• Title/Summary/Keyword: medical quality improvement

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The Correlation between Korean Medical Treatment on Degenerative Meniscus Tear and Kellgren-Lawrence-grade, Body Mass Index (퇴행성 반월상 연골판 파열 환자의 한의학적 치료 효과와 Kellgren-Lawrence-grade, Body Mass Index의 상관성)

  • Lee, Gi-Eon;Lee, Geon-Yeong;Han, Si-Hoon;Kim, Gook-Beom;Kim, Hyo-Jun;Jang, Jae-Won;Jang, Youngwoo;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.71-79
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    • 2018
  • Objectives The aim of this study is to observe the effectiveness of complex Korean medicine treatment applied to the patients with degenerative meniscal tear and the correlation among clinical effectiveness, body mass index (BMI) and Kellgren-Lawrence grade (KL-grade). Methods The study participants were 38 patients who had been diagnosed with degenerative meniscal tear. Participants were classified by BMI, KL-grade and treated with acupuncture, electroacupuncture and pharmacopuncture. Clinical outcomes were assessed using Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index) and EuroQol-5 Dimension Index (EQ-5D Index). Results Both NRS and WOMAC scores were significantly reduced after treatment (p<0.001). The EQ-5D for assessing quality of life showed further improvement (p<0.05). A statistically significant correlation was observed between the BMI and NRS, EQ-5D. KL-grade was correlated with WOMAC. Conclusions These results show that complex Korean medicine treatment to the patient with degenerative meniscal tear may be effective as a conservative therapy. Further research is required to confirm the effectiveness of Korean medicine treatment.

Intrathecal Catheter and Subcutaneous Access Port Implantation in Pain Management for Terminal Cancer Patient - A case report - (말기암 환자의 통증치료를 위한 지주막하강내 카테터 거치와 피하 이식형 약제 주입기 삽입 - 증례보고 -)

  • Seo, Kwi Chu;Chung, Jin Yong;Kim, Ho Young;Rho, Woon Seok;Kim, Bong Il;Song, Seok Young
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.240-245
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    • 2007
  • It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients.

Adaptive Clothing Designs for the Individuals with Special Needs (지체 장애인을 위한 개호복 디자인)

  • Na, Hyun-Shin
    • Journal of the Korean Society of Clothing and Textiles
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    • v.31 no.6 s.165
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    • pp.933-941
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    • 2007
  • Nowadays the numbers of the disabled and elderly have been increasing, and the development of adaptive clothing for these people is in demand. The purpose of this study was to give ideas and solutions for the special needs clothing design. The knowledge of medical situation of the individuals with special needs has been examined and factors affecting adaptive clothing were suggested. Twenty-one web sites were investigated and the most practical, functional, fashionable adaptive clothes were suggested by items. Construction and location of openings, number and type of fastenings, and design of garments for comfort and ease of movement were carefully considered in these clothes. Better appearance through improvement of clothing will help these people to believe that they have worth in the sight of others and in their own view of themselves. Disabled and elderly can obtain the quality of life, maintain the dignity, and make the access to the world a little bit easier by solving the particular clothing problems with all these convenient as well fashionable adaptive clothing.

Impact of GNB3, ADRB3, UCP2, and PPAR${\gamma}$-Pro12Ala polymorphisms on Boiogito response in obese subjects : A randomized, double-blind, placebo-controlled trial (방기황기탕의 유전자 다형성에 따른 비만 치료 효과 : 무작위 배정, 이중 맹검, 위약-대조군 임상시험)

  • Park, Jung-Hyun;Bose, Shambhunath;Lim, Chi-Yeon;Kim, Ho-Jun
    • Journal of Korean Medicine for Obesity Research
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    • v.12 no.2
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    • pp.28-43
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    • 2012
  • Objectives: The aim of the study was to investigate the efficacy of Boiogito for obesity. We examined the efficacy of Boiogito for obese patients and we expected the reaction of Boiogito would vary according to the single nucleotide polymorphism(SNPs). Methods: 111 subjects(body mass index${\geq}25m/kg^2$) were recruited and randomized to receive Boiogito(n=55) or Placebo(n=56) for 8weeks. Anthropometric factors, serum lipid profile, glucose, blood pressure(BP), pulse rate, resting metabolic rate and Korean version of obesity-related quality of life(KOQOL) scale measured at baseline and 8weeks. SNPs(${\beta}3$-adrenergic receptor(ADRB3), G protein ${\beta}3$(GNB3), peroxisome proliferator activated receptor gamma 2 gene(PPAR-${\gamma}2$), uncoupling protein(UCP2)) were conducted at baseline. Adverse reactions and safety outcome variables were also checked during trials. Results: Both groups showed significant improvement on obesity after treatment. Boiogito group decreased triglyceride than did control group and improved KOQOL. Boiogito showed a significant higher efficacy in C/T and T/T genotype of GNB3 gene / in Trp64 and Arg64 genotype of ADRB3 gene / in D/D genotype of UCP2 gene / in Pro/Pro genotype of PPAR-${\gamma}$ gene. Conclusions: Boiogito promoted obesity indexes without severe adverse reactions and proved its safety. Pharmacogenetical studies of Boiogito on obesity could be a effective method for the individualized treatment and prevention of obesity.

