OBJECTIVES: This study evaluated the functional characteristics of hardware and software in Picture Archiving and Communication System (PACS) in dental hospitals and examined the impact of the functional characteristics on user satisfaction, ease of use, and usefulness of PACS. METHODS: A cross-sectional survey was conducted on dentists at 20 dental hospitals. The dentists assessed the functional characteristics of PACS, and also evaluated the outcomes of PACS use such as user satisfaction, ease of use, and usefulness. For each outcome variable, regression analysis was performed to determine the significant functional characteristics influencing each outcome variable. RESULTS: The image quality of device and the diagnosis-supporting function served as the most important factors in user satisfaction. Experience of the PACS system was correlated with ease of use. Dentists specialized in oral maxillofacial surgery evaluated PACS very useful, and intention to participation in education in the future showed significant correlation with usefulness. The more experience of using PACS system and concern about education, the higher usefulness for the system. CONCLUSIONS: This study has significance in that it can be used as reference for constructing high-efficiency system in dental hospitals adopting the PACS system and also in companies producing the system.
Consumer Satisfaction ; Cross-Sectional Studies ; Dental Informatics ; Dentists ; Hospital Information Systems ; Humans ; Intention ; Surgery, Oral

OBJECTIVES: The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life Years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). METHODS: In closely following the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. RESULTS: The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. CONCLUSIONS: Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.
Cause of Death ; Cost of Illness ; Developed Countries ; Developing Countries ; Female ; Health Transition ; Humans ; Infant ; Judgment ; Korea* ; Life Expectancy ; Male ; Mortality, Premature*

Purpose: This study was done to provide basic data for nursing intervention to increase communication ability of operating room nurses by identifying the relation among their verbal violence experience, job stress, resilience, and communication ability. Methods: The participants were 136 nurses, working in the operating rooms of six academic and general hospitals located in Seoul and Gyeonggi-Do. Data were collected from May 1st through October 31st, 2016. Collected data were analyzed for frequency and percentage, mean and standard deviation, association among related factors, and stepwise multi-regression using the SPSS 21.0 program. Results: It was found that the strongest factor influencing the communication ability of operating room nurses was persistence (β=.41, p <.001; sub-item of Resilience), followed by support (β=.26, p =.001; sub-item of Resilience). These two sub-items have positive influences on communication ability of operating room nurses. The lack of professional knowledge and skill (β=-.19, p <.001; sub-item of job stress) and verbal violence experience from nurse (β=-.16, p <.001; sub-item of verbal violence experience) have negative influences on communication ability of operating room nurses. These sub-items explained 47.0% of communication ability of operating room nurses. Conclusion The study results can be used as basic data to develop effective communication. Also, the results show the necessity of developing and applying concrete nursing interventions to improve job satisfaction of operating room nurses.

Purpose: This descriptive study aimed to identify the incidence and related factors of reintubation after unplanned extubation in the neonatal intensive care unit. Methods: A secondary data analysis was conducted using electronic medical records. All events of unplanned extubation were audited from January 2020 to August 2021. The data were analyzed by chi-square test using IBM SPSS Statistics ver. 24.0 program. Results: Fifty-eight unplanned extubation events were identified for 20 months. The incidence was 2.6 per 100 ventilation days during the study period. After unplanned extubation, 35 neonates (60.3%) were immediately reintubated. There was a statistically significant difference between the gestational age (p=0.018) and postconceptional age at unplanned extubation (p=0.044) and the total intubation period (p=0.003) between the reintubation and nonreintubation groups. Conclusion These findings indicate that the incidence of unplanned extubation was significantly higher than that of an adult in South Korea. According to this study, targeting interventions are required to prevent unplanned extubation and ensure patient safety.

