The objectives of this study were to examine effects of B2B e-commerce on the material management by comparing the performance of B2B and non-B2B hospitals, and surveying the extent of the objective of B2B implementation was achieved and success and failure factors of the implementation. Managerial data from six hospitals, three B2B and three non-B2B, and survey data from 107 employees involved in the material management at the study hospitals were analyzed. The number of employees at the department of purchasing, time spent for placing order, cycle time from order to delivery were better at the B2B hospitals, and employees' satisfaction with the material management system was significantly higher in the B2B hospitals than in the non-B2B hospitals as well. However, intended effects of B2B e-commerce in wider areas of the material management such as inventory management and sharing of business information were not substantiated in this study. The study results indicated that B2B ecommerce in the study hospitals improved work efficiency and effectiveness in the area of procurement, and implied needs for an ERP-type system and process reengineering with the implementation of B2B e-commerce to obtain wider ranges of effects in the material management. Also the study results implied a need for communication with employees during the course of implementation for the system success.
Commerce

PURPOSE: Peak urinary flow rate is a widely used parameter in the diagnosis and evaluation of treatment erect of BPH because of its objectiveness and non-in vasiveness. The peak urinary flow rate, however is different with each voided volume in the same patient and tends to decrease even in an asymptomatic man with increasing ages. Therefore we need an adjusted peak urinary flow rate corresponding with the age and voided volume. This adjusted peak urinary flow rate can be used to evaluate the voiding function more easily in the same patient periodically or In the different patient of various voided volume and ages. MATERIALS AND METHODS: Data on age, volume voided and peak urinary flow rate were accumulated from 216 male aged from 10 to 80 who were free of voiding symptoms. All combinations of peak urinary flow rate, age and volume voided were tested for equation of bet fit by the least squares method with search for the equation providing least residual standard deviation with SAS package. RESULTS: When the peak urinary flow rate is defined as a function of age and voided volume, the equation is Q=35.01+0.086A-0.0031A2-1612/V(Q: peak urinary flow rate, A: age, V: voided volume). At the point of population means for volume voided(247.5ml) arid age(35.2) the reference peak urinary flow rate was 27.7m1/sec. Adjusted peak flow rate can be obtained by subtracting the difference between the measured and expected peak flow rate(expected minus measured) from the reference peak flow rate. To make the adjusted peak flow rate obtained easily with measured peak flow rate, age and voided volume nomogram that incorporates the equation has been designed. In our nomogram an adjusted peak flow rate < 19.9 ml/sec or > 1.3 standard deviation below mean should be considered suspicious for obstruction. CONCLUSIONS: Nomogram for adjusted peak flow rate that incorporates the age, voided volume and measured peak flow rate would be satisfactory for clinical use.
Diagnosis ; Humans ; Least-Squares Analysis ; Male* ; Nomograms

ESWL has become the most widely advocated procedure for urinary calculi because of its minimal invasiveness and high effectiveness. Unfortunately, so far most urologist use push-up or push-down technique in the treatment of mid ureter stone with ESWL. Herein, we tried in situ ESWL with ultrasonographic targeting system (Lithostar ultra, Siemens Co., Germany) in 74 mid ureter stone patients. We could target the stone in 71 out of 74 patients (71/74, 95.6%) in semilateral position in the patients with upper half of mid ureter stone or in supine position in the patients with lower half of mid ureter stone The stone was successfully removed in sixty eight patients and the success rate was 9l.1% (68/ 74). The number of treatment session was 1 to 5 (mean 1.3+/-0.8) and the duration was 20-150 minutes (mean 46.4+/-19.7 minutes). Complications were gross hematuria in 5 cases(7.0%), severe colicky pain in 2 cases (2.8%). In conclusion, we think in situ ESWL with ultrasonographic targeting system is a recommendable treatment of modality in mid ureter stone patients.
Abdominal Pain ; Hematuria ; Humans ; Supine Position ; Ureter* ; Urinary Calculi

Objective: Peripheral vertigo is one of the most common causes of the emergency department (ED) visits. It can impair balance and might predispose patients to injuries after discharge. The purpose of this study was to determine whether peripheral vertigo is associated with an increased risk of trauma. Methods: This matched-cohort study used the nationally representative dataset of de-identified claim information of 1 million randomly sampled individuals from a real Korean population, from 2002 to 2013. The exposure cohort included patients who visited EDs for new-onset peripheral vertigo without prior or concurrent injury. Each patient was randomly matched to five unexposed individuals (also without previous injury) by incidence density sampling. The primary outcome was a new injury within 1 year. The secondary outcomes were various injury subtypes. The time-dependent effect of the exposure was modeled using the extended Cox model. Age, sex, comorbidities, and household income level were included as covariates. Results: A total of 776 and 3,880 individuals were included as the exposure and comparison cohorts, respectively. The risks of trunk injury and upper extremity injury were significantly higher in the exposure cohort. Extended Cox models with multivariable adjustment showed significantly increased risk for up to 1 year, with the first 1-month; 1 month to 3 months; and 3 months to 1 year hazard ratios of 5.23 (95% confidence interval [CI], 2.83–9.64); 1.50 (95% CI, 1.02–2.20); and 1.37 (95% CI, 1.11–1.68), respectively. Conclusion Patients visiting EDs for acute peripheral vertigo are at a higher risk of a new injury for up to a year.

