• Korea Journal of Hospital Management
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• v.20 no.3
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• pp.45-55
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• 2015

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.59-71
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• 2008

Purpose: This study was to identify the effects of simulation-based training for advanced cardic life support on the competence of nurses in critical care settings. Methods: In this study, a nonequivalent control pretest-post test quasi-experimental design was used. Data were collected from May 1 to June 1, 2006 at one general hospital in W city. Among 40 nurses in critical care settings, twenty were assigned to the experimental group and twenty to the control group. Nurses in the experimental group received simulation-based training for advanced cardiac life support. Measurement tool were ACLS related knowledge and skills developed by AHA & Mega Code (2005) and some items were modified. The collected data were statistically processed using SPSS version 12.0 for Windows, and analyzed using descriptive statistics, $X^2$test, t-test, paired ttest, Pearson correlation coefficients. Results: 1) Hypothesis 1“: Nurses who received simulationbased training would have more knowledge of advanced cardiac life support than nurses who received traditional training”, was supported (t=11.51, p=.00). 2) Hypothesis 2: “Nurses who received simulation-based training would have better advanced cardiac life support skills than nurses who received traditional training”, was supported (t=2.38, p=.00). Conclusion: Simulation-based training for advanced cardiac life support is an effective strategy for increasing the competence of nurses in advanced cardiac life support in critical care settings.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.395-407
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• 2020

Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.33-40
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• 1995

Purpose : To assess the efficacy and toxicity of the preoperative radiotherapy with or without chemotherapy in locally advanced rectal cancer Methods : Forty three patients (clinically diagnosed stages above or equal to Astler-Coiler stage B2 without distant metastasis) were assigned to preoperative radiotherapy alone arm (n=16) or combined preoperative radiotherapy and chemotherapy arm (n=27). Preoperative radiotherapy of 4500 cGy to whole pel-vis +/-540 cGy boost to primary site and concurrent chemotherapy of 2 cycles of 5-FU (500 mg/$m^2$) and leucovorin (20 mg/$m^2$) were used. Fifteen patients of preoperative radiotherapy alone arm and 19 of combined arm received surgical resection after preoperative treatment. Results : During the preoperative treatment, no significant complication was developed in both groups. Pathologic results were as follows; complete remission 1, Bl 1, B2 6, C1 2, C2, 5 in preoperative radiotherapy alone arm and complete remission 2, Bl 8, B2 4, C2 3, D 2 in combined arm. Postoperative complications were delayed perineal wound healing in three patients, intestinal obstruction in three patients (one managed by conservative medical treatment, two by surgical treatment). Conclusion : The combined preoperative radiotherapy and chemotherapy arm was more effective in pathological response and lymph node negativity rate than the preoperative radiotherapy alone arm. Both the preoperative radiotherapy alone arm and the combined arm were generally well tolerated and did not result in an increased postoperative morbidity.

• Korean Medical Education Review
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• v.19 no.2
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• pp.63-69
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• 2017

Resident training programs in South Korea lag far behind that of advanced countries. Given the problems the current system in South Korea has, it is time to consider a new resident training system, resident training for general competencies. Training for the general competencies was practiced in medical fields in advanced countries such as the USA, Canada, and the UK as early as 20 years ago. This system has rendered itself a key component of resident training. Although a few theoretical procedures on general competencies have been practiced in South Korea, the awareness of this concept is still very weak, and the application of the theory to actual training is a long way off from becoming effective. It is urgent for South Korea to adopt competency- and outcome-based training for general competencies. To this end, the knowledge of the concept of this type of training should be improved. Also, the system should be carefully designed to cover a doctor's whole career, and be applied immediately. The competency- and outcome-based training for general competencies is a system that assures high level qualifications. It reflects the needs of our society under the recognition that a professional organization should be committed and accountable in order to respond to social demands. As the benefits of the new training system reach the public and medical care consumers, training-related expenses should be borne by social costs.

• Journal of Radiation Protection and Research
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• v.11 no.2
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• pp.146-151
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• 1986

In this paper, general features and measured results of vacuum pressure on the vacuum system of 50 MeV proton KCCH-cyclotron which was installed in Korea Cancer Center Hospital are described. The vacuum system comprises five subgroups and the operating sequences are automatically controlled by EPROM-programmable controller. In normal operation, the obtained ultimate pressures of vacuum groups were $5{\times}10^{-6}mbar(I,\;II),\;2{\times}10^{-6}mbar(III),\;1.2{\times}10^{-5}mbar(IV),\;1.5{\times}10^{-6}mbar(V)$, respectively. It was confirmed that these pressures was enough to accelerate the 50 MeV-proton beam.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.213-221
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• 2018

Purpose: The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. Materials and Methods: Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults(20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. Results: In the relaxing, the masseter was $9.8{\pm}1.3mm$ in females and $11.3{\pm}1.2mm$ in males. In the contracted state, it was $12.4{\pm}1.4mm$ in females and $14.7{\pm}1.4mm$ in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. Conclusion: Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.

• Journal of The Korea Institute of Healthcare Architecture
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• v.1 no.2
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• pp.7-16
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• 1996

As surgical technologies advanced, ambulatory surgery was proposed for reduction hospital stay and patient-oriented health care delivery system. And in recent years, ambulatory surgery is also introduced in this country as medical demands expands. This study aims to represent the standards for architectural planning of the ambulatory surgery center in a general hospital according to domestic situations. For this, the present conditions and space programs of 5 general hospitals were investigated and analyzed. This study also aims to represent the unit area proposal of each departmental operation room and the methodology for deciding the number of the operation threatres in Ambulatory Surgery Center.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.88-94
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• 2013

Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3151-3156
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• 2014

Background: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. Materials and Methods: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. Results: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. Conclusions: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.