• Title/Summary/Keyword: Patients Value

Search Result 4,225, Processing Time 0.033 seconds

A Study on a Plan for Improving the Added Value of the Medical Service Industry

  • Cho, Hak-Rae
    • 한국정보컨버전스학회:학술대회논문집
    • /
    • 2008.06a
    • /
    • pp.121-124
    • /
    • 2008
  • One field that the information society has recently taken much interest in and has continuously implemented is medical services. Health tourism services which emphasize today's patient-oriented management rather than the past hospital-oriented management are highly value-added. As interest in physical fitness increases in keeping with such trends of the society at large as the declining birth rate and increasing life expectancy, and the medical market is opened, the added value of medical services that attract and manage domestic and foreign patients from the global market and satisfy their diverse desires with domestic medical competitiveness such as excellent medical staff and technology is on the spotlight. Hereupon, this study intends to suggest the possibility of developing competitive domestic medical services into a highly value-added industry in keeping with changing environment.

  • PDF

The Study on the Effect of Health Care Service Quality upon Customer Loyalty : Based upon SERVPERF (의료서비스 품질요인이 환자충성도에 미치는 영향에 관한 연구: SERVPERF 척도를 중심으로)

  • Han, Sang-Sook;Son, In-Sun;Gu, Ja-Chul;Lee, Sang-Chul
    • Journal of Korean Society for Quality Management
    • /
    • v.35 no.1
    • /
    • pp.61-72
    • /
    • 2007
  • The purpose of this research is to identify causalities among service quality, service value, customer satisfaction and customer loyalty. A Structural Equation Model is used to test the hypothesis of conceptual model. To test the model, we collect data by conducting a survey with 508 patients. Empirical result indicates that three factors such as tangibles, assurance, and empathy have direct impact on service value and customer satisfaction. Especially, customer loyalty is positively related not with service value but with customer satisfaction.

Value and utilization of rice protein (쌀단백질의 가치와 이용방법)

  • Jung, Kwangho
    • Food Science and Industry
    • /
    • v.52 no.1
    • /
    • pp.60-67
    • /
    • 2019
  • Protein is a major nutrient of food and has long been studied for nutritional and utility value. Among them, rice protein is attracting attention because of its hypoallergenic characteristics and nutritional value. Rice proteins are divided into endosperm protein and bran protein depending on their location. The two proteins differ in their nutritional characteristics and applications. The endosperm protein is an insoluble protein and has an advantage of digestion and absorption. Rice bran protein dissolves well in water. Its amino acid value is high enough to be comparable to that of soy protein, and it has strong antioxidant ability. Rice protein is a healthy vegetable protein because of its health and hypoallergenic properties. It has been widely used in children's or patients' food, and recently for muscle supplement and health food. Rice protein is considered to be a very effective and useful material as it has been discovered so far.

Ideal Right Ventricular Outflow Tract Size in Tetralogy of Fallot Total Correction (팔로네징후 완전교정술 시 이상적인 우심실 유출로 크기에 관한 분석)

