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Survey for Alternative Therapy Used by Cancer Patients Receiving Radiation Therapy (방사선치료 암 환자의 대체요법 경험실태 조사연구)

  • Park Cheol Woo;Park Tae-Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.75-90
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    • 2001
  • Although it is presumed that cancer patients take various alternative therapies, the present status is not well recognized. The purpose of this study is to survey alternative therapies used by cancer patients receiving radiation therapy and then, find associated factors of taking alternative therapies. The study subjects were composed of those who receiving radiation therapy in the department of radiation oncology in 5 hospitals located at Extended Busan city and who were on follow-up after medical cure. They were 394 male and female patients over 20 years old. The mean age of the subjects was 53.2 years old and the age ranged from 23 to 83 years old. 188 patients($47.7\%$) used alternative therapies. Total 68 different kinds of alterative therapies were used, average 7.3 kinds per patient were experienced, and average total cost expenditure was 2,830,000 won. Among the alternative therapies, black bean($38.8\%$) was the most commonly used and brown rice($38.3\%$), ganoderm lucidum($37.8\%$), elm tree($33.5\%$), and phellinus linteus($30.8\%$) were followed in order of frequency. However in considering the time, cost and effort spent, phellinus linteus was the first. In terms of cost, phellinus linteus was the highest with average expenditure of 2,740,000 won. Among the motivation of using alternative therapies, expecting auxiliary help for the hospital therapy was the highest ($31.4\%$). About half of users($56.9\%$) of alternative therapies were recommended by their relatives to use alternative therapies. In comparing the characteristics of experienced and unexperienced groups, alternative therapy was experienced significantly more in patients of younger age(p=0.001), in patient of higher educational level(p=0.001), and in patients of higher income(p=0.030) The proportion of using alternative therapies was significantly higher in the group treated with chemotherapy(p=0.005), and in the patients who did not satisfy with radiation therapy(p=0.001). The frequency of drinking was significantly higher tendency in the inexperienced group(p=0.046), There was no significant difference in marital status, job, religion, other disease, surgical operation of the cancer and smoking staus between the two groups. Among the unexperienced group, $34.0\%$ of the patients did not take the alternative therapies because they did not have know]edge for the alternatives, and $22.3\%$ worried about negative effects on hospital-based therapy $58.7\%$ of them were willing to take the alternative therapies if the effects and safety were proven by the government or research institutes. $21.9\%$ of the patients wanted to take the alternatives if they were affordable. $72.3\%$ of the patients was willing to take them if their families recommend, but $27.2\%$ responded they would not take them in any situation. Conclusively, various kinds of alternative therapies which were not proved medically were exposed to patients, In these circumstances, it is required to investigate, study and evaluate the medical effects and safety of the alternative therapies.

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Distribution of Human Rotavirus Genotypes in a Tertiary Hospital, Seoul, Korea During 2009-2013 (2009년부터 2013년까지 서울의 일개 대학병원에서 동정된 로타바이러스 유전형의 분포)

  • Han, Tae Hee;Park, Sang-Hun;Chung, Ju-Young;Hwang, Eung-Soo
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.81-90
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    • 2015
  • Purpose: Group A rotavirus (RV) is most common etiologic agent of acute gastroenteritis (AGE) in children worldwide. Recently, vaccination has been introduced in several countries to reduce the disease burden caused by RV infections, but continuous surveillance of RV strains is necessary to detect the emergence of potential variants induced by vaccine-immune pressure. This study aimed to investigate the changing pattern of RV genotypes in children with AGE, following the introduction of vaccination in Korea. Methods: Genotyping of RVs by RT-PCR on the basis of VP7 and VP4 gene segment sequence was carried out on 201 rotavirus-positive stool samples, from children hospitalized with AGE between August 2009 and June 2013. We have directly sequenced PCR products and analyzed the phylogenetic tree. Results: The most prevalent G genotype was G9 (33.3%), followed by G1 (22.4%), G3 (15.9%), G2 (6.0%), G4 (3.0%), G10 (1.5%), and mixed G-type (15.4%), with some nontypeable cases (2.5%). The detected P genotypes were P[4] (45.3%), P[8] (43.8%), mixed P-type (10.4 %), and P[2] (0.5%). The G9P[4] genotype was predominantly observed in hospitalized cases in Seoul in 2010/2011, however G1P[8] has been re-emerged as the predominant genotype in the following season (P =0.004). Conclusions: It seems that the periodic fluctuation in predominance of the G1, G3, and G9 strains occurred in Korea during 2009-2013, following the introduction of RV vaccination.

Development of severity-adjusted length of stay in knee replacement surgery (무릎관절치환술 환자의 중증도 보정 재원일수 모형 개발)

  • Hong, Sung-Ok;Kim, Young-Teak;Choi, Youn-Hee;Park, Jong-Ho;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.13 no.2
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    • pp.215-225
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    • 2015
  • This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.

