomach was observed by radiograph. Supportive oxygen, heat, fluid, and drugs were administered with gastric decompressions (e.g., gastrocentesis and nasogastric tube). However the patient entered into comatose status with uncontrollable systolic blood pressure, despite the administration of dobutamine intravenously. The case was closed by euthanasia, considering welfare and age. We finally diagnosed the patient as a GDV, thus this is the first GDV case report in small-breed dog such as Shih-tzu.

A Study of the Correlation between Stroke Incidence by Day of the Week and Risk Factors (중풍(中風)의 요일별(曜日別) 발생(發生)과 위험요인(危險要因)과의 상관성(相關性)에 관(關)한 연구(硏究))

  • Kim, Yong-Hyung;Choi, In-Young;Ma, Mi-Jin;Gang, A-My;Choi, Dong-Jun;Han, Chang-Ho;Lee, Won-Chul;Jun, Chan-Yong;Cho, Ki-Ho;Choi, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.285-298
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    • 2008
  • Objective : This study was aimed to investigated the correlation between the stroke incidence by day of the week and risk factors in acute stroke patients. Methods : From October in 2005 to October in 2007, 673 acute stroke patients wereincluded. Patients were hospitalized within 14 days after the onset of stroke in DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital or the Department of Cardiovascular and Neurologic Diseases (Stroke Center), Kyung Hee University Oriental hospital. We investigated general characteristics, stroke types, age group, educational backgrounds, medical history, lifestyle (the impact of stress, exercise, smoking and drinking) and Sasang constitution according to the stroke incidence by day of the week. Results : After examining each participants with day of the week, the order of days by incidence was Monday, Wednesday, Sunday, Saturday, Tuesday, Thursday and Friday respectively. Monday and Tuesday showed the highest ratio. As the aspect of demographic data of subjects, the group under 55 years and from 55 years to 70 years showed the highest ratio on Monday. In the group between 25 years to 55 years, the ratio, by the classification of actual productive age, was statistically higheron Monday. In addition, the ratio showed statistically higherby educational background, from elementary school to high school and over high school. In regard tothe medical aspect, incidence of cerebral hemorrhage showed higher ratio on Sunday, and incidence of brain infarction was higheron Monday. However, there was no difference of the past history between the two groups. With regard tothe aspect of lifestyle of subjects, the group with huge stress before the incidence of stroke showed a higher ratio of stroke incidence on Monday. Participants who didn't exercise regularly and participants who didn't smoke or drink showed higher ratio of stroke incidence on Monday. However, this was not important statistically. In regard to the aspect of Sasang constitution, Soeumin showed the highest ratio of stroke incidence on Wednesday, Taeuminon Monday, and Soyangin on Saturday and Monday. Conclusion : According to these results, several cardiovascular risk factors affect stroke incidences on Monday. Further studies will be needed to help understand the correlation between stroke incidence by day of the week and risk factors in acute stroke patients.

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Clinicopathological evaluation of Childhood Henoch-$Sch{\ddot{o}}nlein$ Purpura(HSP) Nephritis with Nephrotic Syndrome (신증후군을 동반한 Henoch-$Sch{\ddot{o}}nlein$ 신염 환아의 임상병리 적 고찰)

  • Kang Hyeon-Ho;Yoon Kyung-Leem;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.111-119
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    • 2000
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998. Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$\%$, gross hematuria 17.6$\%$, microscopic hematuria 50$\%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C). Conclusion : Among the 디le patients with Henoch-$Sch{\ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

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The Significance of $^{99m}Technetium$ Dimercaptosuccinic Acid(DMSA) Scan as a Substitute for Voiding Cystourethrography(VCUG) in Evaluating Children with first Febrile Urinary Tract Infection (생애 첫 발열성 요로 감염 환아에 대한 평가에서 배뇨성 방광 요도 조영술을 대체하기 위한 검사로서 $^{99m}technetium$ dimercaptosuccinic acid(DMSA) scan의 의의)

