This study was conducted in the National Capital District during the months of August, September and October 2000. The study sites were the 3 urban clinics situated in the suburbs of Six Mile, Hohola and Konedobu. The aim of the study was to determine the patients' waiting times and nursing consultation times in the urban clinics. A total of 1075 patients were surveyed, including 264 children under 5 years of age. 58% of patients were males. 24% of patients were able to see a nurse within 30 minutes and 70% within 2 hours. 47% had to wait 1-3 hours to see a consulting nurse and a further 9.5% had to wait 3-5 hours. 67% of nursing consultations were 5 minutes or less, which is too short to interview, examine and prescribe treatment for the patients and to use the Paediatric 10 Steps. The short consultations of 5 minutes or less did not involve children under 5 years of age. There were only one to two nurses seeing the patients when 79% of patients were seen. This explains why the patients' waiting time was long. After consultations many patients (71%) were able to get their treatment within 30 minutes but 28% had to wait from 30 minutes to 2 hours for their treatment. The small number of nurses giving treatment leads to long waiting times. From the time of entry to exit out of the clinic, only 11% of patients spent 30 minutes or less in the clinic while 51% spent between 1 and 3 hours. The patients' waiting times and the short nursing consultation times are directly related to the insufficient number of nursing officers working in the clinics.
nursing therapy ; Hour ; waiting time ; therapeutic aspects ; seconds

PURPOSE: The increasing number of recipients on the waiting list for orthotopic liver transplantation (OLT) and the scarcity of donors contribute to recipient's pre-transplantation mortality. So, the expansion of donor criteria has become necessary with the increasing number of liver transplantation candidates, as aged donors who have been considered to yield marginal organs. METHODS: We retrospectively analyzed the 18 deceased donor liver transplantations which had been performed between November 2004 and December 2007. Nine patients received liver grafts from donors older than 50 years, the other 9 patients from donors younger than 40 years. Pre- transplantation characteristics of donors and the early graft outcomes of recipients were evaluated. RESULTS: The pre- transplantation status of the patients who received the older and younger grafts was similar, except donor age. Graft function - as determined by peak aminotransferase levels, prothrombin time (INR) and total bilirubin level after transplantation - was not significantly different in older versus younger grafts. Length of ICU stay and hospital stay of recipients were not influenced from donor's pre-transplant status and cold ischemic time. Fatty changes on frozen section biopsy was related with length of recipient's ICU stay (P=0.049), but all enrolled donors had mild macrovesicular fatty changes (<30%) and fatty changes had no relationship with early graft function and total length of recipient's hospital stay. CONCLUSION: Fifty to sixty-five years brain-dead donors could be transplanted with the same initial success as younger livers provided that other generally accepted donor criteria are satisfactory and the cold ischemic time is short. Further studies should be performed for long-term results and we must make effort to find donors older than 65 years.
Age Factors ; Aged ; Bilirubin ; Biopsy ; Cold Ischemia ; Frozen Sections ; Humans ; Length of Stay ; Liver ; Liver Transplantation ; Prothrombin Time ; Retrospective Studies ; Tissue Donors ; Transplants ; Waiting Lists

To adopt the model for end-stage liver disease (MELD) score-based system in Korea, the feasibility should be evaluated by analysis of Korean database. The aim of this study was to investigate the feasibility of the MELD score-based system compared with the current Child-Turcotte-Pugh (CTP) based-system and to suggest adequate cut-off to stratify waiting list mortality among Korean population. We included 788 adult patients listed in waiting list in Seoul National University Hospital from January 2008 to May 2011. The short-term survival until 6 months after registration was evaluated. Two hundred forty six (31.2%) patients underwent live donor liver transplantation and 353 (44.8%) patients were still waiting and 121 (15.4%) patients were dropped out due to death. Significant difference was observed when MELD score 24 and 31 were used as cut-off. Three-months survival of Status 2A was 70.2%. However, in Status 2A patients whose MELD score less than 24 (n=82), 86.6% of patients survived until 6 month. Furthermore, patients with high MELD score (> or =31) among Status 2B group showed poorer survival rate (45.8%, 3-month) than Status 2A group. In conclusion, MELD score-based system can predict short term mortality better and select more number of high risk patients in Korean population.
Area Under Curve ; Cohort Studies ; End Stage Liver Disease/*mortality/therapy ; Humans ; *Liver Transplantation ; *Models, Statistical ; ROC Curve ; Registries ; *Severity of Illness Index ; Survival Rate ; Time Factors ; Waiting Lists

PURPOSE: Although there is a consensus about the need for surveillance colonoscopy after endoscopic resection, the interval remains controversial for large sessile colorectal polyps. The aim of this study was to evaluate the long-term outcome and the adequate surveillance colonoscopy interval required for sessile and flat colorectal polyps larger than 20 mm. MATERIALS AND METHODS: A total of 204 patients with large sessile and flat polyps who received endoscopic treatment from May 2005 to November 2011 in a tertiary referral center were included. RESULTS: The mean age was 65.1 years and 62.7% of the patients were male. The mean follow-up duration was 44.2 months and the median tumor size was 25 mm. One hundred and ten patients (53.9%) received a short interval surveillance colonoscopy (median interval of 6.3 months with range of 1-11 months) and 94 patients (46.1%) received a long interval surveillance colonoscopy (median interval of 13.6 months with range of 12-66 months). There were 14 patients (6.9%) who had local recurrence at the surveillance colonoscopy. Using multivariate regression analysis, a polyp size greater than 40 mm was shown to be independent risk factor for local recurrence. However, piecemeal resection and surveillance colonoscopy interval did not significantly influence local recurrence. CONCLUSION: Endoscopic treatment of large sessile colorectal polyps shows a favorable long-term outcome. Further prospective study is mandatory to define an adequate interval of surveillance colonoscopy.
Adult ; Aged ; Colonic Neoplasms/*diagnosis/pathology/surgery ; Colonic Polyps/*diagnosis/pathology/surgery ; *Colonoscopy ; Endoscopic Mucosal Resection ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis ; Prospective Studies ; Time Factors ; Watchful Waiting/*methods