Expectation and Satisfaction of Parents with Inpatient Hospital Service (입원 아동 부모의 병원서비스 기대수준과 만족도)

  • Choi, Eun Kyoung;Kim, Sun Hee;Jung, Song Yi;Cho, Eun Hee;Choi, Kyung Sook;Sim, So Jung;Mok, Mi Soo;Kang, Eun Kyung;Cho, Youn Kyoung;Byun, Eun Sook;Kim, Kyung Hee;Yoo, Il Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.228-238
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    • 2011
  • Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

Analysis of Sensible Factors on Service Acceptance Intention of Smart City (스마트시티의 서비스 수용의도에 대한 체감요소 분석)

  • Yang, Jeon-Seong;You, Yen-Yoo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.20 no.5
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    • pp.146-156
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    • 2021
  • A smart city refers to an intelligent city solving problems arising from the concentration its population using IT technology. Various services such as safety, transportation, environment, education, and medical care are provided in a smart city. Still, the degree of service experienced by the residents is lower compared to the technological maturity. Hence, the service acceptance intention factor needs to be improved. In this study, User Characteristic and Service Characteristic variables were identified separately to improve the awareness and experience of smart services among citizens of the smart city and analyze the intention of easy service acceptance. Based on the results, the present study is expected to improve citizen's quality of life and form a happy society. This improvement in citizens and society is achieved by drawing active participation from citizens and investments from the government and private enterprise through solving various problems in the city.

Comparison of Inpatient and Outpatient Preoperative Factors and Postoperative Outcomes in 2-Level Cervical Disc Arthroplasty

  • Hill, Patrick;Vaishnav, Avani;Kushwaha, Blake;McAnany, Steven;Albert, Todd;Gang, Catherine Himo;Qureshi, Sheeraz
    • Neurospine
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    • v.15 no.4
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    • pp.376-382
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    • 2018
  • Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed. Results: The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups. Conclusion: Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients.

Anemia Screening, Prevalence, and Treatment in Pediatric Inflammatory Bowel Disease in the United States, 2010-2014

  • Miller, Steven D.;Cuffari, Carmelo;Akhuemonkhan, Eboselume;Guerrerio, Anthony L.;Lehmann, Harold;Hutfless, Susan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.152-161
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    • 2019
  • Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

A Study on the Using of Automatic Exposure Control in the Chest Radiography (흉부 방사선검사에서 자동노출제어 사용에 관한 연구)

  • Choi, Sung-Sik;Lim, Cheong-Hwan;Jung, Sung-Hoon
    • Journal of radiological science and technology
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    • v.42 no.1
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    • pp.19-24
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    • 2019
  • For general radiological examinations, even in the same area and the same test, the test conditions must be set differently according to the patient. However, since it is impossible to consider the body shape and conditions of patients every time in medical institutions where various patients visit, the tests are conducted by setting the AEC which automatically sets the test conditions. AEC is most commonly used in chest radiography. Therefore, the purpose of this study is to propose the improvement plans for using AEC by measuring the exposure dose and evaluating the image quality according to whether the AEC is used or not, and to provide basic data for AEC research. In the present study, images were acquired while varying tube voltage and test distance according to the use of AEC in chest radiography. The radiation dose was measured by placing the dosimeter in front of the chest phantom, and the CNR and SNR of acquired images were analyzed using Image J. The t-test was conducted for the statistical analysis and the significance was determined at the level of 95%(p<.05). As a result of this study, in the inspection distance (100cm, 140cm, 180cm) according to the use of AEC, high doses were observed when the AEC was used and there was statistically significant difference(p<.05). In the t-test to determine the difference between CNR and SNR depending on whether AEC was used or not, there was no significant difference according to the use of AEC(p>.05). Therefore, when performing chest radiography, if the radiologist establishes the appropriate examination conditions and conducts the examination by not just relying solely on AEC, it may be possible to reduce unnecessary radiation exposure to the patient.

Still Image Improvement of Adaptative DWT(Discrete wavelet transform) Decomposition Level Through the Implementation of JPEG2000 Hardware (JPEG2000의 하드웨어 구현을 통한 최적 DWT 레벨의 정지영상 화질개선)

  • Lee, Cheol;Ryu, Jae-Jung;Lee, Jung-Suk
    • The Journal of the Korea institute of electronic communication sciences
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    • v.13 no.6
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    • pp.1343-1352
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    • 2018
  • This paper is designed for hardware to be applied to JPEG2000 standard in the fields of digital photography, remote sensing, aerial remote telemetry, medical imaging, high resolution, and high compression telemetry applications. The software implementation of the JPEG2000 standard for image compression has disadvantages that the processing speed is very slow compared to the conventional JPEG, also the degradation occurs when the DWT level of the JPEG2000 standard is improved. In order to solve this problem, we designed and applied JPEG2000 compression/decompressor. In this paper, the hardware of the JPEG 2000 compression/storage device shows optimal compression speed, faster processing speed, and the image quality for still images by changing the optimal DWT level.