• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.3
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• pp.197-208
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• 2021

Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.

• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.112-121
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• 2020

Background: Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients. Methods: A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis. Results: The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis. Conclusion: Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.

• Korean Journal of Environmental Agriculture
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• v.17 no.1
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• pp.70-75
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• 1998

A model of pond system is developed for treatment and recycling of excreta from twenty-five adult dairy cattle. It is composed of wastewater treatment ponds and small fish ponds. Those are three facultative ponds in series; primary-secondary-tertiary pond and these are designed to rear carps without feeding. A pit is constructed at the bottom of primary pond for efficient sludge sedimentation and effective methane fermentation. It is contrived to block into it the penetration of oxygen dissolved in the upper layer of pond water. The excreta from the cattle housed in stalls are diluted by water used for clearing them. The washed excreta flow into the pit. The average yearly $BOD_5$ concentration of influent is 398.7mg/l. That of the effluent from primary, secondary and tertiary pond of the system is 49.18, 27.9, and 19.8.mg/l respectively. Approximate 88, 93, and 95 % of BOD5 are removed in each pond. The mean yearly SS concentration of influent is 360.5 mg/l That of the effluent from each pond is 53.4, 45.7, and32.7mg/l respectively. Approximate 86, 88, and 91% of SS are removed in each pond. The $BOD_5$ concentration of secondary and tertiary pond can satisfy 30mg/l secondary treatment standard. The SS concentration of effluent from tertiary pond, however, is slightly greater than the standard, which results from activities of carps growing in the pond. The average yearly total nitrogen concentration of influent is 206.8mg/l and that of the effluent from each pond is 48.6, 30.8, and 21.0mg/l respectively. Approximate 74, 88, and 90% of total nitrogen are removed in each pond. The mean yearly total phosphorous concentration of influent is 20.7mg/l and that of the effluent from each pond is 5.3, 3.2, and 2.1mg/l respectively. Approximate 97, 98, and 99% of total phosphorous are removed in each pond. The high removal of nitrogen and phosphorous results from active growth of algae in the upper layer of pond water. Important pond design parameters for southern part of Korea -- areal loading of BOD5, liquid depth, hydraulic detention time, free board, and pond arrangement -- are taken up.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.51-60
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• 2022

Objectives: Currently, Korea's medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it. Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021. Results: For the advantages of collaborative treatment 'increased in psychological stability,' and for disadvantages 'longer time spent for treatment' were the most common. If integrated medical services are implemented in the future, expected advantages include 'consideration of various treatments.' and expected disadvantages include 'increased medical cost.' The needs to expand support for health insurance for integrated medical services were 75.5% among responders. Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.

• The Korean Journal of Emergency Medical Services
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• v.10 no.1
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• pp.13-21
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• 2006

Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

• Journal of the Korean Geosynthetics Society
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• v.20 no.3
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• pp.1-10
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• 2021

The purpose of this study is to present the possibility a utilization of the tertiary mudstone in Pohang as road subsoil material through pilot experiments on the road embankment structure. This mudstone is an unconsolidated rock that is distributed in the soft rock sedimentary layer, the tertiary layer of the Cenozoic, and causes physical problems such as slaking, swelling, and reduced shear strength and chemical problem like acid drainage. In order to solve various complex problems, an laboratory mixing test was conducted, and the optimal mixing conditions of the tertiary mudstone (90%), composite slag (steel making 70%, blast furnace 30%), and neutralization and coating agent treatment were derived. In order to prove its utilization, a real-scale road embankment structure was constructed and tests were conducted for each section. The pre-processing section is stable due to the design of optimal mixing conditions, while in post-processing section, natural weathering proceeded rapidly, and structural problems were concerned. Since the effect of neutralizing and coating agents was confirmed in temporary-staking section, the neutralizing and coating agents can be applied during the temporary storage period.

• Tuberculosis and Respiratory Diseases
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• v.70 no.2
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• pp.143-149
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• 2011

Background: Stopping medical treatment by tuberculosis (TB) patients prior to completing treatment period is a major concern in private hospitals. We evaluated the impact of public-private mix (PPM) project on increasing treatment success rate of TB in a private tertiary hospital in Korea. Methods: Starting in February 2009, TB patients treated at Dankook University Hospital received health education and case monitoring activities by specially trained public health nurses (PPM project). On a retrospective basis, we reviewed medical records and compared the treatment outcome of TB patients treated under the PPM project (PPM group) to patients treated without the PPM project (control group) between January 2008 and June 2010. In addition, we also evaluated the risk factors treatment non-completion. Results: The number of patients in the PPM group and control group were 123 (85 pulmonary TB and 38 extrapulmonary TB) and 146 (101 pulmonary TB and 45 extra-pulmonary TB), respectively. The PPM group had demographic and clinical findings comparable to those of control group. The PPM group showed a significantly higher treatment success rate (93.5%) compared to the control group (77.9%). However, development of complications, proximity to the hospital, and presence of co-morbid disease did not influence the treatment success rate. Conclusion: The PPM project was effective at increasing the TB treatment success rate. An effort to improve and to expand the PPM project is needed in private Korean hospitals.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3541-3547
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• 2013

Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.274-280
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• 2018

Background: The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods: This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results: In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20-67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion: Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.83-91
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• 2017

Background: Piperacillin/tazobactam (TZP) is an antibiotic against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. Due to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate and monitor TZP based on their renal functions and Body Mass Index (BMI) levels. The purpose of this study was to determine the appropriateness of administration doses of TZP based on renal functions of obese cancer patients in a tertiary hospital. Methods: This study was retrospectively conducted with obese cancer patients with $BMI{\geq}30kg/m^2$ in a tertiary hospital, Korea from September 2004 to August 2014. Data were collected through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Results: Among 7,058 patients during the study period, 102 prescriptions were selected based on inclusion and exclusion criteria and classified by their renal functions. Although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with $20mL/min{\leq}CrCl{\leq}40mL/min$ received domestically 4.5 g instead of 2.25 g as the TZP starting dose. Conclusion: The appropriate doses of TZP were administered to almost all of obese cancer patients; however, the recommended TZP dose was different between Korea and other countries by twice the amount. Further related studies are necessary to clearly determine the results, to optimize TZP treatment for obese patients with cancer in clinical practice, and to design and develop new TZP formulations for them in pharmaceutical industry.