We estimated the burden of diseases in Korea especially caused by major cancers using DALY (disability adjusted life year) measurement. Firstly, the burden of disease due to premature death was estimated by using YLLs (years life lost due to premature death) measurement developed by the global burden of disease study group. Secondly, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula; incidence rate, case fatality rate and disability weight of major cancers. Thirdly, we estimated DALY of major cancers by adding YLLs and YLDs. The burden of major cancers for male per 100,000 population was attributed mainly to liver cancer (528.8 person-year), stomach cancer (451.4 person-year), and lung cancer (374.9 person-year). The burden of major cancers for female per 100,000 population was attributed mainly to liver cancer (140.0 person-year), stomach cancer (259.7 person-year), and lung cancer (125.2 person-year). Each of these cancers was responsible for the loss of over 100 person-year per 100,000 population based on our DALY measurement. We found the DALY method employed was appropriate to quantify the burden of disease. Thereby, it would provide a rational bases to plan a national health policy regarding the burden of disease caused by major cancers in Korea.
Adult ; Aged ; Female ; Health Policy ; Humans ; Korea/epidemiology ; Liver Neoplasms/epidemiology/mortality ; Lung Neoplasms/epidemiology/mortality ; Male ; Middle Aged ; Neoplasms/*epidemiology/mortality ; Quality-Adjusted Life Years ; Stomach Neoplasms/epidemiology/mortality

BACKGROUND: Medical device adverse event reporting is an essential activity for mitigating device-related risks. Reporting of adverse events can be done by anyone like healthcare workers, patients, and others. However, for an individual to determine the reporting, he or she should recognize the current situation as an adverse event. The objective of this report is to share observed individual differences in the perception of a medical device adverse event, which may affect the judgment and the reporting of adverse events. METHODS: We trained twenty-three participants from twelve Asia-Pacific Economic Cooperation (APEC) member economies about international guidelines for medical device vigilance. We developed and used six virtual cases and six questions. We divided participants into six groups and compared their opinions. We also surveyed the country's opinion to investigate the beginning point of ‘patient use’. The phases of ‘patient use’ are divided into: 1) inspecting, 2) preparing, and 3) applying medical device. RESULTS: As for the question on the beginning point of ‘patient use,’ 28.6%, 35.7%, and 35.7% of participants provided answers regarding the first, second, and third phases, respectively. In training for applying international guidelines to virtual cases, only one of the six questions reached a consensus between the two groups in all six virtual cases. For the other five questions, different judgments were given in at least two groups. CONCLUSION: From training courses using virtual cases, we found that there was no consensus on ‘patient use’ point of view of medical devices. There was a significant difference in applying definitions of adverse events written in guidelines regarding the medical device associated incidents. Our results point out that international harmonization effort is needed not only to harmonize differences in regulations between countries but also to overcome diversity in perspectives existing at the site of medical device use.
Consensus ; Delivery of Health Care ; Education ; Humans ; Individuality ; Judgment ; Social Control, Formal

PURPOSE: In some patients who receive adjuvant radiotherapy (RT) for the left breast, the stomach is located inside the RT field. This study investigates the incidence of gastric complications following adjuvant RT for breast cancer using data of the Health Insurance Review and Assessment Service in South Korea. METHODS: We identified 37,966 women who underwent surgery and received adjuvant RT for breast cancer. The cumulative incidence rate of gastric hemorrhage and gastric cancer was calculated and compared for left and right breast cancers. RESULTS: Among 37,966 patients, 19,531 (51.4%) and 18,435 (48.6%) had right and left breast cancers, respectively. After a median follow-up duration of 6.3 years, the cumulative incidence of gastric cancer and gastric hemorrhage did not differ between right and left breast cancers (p = 0.414 and p = 0.166, respectively). The multivariable analysis revealed that old age was the only factor associated with the development of gastric cancer (p < 0.001) and gastric hemorrhage (p < 0.001). The incidence of gastric cancer and hemorrhage did not differ between patients who received adjuvant RT for right and left breast cancers. CONCLUSION: Irradiation-related chronic complications of the stomach in patients with breast cancer are minimal. A study with a longer follow-up duration might be needed to assess the risk of gastric cancer.
Breast Neoplasms ; Breast ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Incidence ; Insurance, Health ; Korea ; Radiotherapy ; Radiotherapy, Adjuvant ; Stomach ; Stomach Neoplasms