A Study on Job Satisfaction and Commitment of Service Nature Based Organizations: Centering on Labor Relations and Mediation of High-Involvement Work Organizations in Dental Hospital (서비스본질기반 조직의 직무만족 및 몰입에 관한 연구 : 치과병원에서 노사관계와 참여적 작업조직의 매개를 중심으로)

  • Kim, Bosung;Kim, Hyunsoo
    • Journal of Service Research and Studies
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    • v.9 no.1
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    • pp.17-31
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    • 2019
  • This study empirically analyzed the effect of service nature of dental clinic on job satisfaction and job commitment. In recent years, the demand for medical services has been increasing in the dental clinics. As the dental clinics are faced with various competition situations through new establishment and expansion, the importance of job satisfaction and job involvement is more emphasized. The service nature of dental hospitals is known to be influenced by job satisfaction and job commitment. These two factors are important factors for securing the competitiveness of dental hospitals as well as the functions of hospitals required for survival and development of dental hospitals In this study, we analyzed the effects of labor - management relations and high-involvement work organization on the organizational satisfaction and organizational commitment affecting service nature of dental hospital. As a result of the analysis, it was found that the service nature based organization has a full mediating effect which is not established without labor relations and participatory work organization in the process of affecting job commitment. Therefore, unlike previous studies which focus on incentives or external rewards to increase job satisfaction of employees, this study concluded that internal support system reflecting service nature factors should be strengthened. Job satisfaction and job commitment, which are variables in this study, are expected to be the basis for improving competitiveness of dental hospitals. Future research should be extended to small and medium dental hospitals and dental clinics. It is also necessary to study various organizations in order to strengthen the competitiveness of the service organization by fostering the nature of service such as relationship and interactivity at the organizational level.

Developing data quality management algorithm for Hypertension Patients accompanied with Diabetes Mellitus By Data Mining (데이터 마이닝을 이용한 고혈압환자의 당뇨질환 동반에 관한 데이터 질 관리 알고리즘 개발)

  • Hwang, Kyu-Yeon;Lee, Eun-Sook;Kim, Go-Won;Hong, Sung-Ok;Park, Jong-Son;Kwak, Mi-Sook;Lee, Ye-Jin;Im, Chae-Hyuk;Park, Tae-Hyun;Park, Jong-Ho;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.14 no.7
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    • pp.309-319
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    • 2016
  • There is a need to develop a data quality management algorithm in order to improve the quality of health care data. In this study, we developed a data quality control algorithms associated diseases related to diabetes in patients with hypertension. To make a data quality algorithm, we extracted hypertension patients from 2011 and 2012 discharge damage survey data. As the result of developing Data quality management algorithm, significant factors in hypertension patients with diabetes are gender, age, Glomerular disorders in diabetes mellitus, Diabetic retinopathy, Diabetic polyneuropathy, Closed [percutaneous] [needle] biopsy of kidney. Depending on the decision tree results, we defined Outlier which was probability values associated with a patient having diabetes corporal with hypertension or more than 80%, or not more than 20%, and found six groups with extreme values for diabetes accompanying hypertension patients. Thus there is a need to check the actual data contained in the Outlier(extreme value) groups to improve the quality of the data.

A Study on Self-sufficiency for Hospital Injury Inpatients in Korea (우리나라 의료기관 입원손상환자의 자체충족도에 관한 연구)

  • Lee, Hee-Won;Park, Jong-Ho;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5779-5788
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    • 2011
  • This study was conducted to comprehend the current status of regional self-sufficiency of Hospital injury inpatients and, based on this, to prepare some measures for improving the self-sufficiency. For this purpose, 2005 & 2008 Patient Survey data, regional medical utilization data of National Health Insurance Corporation, yearbook of Central Emergency Medical Center and evaluation results of emergency medical institutions were obtained. Frequency analysis, cross-tabulation, decision tree and logistic regression techniques were used in the analysis of data. Self-sufficiency in 'metropolitan city/Do' area was lowest for Chungcheongnam-do for the year 2005 and 2008, followed by Gyeongsangbuk-do, Gyeonggi-do and Jeollanam-do. As for the self-sufficiency in 'Si/Gun/Gu' area with regard to local medical supply, for both 2005 and 2008, It was higher when general hospital, district emergency medical center, regional emergency medical center and regional emergency medical institution existed in the residential area. It was also found that, the higher the quality level of local emergency medical institution, the higher the self-sufficiency. It was confirmed that, when promoting the national policy for injury patients, priority should be placed on 'Do' area where the level of emergency medical supply was low, and that enhancing the quality level of emergency medical institutions was helpful for the improvement of self-sufficiency.