  • Kim Jin-Sun;Choi Jin-Ho;Yang Ji-Hyuk;Park Pyo-Won;Youm Wook;Jun Tae-Gook
    • Journal of Chest Surgery
    • /
    • v.39 no.8 s.265
    • /
    • pp.588-597
    • /
    • 2006
  • Background: The surgical repair of a tetralogy of Fallot (TOF) has been performed successfully with a favorable early and late outcome. However, the later development of pulmonary regurgitation and stenosis remains a problem. The development of pulmonary regurgitation and stenosis may be changed by the size of right ventricular outflow tract (RVOT) reconstruction at the initial total correction. Hence, it is necessary to investigate the ideal size of RVOT reconstruction. Material and Method: This prospective study was carried out to determine how a surgical strategy and the RVOT size affect the occurrence of pulmonary regurgitation and stenosis. From January 2002 to December 2004, 62 patients underwent the TOF total correction. The RVOT size (diameter of pulmonary valve annulus) of each case was measured after the RVOT reconstruction and converted to a Z value. A pre-scheduled follow up (at discharge, 6 months, 1 year, 2 years and 3 years) was carried out by echocardiography to evaluate the level of pulmonary regurgitation and stenosis. Result: The patients were divided to two groups (transannular group n=12, nontransannular group n=50) according to the method of a RVOT reconstruction. The Z value of RVOT=iameter of pulmonary valve annulus) (transannular group -1, $range\;-3.6{\sim}-0.8;$ nontransannular group -2.1, $range\;-5.2{\sim}-1.5)$ and the average pRV/LV after surgery ${(transannular group 0.44{\pm}0.09,\;nontransannular group\;0.42{\pm}0.09)}$ did not show any significant difference between two groups. The occurrence of pulmonary regurgitation above a moderate degree was more frequent in the transannular group (p<0.01). In nontransannular group, the development of pulmonary regurgitation more than moderate degree occurred to the patients with larger RVOT size (Z value>0, p<0.02) and the progressing pulmonary stenosis more than mild to moderate degree developed in the patients with smaller RVOT size (Z value<-1.5, p<0.05). A moderate degree of pulmonary stenosis developed for 4 nontransannular patients. Three underwent additional surgery and one underwent a balloon valvuloplasty. Their Z value of RVOT were -3.8, -3.8 -2.9, -1.8, respectively. Conclusion: When carring out a TOF total correction, transannular RVOT reconstruction group has significantly more pulmonary regurgitation. In the nontransannular RVOT reconstruction. the size of the RVOT should be maintained from Z value -1.5 to 0. If the Z value is less than -1.5, we should follow up carefully for the possibility of pulmonary stenosis.

Multi-Parameter Approach for Evaluation of Genomic Instability in the Polycystic Ovary Syndrome

  • Sekar, Nishu;Nair, Manju;Francis, Glory;Kongath, Parvathy Raj;Babu, Sandhya;Raja, Sudhakaran;Gopalakrishnan, Abilash Valsala
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.16
    • /
    • pp.7129-7138
    • /
    • 2015
  • Background: The polycystic ovary syndrome (PCOS), characterized by hyperandrogenism and chronic anovulation, is a common endocrine disorder in women. PCOS, which is associated with polycystic ovaries, hirsutism, obesity and insulin resistance, is a leading cause of female infertility. In this condition there is an imbalance in female sex hormones. All the sequelae symptoms of PCOS gradually lead to cancer in the course of time. It is heterogeneous disorder of unknown etiology so it is essential to find the exact cause. Materials and Methods: In this study both invasive and non-invasive techniques were employed to establish the etiology. Diagnosis was based on Rotterdam criteria (hyperandrogenism, ovulatory dysfunction, PCOM) and multiparameters using buccal samples and dermatoglypic analysis and cytogenetic study for 10 cases and four age and sex matched controls. Results: In clinical analysis we have observed the mean value of total testosterone level was 23.6nmol/L, total hirsutism score was from 12-24, facial acne was found in in 70% patients with 7-12 subcapsular follicular cysts, each measuring 2-8 mm in diameter. In dermatoglypic analysis we observed increases in mean value ($45.9^{\circ}$) of ATD angle when compared with control group and also found increased frequency (38%) of Ulnar loops on both fingers (UU), (18%) whorls on the right finger and Ulnar loop on left finger (WU) and (16%) arches on right and left fingers (AA) were observed in PCOS patients when compared with control subjects. Features which could be applied as markers for PCOS patients are the presence of Ulnar loops in middle and little fingers of right and left hand. The buccal micronucleus cytome assay in exfoliated buccal cells, we found decrease in frequency of micronuclei and significant increases in frequency of karyolysed nuclei in polycystic ovarian syndrome patients. Chromosome aberration analysis revealed a significant increase in frequency of chromosome aberrations (CAs) in PCOS patients when compared with controls. Conclusions: From this present work it can be concluded that non-invasive technique like dermatoglypics analysis and buccal micronucleus cytome assays with exfoliated buccal cell can also be effective biomarkers for PCOS, along with increased CAs in lymphocytes as a sign of genetic instability. There is a hypothesis that micronuclei and chromosomal aberrations could have a predictive value for cancer. From this present work it can be concluded to some extent that non-invasive technique like dermatoglypics and buccal cell analysis can also be effective for diagnosis.