Fexuprazan (DWP14012), a potassium-competitive acid blocker, is a medical formulation prescribed to inhibit the secretion of gastric acid. The present study encompasses a comparative evaluation of pharmacokinetic (PK) analysis between the previous (reference) and size-reduced (test) formulation of fexuprazan 20 mg in healthy subjects. The study employed a randomized, open-label, single-dose, 2-sequence, 2-period, crossover design with a 7-day wash-out between periods. A total of 24 subjects were enrolled in this randomized study. During each period, the 21 subjects received either the test or reference formulation. Blood samples were collected at multiple time point ranging from 0 (pre-dose) to 48 hours post-dosing for PK analysis. The calculated PK parameters were considered bioequivalent when the 90% confidence intervals (CIs) of the geometric mean ratios (GMRs) were within the bioequivalence limit of 0.8–1.25. Safety and tolerability were included in the evaluation. A total of 20 subjects completed the study. Point estimates (90% CIs) of the GMRs were 1.1014 (0.9892–1.2265) for the maximum plasma concentration and 1.0530 (0.9611–1.1536) for the area under the plasma concentration-time curve from zero to the time of the last quantifiable concentration, between the test and reference formulations.The reference and size-reduced test formulations of fexuprazan were well tolerated with no reports of serious adverse events. In conclusion, size-reduced and previous formulations of fexuprazan 20 mg were bioequivalent with regard to PKs, safety and tolerability.

Vitamin C is a well-known antioxidant with antiviral, anticancer, and anti-inflammatory properties based on its antioxidative function. Aptamin C, a complex of vitamin C with its specific aptamer, has been reported to maintain or even enhance the efficacy of vitamin C while increasing its stability. To investigate in vivo distribution of Aptamin C, Gulo knockout mice, which, like humans, cannot biosynthesize vitamin C, were administered Aptamin C orally for 2 and 4 weeks.The results showed higher vitamin C accumulation in all tissues when administered Aptamin C, especially in the spleen. Next, the activity of natural killer (NK) cells were conducted. CD69, a marker known for activating for NK cells, which had decreased due to vitamin C deficiency, did not recover with vitamin C treatment but showed an increasing with Aptamin C. Furthermore, the expression of CD107a, a cell surface marker that increases during the killing process of target cells, also did not recover with vitamin C but increased with Aptamin C. Based on these results, when cultured with tumor cells to measure the extent of tumor cell death, an increase in tumor cell death was observed. To investigate the signaling mechanisms and related molecules involved in the proliferation and activation of NK cells by Aptamin C showed that Aptamin C treatment led to an increase in intracellular STAT3 activation. In conclusion, Aptamin C has a higher capability to activate NK cells and induce tumor cell death compared to vitamin C and it is mediated through the activation of STAT3.

Vitamin C is a well-known antioxidant with antiviral, anticancer, and anti-inflammatory properties based on its antioxidative function. Aptamin C, a complex of vitamin C with its specific aptamer, has been reported to maintain or even enhance the efficacy of vitamin C while increasing its stability. To investigate in vivo distribution of Aptamin C, Gulo knockout mice, which, like humans, cannot biosynthesize vitamin C, were administered Aptamin C orally for 2 and 4 weeks.The results showed higher vitamin C accumulation in all tissues when administered Aptamin C, especially in the spleen. Next, the activity of natural killer (NK) cells were conducted. CD69, a marker known for activating for NK cells, which had decreased due to vitamin C deficiency, did not recover with vitamin C treatment but showed an increasing with Aptamin C. Furthermore, the expression of CD107a, a cell surface marker that increases during the killing process of target cells, also did not recover with vitamin C but increased with Aptamin C. Based on these results, when cultured with tumor cells to measure the extent of tumor cell death, an increase in tumor cell death was observed. To investigate the signaling mechanisms and related molecules involved in the proliferation and activation of NK cells by Aptamin C showed that Aptamin C treatment led to an increase in intracellular STAT3 activation. In conclusion, Aptamin C has a higher capability to activate NK cells and induce tumor cell death compared to vitamin C and it is mediated through the activation of STAT3.