A Prediction Model for the Development of Cataract Using Random Forests (Random Forests 기법을 이용한 백내장 예측모형 - 일개 대학병원 건강검진 수검자료에서 -)

  • Han, Eun-Jeong;Song, Ki-Jun;Kim, Dong-Geon
    • The Korean Journal of Applied Statistics
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    • v.22 no.4
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    • pp.771-780
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    • 2009
  • Cataract is the main cause of blindness and visual impairment, especially, age-related cataract accounts for about half of the 32 million cases of blindness worldwide. As the life expectancy and the expansion of the elderly population are increasing, the cases of cataract increase as well, which causes a serious economic and social problem throughout the country. However, the incidence of cataract can be reduced dramatically through early diagnosis and prevention. In this study, we developed a prediction model of cataracts for early diagnosis using hospital data of 3,237 subjects who received the screening test first and then later visited medical center for cataract check-ups cataract between 1994 and 2005. To develop the prediction model, we used random forests and compared the predictive performance of this model with other common discriminant models such as logistic regression, discriminant model, decision tree, naive Bayes, and two popular ensemble model, bagging and arcing. The accuracy of random forests was 67.16%, sensitivity was 72.28%, and main factors included in this model were age, diabetes, WBC, platelet, triglyceride, BMI and so on. The results showed that it could predict about 70% of cataract existence by screening test without any information from direct eye examination by ophthalmologist. We expect that our model may contribute to diagnose cataract and help preventing cataract in early stages.

Tc-99m EHIDA Scintigraphic Demonstrability of Biliary Elements and Liver Function Tests in Hepatobiliary Diseases (몇가지 간담도질환에서 간기능에 따른 Tc-99m EHIDA의 담도영상능)

  • Kim, Choon-Yul;Lee, Myung-Hee;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.71-80
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    • 1982
  • In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases oft hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10.5mg/dl. The usefulness of Tc-99m EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphic demonstrability of the hepatobiliary tract, GB and duodenum following intravenous injection of Tc-99m EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobiliary diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphic examination was started at end of 3 minutes after intravenous injection of Tc-99m EHIDA in the amount of $50{\mu}Ci/kg$ and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obatained at 1 1/2, 3, 4 and 6 hours when reeded. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common bile duct, GB and duodenum was closely paralleled to the level of serum bilirubin when it is less than 10.5 mg/dl as shown in figure 1. However when the bilirubin exceeded 10.5 mg/dl the time of visualization between protracted reaching a flat curve or plateau around 10.5 mg/dl. The biliary tract could not be visualized when the bilirubin was higher than 10.5 mg/dl. The correlability between scintigraphic demonstration and serum alkaline phosphatase was less strong and between scintigraphic demonstration and SGOT and SGPT was rather poor. The present clinical study confirmed the usefulness and limitation of Tc-99m EHIDA hepatobiliary scintigraphy in visulizing and diagnosing the biliary system and duodenum when radiogrpahy and ultrasonography failed to provide useful informations. Scintigraphy was very helpful in the diagnosis of neonatal hepatitis, biliary atresia, cholecystitis and extrahepatic biliary obstruction. The hepatobiliary system and duodenum were visualized when serum bilirubin level was less than 10.5 mg/dl, SGOT 135 units, SGPT 114 units and alkaline phosphatase 52.2 KAU.

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A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

Contrast Media Side Effects Prediction Study using Artificial Intelligence Technique (인공지능 기법을 이용한 조영제 부작용 예측 연구)

  • Sang-Hyun Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.423-431
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    • 2023
  • The purpose of this study is to analyze the factors affecting the classification of the severity of contrast media side effects based on the patient's body information using artificial intelligence techniques to be used as basic data to reduce the degree of contrast medium side effects. The data used in this study were 606 examiners who had no contrast medium side effects in the past history survey among 1,235 cases of contrast medium side effects among 58,000 CT scans performed at a general hospital in Seoul. The total data is 606, of which 70% was used as a training set and the remaining 30% was used as a test set for validation. Age, BMI(Body Mass Index), GFR(Glomerular Filtration Rate), BUN(Blood Urea Nitrogen), GGT(Gamma Glutamyl Transgerase), AST(Aspartate Amino Transferase,), and ALT(Alanine Amiono Transferase) features were used as independent variables, and contrast media severity was used as a target variable. AUC(Area under curve), CA(Classification Accuracy), F1, Precision, and Recall were identified through AdaBoost, Tree, Neural network, SVM, and Random foest algorithm. AdaBoost and Random Forest show the highest evaluation index in the classification prediction algorithm. The largest factors in the predictions of all models were GFR, BMI, and GGT. It was found that the difference in the amount of contrast media injected according to renal filtration function and obesity, and the presence or absence of metabolic syndrome affected the severity of contrast medium side effects.