Effects of Head Posture on Resting EMG Activity of Craniocervical Muscles and on Occlusal Contacts (두부자세에 따른 두경부 근활성 및 교합접촉양태의 변화)

  • Chang-Kweon Song;Kyung-Soo Han;Chan Chung
    • Journal of Oral Medicine and Pain
    • /
    • v.21 no.1
    • /
    • pp.89-101
    • /
    • 1996
  • This study was performed to investigate influence of the changes of head posture on resting electromyographic (EMG) activity in anterior temporalis, masseter, sternocleidomastoid muscle and trapezius, and on status of occlusal contacts. For this study twenty-nine patients with temporomandibular disorders(TMD) and thirty dental students without any masticatory symptoms were selected as patients group and control group, respectively. EMG activity($\mu$V) at rest was observed in four kind of head postures such as natural or normal head posture(NHP), forward head posture(FHP), upward head posture(UHP), downward head posture(DHP), and in NHP and FHP, EMG activity with flat occlusal splint was also checked. BioEMG$^\textregistered$(Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles with eight locations on both sides. The author used T-Scan$^\textregistered$(Tekscan Co., USA) system to investigate the changes of oclusal contats on clenching in the four head postures about number, force, time(duration) and total left-right statistis(TLR, occlusal stability crossing left-right dental arch on clenching). For taking in upward or downward head posture, head was inclined $10^{\circ}$ upward or downward and CROM$^\textregistered$ (cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure. The results obtained were as follows : 1. For resting EMG activity, anterior temporalis did not show any difference by change of head posture, but masseter and sternocleidomastoid muscle showed higher value of EMG activity in FHP and UHP, and trapezius showed higher value of EMG activity in FHP and DHP. 2. EMG activity of trapezius was higher than that of any other muscles in NHP, FHP, and DHP, but in UHP, the activity was the lowest reversely. 3. Patients group showed higher EMG activity than control group did in all the muscles in NHP. And significant difference between the two groups were also observed in anterior temporalis in FHP, in sternocleidomastoid muscle in UHP, and in sterno-cleidomastoid muscle and trapezius in DHP with higher activity in patients group. 4. There was no change of EMG activity in NHp with splint, but EMG activity in anterior temporalis and masseter was decreased in FHP with splint. 5. In general, status of occlusal contacts was not changed with head posture in all subjects, and difference between patients group and control group was only noted for number and force of tooth contact in UHP and DHP with more value in control group. 6. Correlationship between EMG activity and number ad force of tooth contacts was shown negatively with regard to masseter in NHP, and trapezius in UHP and DHP.

  • PDF

A clinical study on the effects of myocardial protection during open heart surgery (개심술에서 술중 심근보호효과에 관한 임상적연구)

