PURPOSE: This study was conducted to investigate the trend in functional changes over time and factors associated with the number of areas showing functional decline in older adults who had been discharged from acute care hospitals. METHODS: This longitudinal study involved 156 patients aged ≥ 65 years who were admitted to one tertiary hospital in Seoul and discharged home. Authors investigated patient demographic and health-care characteristics and the number of areas showing functional decline at 1 and 3 months after discharge. The data were analyzed using univariate and multivariate Poisson regression models. RESULTS: The number of areas showing functional decline increased between admission and 1 month after discharge and had declined slightly at 3 months after discharge. The factors associated with the number of areas showing functional decline at 3 months after discharge were age, education level, and length of hospitalization (p < .05); the factors associated at 1 month after discharge were medical department and caregiver relationship (p < .05). CONCLUSION: The results indicate that older patients with no spouse or those with their elderly spouse as their caregiver are at risk of functional decline in a greater number of areas after discharge. Therefore, a comprehensive health-care policy to ensure care continuity is required for functional health maintenance for older adults after hospital discharge.
Adult ; Aged ; Caregivers ; Continuity of Patient Care ; Education ; Hospitalization ; Humans ; Longitudinal Studies ; Seoul ; Socioeconomic Factors ; Spouses ; Tertiary Care Centers

PURPOSE: Since the revised Cancer Act of October 2006, cancer registration was reactivated, based on the Statistics Law. MATERIALS AND METHODS: The incidence of cancer during 2002 was calculated on the basis of the information available from the National Cancer Incidence Database. Crude and age-standardized rates were calculated by gender for 18 age groups (0~4, 5~9, 10~14, every five years, 85 years and over). RESULTS: The overall crude incidence rates (CRs) were 269.2 and 212.8 per 100,000 for males and females, and the overall age-standardized incidence rates (ASRs) were 287.8 and 172.9 per 100,000, respectively. Among males, the five leading primary cancer sites were stomach (CR 62.4, ASR 65.7), lung (CR 45.4, ASR 51.0), liver (CR 43.2, ASR 43.7), colon and rectum (CR 30.7, ASR 32.7), and prostate (CR 8.0, ASR 9.6). Among females, the most common cancer sites were breast (CR 33.1, ASR 26.9), followed by stomach (CR 32.8, ASR 26.0), colon and rectum (CR 23.1, ASR 18.5), thyroid (CR 19.1, ASR 15.7), and uterine cervix (CR 18.2, ASR 14.7). In the 0~14 age group, leukemia was the most common cancer for both genders. For males, stomach cancer was the most common cancer in the 15~64 age-group, but lung cancer was more frequent in men 65 or older. For females, thyroid cancer among the 15~34 age-group, breast cancer among 35~64 age-group and stomach cancer in women 65 years or older were the most common forms of cancer for each age group. The quality indices for the percentage of deaths, by death certificate only, were 4.7% for males and 4.5% for females. CONCLUSIONS: Since the National Cancer Incidence Database was started, the annual percent change of cancer cases increased by 4.8% (4.1% for males, 5.7% for females) during 1999~2002. This value reflects the increase in prostate cancer for males and breast and thyroid cancer in females during 2002. The timely reporting of improved quality of cancer registration is needed for evidence-based decisions regarding cancer control in Korea.
Breast ; Breast Neoplasms ; Cervix Uteri ; Colon ; Death Certificates ; Female ; Humans ; Incidence* ; Jurisprudence ; Korea* ; Leukemia ; Liver ; Lung ; Lung Neoplasms ; Male ; Prostate ; Prostatic Neoplasms ; Rectum ; Stomach ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms

The Korean Central Cancer Registry Program analyses data on the incidence and characteristics of cancer gathered from training hospitals across the nation in order to prepare coherent and accurate summary. The program has had these data computer processed through CANCER (version 1.5), a computer program for registry, since 1996. In 2002, we conducted a survey of the registered hospitals on the status of utilization for this cancer registry related-computer program and on the additional requirements to the existing variables. The results showed that the number of hospitals using the CANCER program has slightly outnumbered the hospitals using their own computer system for hospital information. That is because the number of cancer registry cases of the large-scale hospitals such as general hospitals, which comprises the majority of registered hospitals, is so many that they are able to sort out cancer registry data from their own system. They also reported a middle level of satisfaction with the program utilization. Among the least satisfactory items were the program's lack of portability to different situations and the necessity for double input of the same registry field. The field most requested by the surveyed hospitals for addition to the program was one on metastatic site. This study should lead to follow-up measures such as the development of a variety of algorithms to enhance the accuracy of the data by further reducing the errors in processing the data, and the recommendation of standards which are likely to enhance data adaptability. The result will be utilized as a basic reference for building a systematic and effective database on the national cancer registry.
Computer Systems ; Hospitals, General ; Incidence ; Korea*