PURPOSE: The purposes of this study were to investigate daycare teachers'knowledge, anxiety and management of childhood fever and to identify factors affecting their management of childhood fever. METHODS: A descriptive correlation study was conducted. Participants were 109 daycare center teachers from G metropolitan city. A self-administered questionnaire was used for data collection. RESULTS: The mean percent of correct answers for knowledge about childhood fever was 42.9%. Levels of anxiety related to children's fever were high among day care teachers in this study. Many daycare center teachers used management practices which were not recommended for childhood fever management. There was a statistically significant difference in participants' knowledge about childhood fever by marital status and having a child. Moreover, there were statistically significant positive correlation between daycare center teachers' knowledge and management and negative correlation between daycare center teachers' anxiety and management of childhood fever. Knowledge and anxiety related to childhood fever accounted for 15.2% of variance for fever management. CONCLUSION: Results show that day care teachers' knowledge and anxiety related to fever are important factors in predicting their fever management. Development and evaluation of educational interventions to improve daycare teachers' childhood fever management are recommended.
Anxiety ; Child ; Child Day Care Centers ; Data Collection ; Day Care, Medical ; Evidence-Based Practice ; Fever* ; Humans ; Marital Status ; Statistics as Topic

Extracorporeal shock wave lithotripsy (ESWL) is chosen as a primary treatment modality due its non-invasiveness and high effectiveness. But renal damage is reported in 65-85% of patients with renal stone after ESWL. It is Know that the renal collecting tubular enzyme, N-acety1-glucosaminidase (NAG), is increased in urine and 3-4 weeks are needed to be normal in most patients in case of damage by ESWL. Nevertheless, ESWL is performed repeatedly with 1 or 2 weeks interval and moreover daily without checking the renal damage in most ESWL centers. So, this study is performed to know how severely the renal damage is caused by ESWL and to know the safe interval of ESWL in patients with renal stones. We measured the urinary NAG/Creatinine ratio to check the renal damage in 9 patients with renal stone after repeated ESWL (19kV, 2000-3000 shock wave/session) using Lithostar Ultra manufactured by Siemens. The results are as follows; 1. In 3 patients who received ESWL once a day for 2 days repeatedly, one patient had normal urinary NAG/Creatinine ratio, one patient had rapidly increased urinary NAG/Creatinine ratio immediately and the ratio decreased from two weeks later and it needed 4 weeks to be normal. The other one patient had rapidly increased urinary NAG/Creatinine ratio immediately and the ratio was normal 1 week later. 2. All 6 patients who received ESWL with one or two weeks interval had normal urinary NAG/ Creatinine ratio. In conclusion, it is thought that repeated ESWL by Lithostar Ultra (Siemens) with more than 1 week interval is safe. In case of repeated ESWL more than 3 times with one day interval, it is needed to confirm the normal urinary NAG/Creatinine ratio before procedure.
Creatinine ; Humans ; Lithotripsy* ; Shock*

Background: The government should find ways to improve the effectiveness of the policies to control the incidence and mortality of the infectious disease. The purpose of this study is to find out whether the trust in the government’s ability to respond to coronavirus disease 2019 (COVID-19) affects the quarantine and hospitalization rate, incidence and mortality rates of COVID-19 and quarantine rules compliance in each region of Korea. Methods: The subject of this study is 250 regions (si · gun · gu) in Korea, and the 2020 Community Health Survey data from the Korea Disease Control and Prevention Agency (KDCA) was used for the trust in the government’s ability to respond to COVID-19, quarantine and hospitalization rate and quarantine rules compliance. For the incidence and mortality of COVID-19 and community factors, data was obtained from KDCA and Korean Statistical Information Service. Path analysis was used to find out the degree of inter-variable influence, and community factors (socio-demographic factors, community health factors, and health behavior factors) were used as control variables. Results: The regional disparity in key variables showed that the late pandemic period cumulative incidence and mortality of COVID-19 were large, while the early pandemic period quarantine and hospitalization rate and quarantine rules compliance were small. Path analysis showed that when community factors were controlled, the trust in government was statistically significant in all of the late pandemic period cumulative incidence (p=0.024) and mortality (p=0.017), and quarantine rules compliance (p=0.011). Conclusion This study revealed that the higher the trust in the government’s ability to respond to COVID-19, the lower the COVID-19 mortality and the higher the quarantine rules compliance at the regional level in Korea. This suggests that when the government implements healthcare policies to control infectious diseases, it is necessary to consider trust to improve policy compliance and control the mortality of the disease and maintain high trust through several effective methods.

