• Radiation Oncology Journal
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• 제31권4호
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• pp.228-233
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• 2013

Purpose: The aim of this study was to evaluate changes in breast tumor bed volume during whole breast irradiation (WBI). Materials and Methods: From September 2011 to November 2012, thirty patients who underwent breast-conserving surgery (BCS) followed by WBI using computed tomography (CT) simulation were enrolled. Simulation CT scans were performed before WBI (CT1) and five weeks after the breast irradiation (CT2). The tumor bed was contoured based on surgical clips, seroma, and postoperative change. We retrospectively analyzed the factors associated with tumor bed volumetric change. Results: The median tumor bed volume on CT1 and CT2 was 29.72 and 28.6 mL, respectively. The tumor bed volume increased in 9 of 30 patients (30%) and decreased in 21 of 30 patients (70%). The median percent change in tumor bed volume between initial and boost CT was -5%. Seroma status (p = 0.010) was a significant factor in tumor bed volume reduction of 5% or greater. However, patient age, body mass index, palpability, T stage, axillary lymph node dissection, and tumor location were not significant factors for tumor bed volumetric change. Conclusion: In this study, volumetric change of tumor bed cavity was frequent. Patients with seroma after BCS had a significant volume reduction of 5% or greater in tumor bed during breast irradiation. Thus, resimulation using CT is indicated for exquisite boost treatment in breast cancer patients with seroma after surgery.

• 한국병원경영학회지
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• 제26권3호
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• pp.68-83
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• 2021

Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.580-588
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• 2019

Background There are various reconstructive options for nail bed defects. However, it is challenging not to leave a deformity. In this study, we investigated differences in outcomes depending on the reconstruction method, attempted to determine which method was better, and analyzed other factors that may affect outcomes. Methods The long-term outcomes of nail bed reconstruction were reviewed retrospectively. We performed three types of reconstruction depending on the defect type: composite grafts of severed segments, nail bed grafts from the big toe, and two-stage surgery (flap coverage first, followed by a nail bed graft). Subsequent nail growth was evaluated during follow-up, and each outcome was graded based on Zook's criteria. The reconstruction methods were statistically analyzed. Other factors that could contribute to the outcomes, including age, the timing of surgery, germinal matrix involvement, defect size, and the presence of bone injuries, were also compared. Results Twenty-one patients (22 digits) who underwent nail bed reconstruction were evaluated. The type of reconstruction method did not show a significant relationship with the outcomes. However, patients who sustained injuries in the germinal matrix and patients with a defect larger than half the size of the nail bed had significantly worse outcomes than the comparison groups. Conclusions The results suggest that no operative method was superior to another in terms of the outcomes of nail bed reconstruction. Nevertheless, involvement of the germinal matrix and defect size affected the outcomes.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.57-62
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• 2019

Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up. Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed. Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.

• 한국병원경영학회지
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• 제15권4호
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• pp.43-62
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• 2010

This study provides an evidence on the determinants of the profitability of university hospital by analyzing university hospital-level data set of hospital performance during the year 2007 (32 university hospitals in total). For the study, a multiple regression model is employed in which profitability index obtained from the DEA computations, operating margin to total asset and gross revenue are used as the dependent variables, and a number of hospital operating characteristics are chosen as the independent variables such as ownership type, location, bed size, period of establishment, bed occupancy rate, admission ratio of outpatients, patients per medical specialist, personnel cost per patient, liabilities to total assets, current ratio, fixed ratio, total asset turnover, medical assistance rate and public indicator. First, the results indicate that the bed occupancy rate and liabilities to total assets are positively and significantly associated with operating margin to total asset. Second, number of beds, the bed occupancy rate and number of patients per medical specialist are positively and significantly associated with operating margin to gross revenue. Third, the bed occupancy rate, number of patients per medical specialist, liabilities to total assets, total asset turnover are positively and significantly associated with profitability index revealed from DEA.

• 한국실내디자인학회논문집
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• 제27권1호
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• pp.80-87
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• 2018

This study aims to find gender differences in inpatients' privacy and stress concerns in multi-bed hospital room. In the literature review, we consider the characteristics of multi-bed hospital room and patients' privacy as a psychological environment factor. In the survey research, the questionnaires were used to understand the inpatients' general characteristics and privacy requirements. A total of 109 copies were analyzed through a cross-tabulations and T-test using the SPSS 18.0. Results and conclusions are as follows: (1) In the case of multi-bed room patients, there were some gender differences in privacy and stress, but the differences were limited. (2) There is a difference in the patient 's preference of the hospital room according to gender, and this is related to the privacy characteristic. (3) The social communication and strolling are commonly effective stress relief methods for both men and women, so space is needed to do this methods. The meaning of this study is to specify the privacy and stress of the inpatients in multi-bed patients' room.

• 임상간호연구
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• 제27권2호
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• pp.179-186
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• 2021

Purpose: The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. Methods: From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using 𝑥²-test, Fisher's exact test, and a logistic regression. Results: After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). Conclusion: Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 추계학술대회 논문집
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• pp.887-888
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• 2012

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.47-56
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• 2017

Purpose : This study is a basic research to establish guidelines for healthcare facility in Korean healthcare market. As a first step, it is a main purpose for making beginning point of ICU guideline to set a basic level of ICU facility size and quality by analysis current ICU facilities and existed domestic guidelines : law, criteria of healthcare insurance review and assessment service, credit of Korea institute for healthcare accreditation. Methods : First of all, the all requirements of existed guidelines are put together and summarized. The summary is compared with that of US, UK, and Australia to know its quality difference with international market. In addition, all hospitals in Korean market are classified based on total bed number and ICU bed number to know the most occupied facility size range in the market. Second of all, by comparing 15 ICUs' current setting of the public general hospital, a general condition of ICU facility would be extracted based on function, floor area per bed, services Results : 72.8% of hospitals in Korea are belonging below 500 beds hospital. Among them 200-299 beds hospitals occupied 35.3% and are shown as the most occupied hospital size. As 15 public general hospitals are analyzed, it is clear that the more bed size and services the more ICU area per bed. As a result it is sure that the 300~500 bed may be a clear line as a general ICU condition whose function and bed number relatively consistent in the range. Implications : to keep the qualified medical environment and contemporary hospital trend, the guideline as a minimum requirement keep naturally out from current healthcare settings and should reflect their limit to reconcile with the new trend in the market.

• 임상간호연구
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• 제23권3호
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• pp.293-301
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• 2017

Purpose: The purpose of this study was to examine the effects of bed angles and bed rest time combined with hemostatic methods on discomfort and hemorrhagic complications in patients after transfemoral cerebral angiography. Methods: Data were collected from 93 inpatients following transfemoral cerebral angiography, from April 20 to September 23, 2016. Patients were grouped according to bed angle ($0^{\circ}$ vs. $30^{\circ}$) and bed rest time combined with hemostatic methods (4-hour bed rest after manual compression vs. 2-hour bed rest after applying vascular closure device). Results: There was a significant group differences on discomfort (F=46.44, p<.001). The post-hoc analysis showed the lowest score of discomfort in those with bed angle $30^{\circ}$ and 2-hour bed rest. There was no difference in hemorrhagic complications among 4 groups. Conclusion: The postangiograpy discomfort can be effectively reduced with the least hemorrhagic complications by bed angle $30^{\circ}$ elevation and 2-hour bed rest after applying vascular closure device for those underwent transfemoral cerebral angiography.