  • 김근호
    • Journal of Chest Surgery
    • /
    • v.20 no.2
    • /
    • pp.230-240
    • /
    • 1987
  • Cardioplegia and myocardial protection were performed under cardiopulmonary bypass during open-heart surgery with the use of cold St. Thomas Hospital cardioplegic solution [4=C] for the coronary artery perfusion and normal saline solution [4- C] for the topical cardiac cooling. To maintain the state of myocardial protection, coronary artery reperfusion was carried out using St. Thomas Hospital cardioplegic solution at the interval of 30 minutes. A total number of patients studied were 57 cases, including 37 cases of correction for congenital cardiac anomalies and 20 cases for acquired heart valvular diseases. Cardiopulmonary bypass time during the surgery was observed to be average of 87.89*47.55 hours, aortic cross-clamping time to be average of 76.68~44.27 hours raging from 30 to 191 minutes. In order to evaluate the effects of myocardial protection in the surgery, serum enzyme levels were determined. To observe the relationship between aortic cross-clamping time and myocardial protection effects, patients studied were divided into the following 3 groups. I group: aortic cross-clamping time, 60 minutes, II group: aortic cross-clamping time, 90 minutes, III group: aortic cross-clamping time, over 91 minutes. 1. Changes in serum enzyme levels in postoperative period. [1] SCOT; The postoperative value [increased over 200 units] for ischemic myocardial injury during operation was observed in 11 cases [19.3% of the total] of the total patients studied, of which 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [2] LDH; The positive value [increased over 900 units] for ischemic myocardial injury during operation was observed in 9 cases [15.7% of the total] of the total patients studied, of which 2 cases [6.6%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [3] CPK; The positive value [increased over 800 units] for ischemic myocardial injury during operation was observed in 10 cases [17. 5% of the total] of the total patients studied, including 4 cases [13. 3%] in I group, 1 case [10.0%] in II group, and 5 cases [29.4%] in III group. 2. The myocardial protection method used in the present study was demonstrated to be effective for the myocardial protection in the surgery with aortic cross-clamping time of up to 90 minutes. A few ischemic myocardial injury were observed in the surgery with aortic cross-clamping time over 91 minutes, but no significant cardiac dysfunction was noted. The surgery with aortic cross-clamping time of up to 191 minutes did not appear to give rise any significant interference with postoperative recovery.

  • PDF

A New Inflammatory Prognostic Index, Based on C-reactive Protein, the Neutrophil to Lymphocyte Ratio and Serum Albumin is Useful for Predicting Prognosis in Non-Small Cell Lung Cancer Cases

  • Dirican, Nigar;Dirican, Ahmet;Anar, Ceyda;Atalay, Sule;Ozturk, Onder;Bircan, Ahmet;Akkaya, Ahmet;Cakir, Munire
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.12
    • /
    • pp.5101-5106
    • /
    • 2016
  • Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein ${\times}$ NLR (neutrophil/ lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p<0.001). Progression free survival values of the patients who had high vs low IPI were determined 6 months (95% CI:5.3-6.6) and 14 months (95% CI:12.1-15.8), respectively (HR; 2.4, P<0.001). On multivariate analysis, stage, performance status, lactate dehydrogenase and IPI were independent prognostic factors for OS. Subgroup analysis showed IPI was generally a significant prognostic factor in all clinical variables. Conclusion: The described IPI may be an inexpensive, easily accessible and independent prognostic index for NSCLC patients, useful for clinical practice.

Contribution of the MLH1 -93G>A Promoter Polymorphism in Modulating Susceptibility Risk in Malaysian Colorectal Cancer Patients