Purpose: The purpose of this study was to use a systematic review to investigate how infection control education has been designed, implemented and evaluated in undergraduate programs in nursing. Methods: This study was conducted base on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to infection control education programs, Ovid-EMBASE, CINAHL, Pubmed, KoreaMed, KMBASE and KISS were used. A total of 2,306 studies were identified, and 13 studies were selected for final analysis. Results: Ten studies out of 13 were designed as pre-post, no control group, quasi-experimental study designs. Nosocomial infection and standard precautions related infection control education were the most frequently selected topics and online was the most common teaching-learning method. The infection control education programs showed significant effect on knowledge and attitude. The mean difference of 7 studies for knowledge was 5.1 (95% CI: 2.36, 8.67, p<.001) and the mean difference of 4 studies for attitude was 3.34 (95% CI: 0.12, 6.55, p<.001). Conclusion The results of this study indicate that infection control education effectively improves the knowledge, attitude and compliance of nursing students. Therefore, it is necessary to develop more specific educational programs that can reflect the changes of the times and the demands of clinical nurses.

PURPOSE: TURP(transurethral resection of prostate) is the standard surgical treatment for BPH. However, myocardial damage is the most serious complication and has been postulated to develop as a result of irrigating fluid absorption during TURP. The aim of this study is to evaluate the relationship between the amount of irrigating fluid absorption and myocardial damage, and the factors that affect irrigating fluid absorption. MATERIALS AND METHODS: From March 2002 to January 2003, 52 patients who had undergone TURP were evaluated. TURP was performed under epidural anesthesia and URIONE(R) solution was used as the irrigating fluid. The amount of absorbed irrigating fluid was measured and serum troponin I was checked as a marker of perioperative myocardial damage. Resection time, weight of resected prostatic tissue, and the amount of blood loss were evaluated as the factors that affect the irrigating fluid absorption. RESULTS: Weight of resected prostatic tissue(r=0.566, p=0.001) and blood loss(r=0.339, p=0.01) were found to have moderate correlation with the amount of absorbed irrigating fluid, whereas the amount of irrigating fluid(r=0.293, p=0.11) and resection time(r=0.296, p=0.062) had no correlation. Myocardial damage was observed in 2 out of the 52 patients(3.8%), whosepostoperative serum troponin I was higher than 0.4microgram/L, and absorbed irrigating fluid being more than 1,000ml. CONCLUSIONS: Therefore, in the case of large prostate volume and excessive blood loss, the use of diuretics during TURP is recommended to reduce the incidence of myocardial damage.
Absorption* ; Anesthesia, Epidural ; Diuretics ; Humans ; Incidence ; Prostate ; Transurethral Resection of Prostate* ; Troponin ; Troponin I

Purpose: A video-urodynamic study is known as the most accurate test to differentiate between benign prostatic hyperplasia (BPH) with overactive bladder and detrusor instability but requires expensive equipment and an expert technique, so is not commonly available. We performed a video- urodynamic study and ice-water test which is easily performed for the diagnosis of a neurogenic bladder in the patients with symptomatic BPH associated with overactive bladder and compared the results. Materials and Methods: The video-urodynamic study using a 10-Fr triple lumen urodynamic catheter was performed in 36 patients with symptomatic BPH associated with overactive bladder that had frequency, weak stream, nocturia, urgency, urge incontinence, dysuria and no clinical neurogenic defect. After the video-urodynamic study, the ice-water test was performed by instilling 4degreesC sterilized water through a catheter at 200ml/ min in the supine position. The volume instilled was about 30% of the bladder capacity. The ice-water test was positive if there was an efflux of water around the catheter during or after water instillation. Results: Thirty two of the 36 symptomatic BPH patients with an overactive bladder were negative on the ice-water test. All 32 patients who had a negative ice-water test were BPH with overactive bladder on the video- urodynamic study. Four of the 36 symptomatic BPH patients with an overactive bladder were positive on the ice-water test. Two of the 4 patients who had a positive ice-water test were BPH with overactive bladder and the other two were detrusor instability on the video-urodynamic study. Conclusions: Therefore, in case of a positive ice water test, a video-urodynamic study is needed to differentiate between BPH with overactive bladder and detrusor instability in patients with symptomatic BPH associated with overactive bladder.
Catheters ; Diagnosis ; Dysuria ; Humans ; Ice ; Nocturia ; Prostatic Hyperplasia* ; Rivers ; Supine Position ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge ; Urodynamics ; Water