During a four-week period, four healthy term newborn infants born at a regional maternity hospital in Korea developed late-onset neonatal group B Streptococcus (GBS) infections, after being discharged from the same nursery. More than 10 days after their discharge, all of the infants developed fever, lethargy, and poor feeding behavior, and were subsequently admitted to the Korea University Medical Center, Ansan Hospital. GBS was isolated from the blood cultures of three babies; furthermore, GBS was isolated from 2 cerebral spinal fluid cultures. Three babies had meningitis, and GBS was isolated from their cerebral spinal fluid cultures. This outbreak was believed to reflect delayed infection after early colonization, originating from nosocomial sources within the hospital environment. This report underlines the necessity for Korean obstetricians and pediatricians to be aware of the risk of nosocomial transmissions of GBS infection in the delivery room and/or the nursery.
Time Factors ; *Streptococcus agalactiae/isolation & purification ; Streptococcal Infections/*epidemiology/microbiology/transmission ; Pregnancy ; Meningitis, Bacterial/epidemiology/microbiology/transmission ; Male ; Korea/epidemiology ; Infant, Newborn ; Humans ; Hospitals, Maternity ; Female ; *Disease Outbreaks ; Cross Infection/*epidemiology/microbiology/transmission

PURPOSE: During the past decade, various endoscopic thyroid surgeries have been conducted, each with its own benefits. The incorporation of robotic systems to endoscopic thyroid surgery has improved the visualization and precision of endoscopic techniques. We previously reported our initial experience with robotic modified radical neck dissection (MRND) of papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). The aim of this study was to compare surgical outcomes of robotic vs. conventional open MRND of PTC with LNM using propensity score matching. METHODS: From January 2008 to February 2011, 515 patients with PTC with LNM were enrolled. One hundred patients underwent robotic MRND, and 415 patients underwent conventional open MRND. These two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes, and surgical completeness. Furthermore, to avoid selection bias, propensity score matching analysis was used to compare surgical outcomes of each group without any compounding factors. RESULTS: The operative time for the robotic MRND was longer than for the open MRND (297.9±60.2 min vs. 212.1±55.6 min, P=0.089). However, the mean numbers of retrieved lymph nodes and mean hospital stay after surgery were similar in the two groups (36.0±12.9 vs. 40.8±13.3, P=0.235), (6.1±1.6 days vs. 6.1±2.1 days, P=0.577). The complication rates were similar between the two groups, and there was no statistical difference in postoperative thyroglobulin levels between groups (0.51±0.83 ng/ml vs. 0.89±2.46 ng/ml, P=0.593). CONCLUSION: According to our study, robotic MRND shows similar surgical outcomes to conventional open MRND after case-matched analyses. We suggest that robotic MRND is an acceptable alternative as an operative method for PTC with LNM, resulting in excellent cosmesis and patient satisfaction.
Humans ; Length of Stay ; Lymph Nodes ; Methods ; Neck Dissection ; Neck* ; Neoplasm Metastasis* ; Operative Time ; Patient Satisfaction ; Propensity Score* ; Retrospective Studies ; Selection Bias ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: Atopic dermatitis is one of the psychosomatic disorders that have been reported to have profound effect on the development of characteristics and interpersonal relationships. OBJECTIVE: This study was performed to identify the relationship between childhood and adolescent atopic dermatitis, attachment and the quality of parental life. METHODS: Sixty-eight atopic dermatitis patients and thirty nine healthy control subjects were included in our study. Eczema area and severity index (EASI) were examined for evaluating the severity of atopic dermatitis, Revised Adult Attachment Scale for the evaluation of parent-child attachment, and Parents' Index of Quality of Life in Atopic Dermatitis for evaluating the quality of parental life were used in this study. RESULTS: The rate of unstable attachment was higher for the subjects with atopic dermatitis, as compared to that for the healthy controls (chi-square=6.07, p=0.02). The unstable attachment group in the atopic dermatitis group showed more severe AD on the face, upper extremity and lower extremity, and their total EASI score was higher than that for the stable attachment group of the patient group. The score of the quality of parental life for atopic dermatitis was lower than that for the healthy controls (t=7.09, p<0.01). Among the severity of atopic dermatitis and the child-parental attachment, the former more affected the quality of parental life (r=0.798, p<0.0). CONCLUSION: Although childhood and adolescent atopic dermatitis was related with psychologic factors of the parent-child relationship, the state of atopic dermatitis more directly impacted on the quality of parental life.
Adolescent ; Adult ; Child ; Dermatitis, Atopic ; Eczema ; Humans ; Lower Extremity ; Parent-Child Relations ; Parents ; Psychophysiologic Disorders ; Quality of Life ; Upper Extremity