  • Nizam, Zahary Mohd;Abdul Aziz, Ahmad Aizat;Kaur, Gurjeet;Abu Hassan, Muhammad Radzi;Mohd Sidek, Ahmad Shanwani;Lee, Yeong Yeh;Mazuwin, Maya;Ankathil, Ravindran
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.2
    • /
    • pp.619-624
    • /
    • 2013
  • Background: Colorectal cancer (CRC) exists in a more common sporadic form and less common hereditary forms, associated with the Lynch syndrome, familial adenomatous polyposis (FAP) and other rare syndromes. Sporadic CRC is believed to arise as a result of close interaction between environmental factors, including dietary and lifestyle habits, and genetic predisposition factors. In contrast, hereditary forms such as those related to the Lynch syndrome result from inheritance of germline mutations of mismatch repair (MMR) genes. However, in certain cases, the influence of low penetrance alleles in familial colorectal cancer susceptibility is also undeniable. Aim: To investigate the genotype frequencies of MLH1 promoter polymorphism -93G>A and to determine whether it could play any role in modulating familial and sporadic CRC susceptibility risk. Methods: A case-control study comprising of 104 histopathologically confirmed CRC patients as cases (52 sporadic CRC and 52 Lynch syndrome patients) and 104 normal healthy individuals as controls was undertaken. DNA was extracted from peripheral blood and the polymorphism was genotyped employing PCR-RFLP methods. The genotypes were categorized into homozygous wild type, heterozygous and homozygous variants. The risk association between these polymorphisms and CRC susceptibility risk was calculated using binary logistic regression analysis and deriving odds ratios (ORs). Results: When risk association was investigated for all CRC patients as a single group, the heterozygous (G/A) genotype showed a significantly higher risk for CRC susceptibility with an OR of 2.273, (95%CI: 1.133-4.558 and p-value=0.021). When analyzed specifically for the 2 types of CRC, the heterozygous (G/A) genotype showed significantly higher risk for sporadic CRC susceptibility with and OR of 3.714, (95%CI: 1.416-9.740 and p-value=0.008). Despite high OR value was observed for Lynch syndrome (OR: 1.600, 95%CI: 0.715-3.581), the risk was not statistically significant (P=0.253). Conclusion: Our results suggest an influence of MLH1 promoter polymorphism -93G>A in modulating susceptibility risk in Malaysian CRC patients, especially those with sporadic disease.

A Clinical Study on the Effects of Myocardial Protection of St. Thomas Hospital Cardioplegic Solution During Open Heart Surgery (개심술에서 St. Thomas Hospital 심정지액의 심근보호효과에 관한 임상적 연구)

  • Kim, Yeong-Hak;Kim, Geun-Ho
    • Journal of Chest Surgery
    • /
    • v.22 no.2
    • /
    • pp.225-233
    • /
    • 1989
  • Cardioplegia and myocardial protection were performed under cardiopulmonary bypass during open heart surgery with the use of St. Thomas Hospital cardioplegic solution [4 [C] for the coronary artery perfusion and normal saline solution [4[ c] for the topical cardiac cooling. To maintain the state of myocardial protection, coronary artery reperfusion was carried out using St. Thomas Hospital cardioplegic solution at the interval of 30 minutes. A total number of patients studied were 57 cases, including 37 cases of correction for congenital anomalies and 20 cases for acquired heart diseases. Cardiopulmonary bypass time during the surgery was observed to be average of 87.89*47.55 hours, aortic cross-clamping time [ACCT] to be average of 76.68*44.27 hours raging from 30 to 191 minutes. In order to evaluate the effects of myocardial protection in the surgery, serum enzyme levels were determined. To observe the relationship between ACCT and myocardial protection effects, patients studied were divided into the following 3 groups. I group: ACCT 60 minutes, II group: ACCT 90 minutes, III group: ACCT over 91 minutes [1] SGOT; The positive value [increased over 200 units] for ischemic myocardial injury during operation was observed in 11 cases [19.3% of the total] of the total patients studied, of which 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [2] LDH; The positive value [increased over 900 units] for ischemic myocardial injury during operation was observed in 9 cases [15.7% of the total] of the total patients studied, of which 2 cases [6.6%] in I group, 1 case [10.0%] in II group and 6 cases [35.3%] in III group. [3] CPK; The positive value [increased over 800 units] for ischemic myocardial injury during operation was observed in 10 cases [17.5% of the total] of the total patients studied, including 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 5 cases [29.4%] in III group [4] The myocardial protection method used in the present study was demonstrated to be effective for the myocardial protection in the surgery with ACCT of up to 90 minutes. A few ischemic myocardial injury were observed in the surgery with ACCT over 91 minutes, but no significant cardiac dysfunction was noted. The surgery with ACCT of up to 191 minutes did not appear to give rise any significant interference with postoperative recovery.

  • PDF