  • Han, Seung-Beom;Ko, Yong-Min;Lee, Sue-Young;Jeong, Dae-Chul;Kang, Jin-Han;Lee, Kyung-Yeon;Uhm, Mee-Ryung;Kim, Woong-Heum;Kim, Jung-Sue
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.220-228
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    • 2007
  • Purpose : We studied the value of clinical signs, laboratory findings and $^{99m}technetium$ dime-rcaptosuccinic acid(DMSA) scan in predicting the presence of vesicoureteral reflux(VUR) in children with first febrile urinary tract infection(UTI). Methods : A retrospective analysis of 84 hospitalized children with first febrile UTI was performed. They underwent DMSA scan and voiding cystourethrography(VCUG) during the acute phase, and were divided into three groups according to the results of the VCUG: absence of VUR, mild(grade I-II) and severe VUR(grade III-V). We studied the relation of VUR to age, gender, fever duration, causative organism, white blood cell count, serum C-reactive protein and result of DMSA scan. Results : Among 84 patients, 6 had mild and 17 had severe VUR. Thirty-eight had abnormal DMSA scan. results Patients with VUR were older than those without VUR(P<0.01). There was a lower probability of infection with Escherichia coli in patients with severe VUR than in those with mild and absent VUR(P<0.01). An abnormal DMSA scan correlated with the presence and severity of VUR(P<0.05). Severe VUR was present in 10.9% of patients with normal DMSA scan. The sensitivity, specificity, positive and negative predictive values of the DMSA scan in predicting the presence of VUR were 69.6%, 63.9%, 42.1%, and 84.8%, respectively. Conclusion : An abnormal DMSA scan correlated to the presence and severity of VUR, but the sensitivity, specificity and positive predictive value of the DMSA scan were low. There-fore, patient with an abnormal DMSA scan requires a VCUG. In order to prevent missing the 10.9% of patients with severe VUR but normal DMSA scans, a VCUG should be performed in patient with normal DMSA scan.

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Should Voiding Cystourethrography be Performed for Infants with Urinary Tract Infection? (요로감염 영아에서 배뇨성방광요도조영술이 필요한가?)

  • Woo, Mi-Kyeong;Kim, Mun-Sub;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.54-61
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    • 2008
  • Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.

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On decrease program of Radioactive Wastewater and Sewages in High Dose Radioiodine Therapy Ward (고용량 방사성옥소 치료병실의 오.폐수 저감화를 위한 연구)

  • Ryu, Jae-Kwang;Jung, Woo-Young;Shin, Sang-Ki;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.19-26
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    • 2008
  • Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

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Quality of Life among Family Caregivers of Terminal Cancer Patient (말기 암 환자 가족 간병인의 삶의 질)

  • Jung, Jin-Gyu;Kim, Sung-Soo;Kang, Dong-Soo;Kim, Sung-Min;Lee, Dong-Hoon;Han, Kyung-Hee;Kim, Jong-Sung
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.1-10
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    • 2006
  • Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (${\pm}SD$) SF-36 score was 47.9 (${\pm}20.7$). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall $R^2=0.639$, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

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Adenoviral Lower Respiratory Tract Infections in Children; Serotypes and Clinical Characteristics (소아의 아데노바이러스 하기도 감염증: 혈청형 및 임상상)

  • Shin, Seon Hee;Lee, Hoan Jong;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.182-192
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    • 2002
  • Purpose : This study was performed to characterize the epidemiologic and clinical features of acute adenoviral lower respiratory tract infections(LRTIs). Methods : Virological analysis was done from respiratory specimens obtained from patients with LRTIs hospitalized to other hospitals and referred to the Department of Pediatrics, Seoul National University Children's Hospital(SNUCH) from June 1998 to July 2000. Viral diagnosis was made by isolation of viruses employing HEp-2 cell culture and indirect immunofluorescent staining with monoclonal antibodies. Serotypes of adenoviruses were determined by neutralization test using antiserum for types 1, 2, 3, 4, 5, 6, 7 and 11. Medical records of children admitted to the SNUCH were reviewed retrospectively. Results : Adenovirus was isolated from 118(9.0%) of 1,305 children with LRTIs. Serotypes were 3(39.0%), 7(16.9%), 1(11.0%), 2(7.6%), 4(7.6%), 6(5.9%), 11(2.5%), and 5(0.8%) and 10 strains(8.5%) were not neutralized by antisera included in the study. Infections by type 3 and type 7 occurred in outbreaks. Male to female ratio was 1.0:0.9 and mean age was 1.95 years. The clinical diagnoses were pneumonia(83%), acute tracheobronchitis(12%) and bronchiolitis(5%). Associated symptoms, signs and abnormal laboratory findings included cough(100%), sputum(73.5%), fever(54.2%), rale(59.3%), wheezing(34%), anemia(35%) and leukopenia(15.8%). Mortality was in 13.5%. Residual radiologic sequelae was identified in 32.6% of the patients followed. Conclusion : These data confirms that adenovirus may cause severe lower respiratory tract diseases, and infections by type 3 and 7 may occured in outbreaks.

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