PURPOSE: The first Korean national population- based cancer registry using nationwide hospital-based recording system and the regional cancer registries provided the source to obtain national cancer incidences for the period 1999~2001. MATERIALS AND METHODS: The incidence of cancer in Korea was calculated based on the Korea Central Cancer Registry database, data from additional medical record review survey, the Regional Cancer Registry databases, site-specific cancer registry databases, and cancer mortality data from the Korea National Statistical Office. Crude and age-standardized rates were calculated by sex for 18 age groups. RESULTS: The overall crude incidence rates (CR) were 247.3 and 188.3 per 100, 000 for men and women and the overall age-standardized incidence rates (ASR) were 281.2 and 160.3 per 100, 000, respectively. Among men, five leading primary cancer sites were stomach (CR 58.6, ASR 65.6), lung (CR 42.1, ASR 50.9), liver (CR 41.9, ASR 44.9), colon and rectum (CR 24.2, ASR 27.3) and bladder (CR 7.7, ASR 9.2). Among women, the most common cancers were stomach (CR 30.8, ASR 25.8), breast (CR 25.7, ASR 21.7), colon and rectum (CR 19.6, ASR 16.7), uterine cervix (CR 18.4, ASR 15.5), and lung cancer (CR 15.1, ASR 12.4). In 0~14 age group, leukemia was most common for both sexes. For men, stomach cancer was most common in 15~64 age group, but lung cancer was more frequent for over 65 age group. For women, thyroid cancer in 15~34 age group, breast cancer in 35~64 age group, and stomach cancer in over 65 age group were most common for each age group. The proportions of death certificate only were 7.5% for men and 7.4% for women. CONCLUSION: This is the first attempt to determine the national cancer incidence and this data will be useful to plan for research and national cancer control in Korea.
Breast ; Breast Neoplasms ; Cervix Uteri ; Colon ; Death Certificates ; Female ; Humans ; Incidence* ; Korea* ; Leukemia ; Liver ; Lung ; Lung Neoplasms ; Male ; Medical Records ; Mortality ; Rectum ; Registries ; Stomach ; Stomach Neoplasms ; Thyroid Neoplasms ; Urinary Bladder

In 2002, breast became the most common cancer site in Korean women. Using national breast cancer incidence data during 1993-2002, crude, age-standardized, and age-specific rates for incidence and mortality were calculated. Survival was examined for cases diagnosed during 1993-2002 and followed up to 2004. Observed survival was calculated using the life table method and relative survival using the Ederer II method. Age-standardized incidence rates in female increased from 14.5 in 1993 to 26.2 per 100,000 in 2002. Age-specific incidences showed peaks in women in their forties. Mortality rates increased from 3.7 in 1993 to 4.6 per 100,000 in 2002 and showed peaks in women in their fifties. Five-year relative survival for female breast cancer diagnosed during 1993-2002 was 82.2%. When we examined the secular trends using cases diagnosed 1993-1999 for complete 5-yr follow-up, the 5-yr relative survival increased from 75.2% in 1993 to 83.5% in 1999. The data from this study will provide valuable information to plan and evaluate actions against breast cancer including national breast cancer screening.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*epidemiology/mortality ; Breast Neoplasms, Male/epidemiology/mortality ; Epidemiologic Factors ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Survival Rate ; Time Factors

This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C. Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
Adipose Tissue ; Biomarkers ; Cervix Uteri ; Cohort Studies* ; Death Certificates ; Diagnosis ; Environmental Exposure ; Female ; Genetic Predisposition to Disease ; Health Services Needs and Demand ; Hepatitis ; Humans ; Korea* ; Liver ; Lung ; Male ; Mass Screening ; Physical Examination ; Risk Factors ; Rural Population ; Serologic Tests ; Tissue Banks ; Biomarkers, Tumor ; Surveys and Questionnaires

OBJECTIVES: Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). METHODS: SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. RESULTS: The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. CONCLUSIONS: Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.
Achievement ; Disasters ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Information Systems ; North America ; Patient Care ; Patient Safety ; Quality of Health Care