Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p＜.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

OBJECTIVES: Cord blood stem cells have been widely used as donor cells for bone marrow transplantation recently. These cells can give rise to a variety of hematopoietic lineages to repopulate the blood. Recent observations reveal that some bone marrow cells and bone marrow stromal cells(MSCs) can grow to become either neurons or glial cells. It is, however, unclear whether or not there exists stems cells which can differentiate into neurons in the blood during the early stages of postnatal life. METHODS: Human cord blood stem cells were prepared from human placenta after full term delivery. To induce neuronal differentiation of stem cells, beta-mercaptoethanol was treated. To confirm the neuro-glial characteristics of differentiated stem cells, immunocytochemical stain for NeuN, neurofilament, glial fibrillary acidic protein(GFAP), microtubule associated protein2(MAP2) was performed. RT-PCR was performed for detecting nestin mRNA and MAP2 mRNA. RESULTS: We showed in this experiment that neuro-glial markers(NeuN, neurofilament, MAP2, GFAP) were expressed and axon-like cytoplasmic processes are elaborated in the cultured human cord blood stem cells prepared from new born placenta after full term delivery. Nestin mRNA was also detected in fresh cord blood monocytes. Conclusions: These results suggest that human cord blood derived stem cells may be potential sources of neurons in early postnatal life.
Bone Marrow ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cytoplasm ; Fetal Blood* ; Humans* ; Microtubules ; Monocytes ; Nestin ; Neural Stem Cells ; Neuroglia ; Neurons ; Placenta ; RNA, Messenger ; Stem Cells ; Tissue Donors ; Umbilical Cord*

BACKGROUND: The level of physical adaptation through active lifestyle can result in changes in appetite; and caused by physical activity and exercise, physical adaptation may change carbohydrate and fat metabolism during exercise. This study investigated the differences in carbohydrate and fat metabolism after moderate treadmill running and the difference in appetite response before and after exercise in active, regularly exercising individuals and those inactive. METHODS: We analyzed the effects of moderate physical activity (70% of oxygen uptake reserve, 30 minutes on the treadmill) on free fatty acids, glucose, growth hormone, insulin and an appetite visual analogue scale (VAS). Our subjects included 28 healthy males who were divided into two groups, the activity group (n=14) and the inactivity group (n=14) according to the International Physical Activity Questionnaire (IPAQ). The serum samples and VAS were collected at pre, post and 30 min post-exercise. RESULTS: The results of the serum analysis showed no significant effects on free fatty acids, glucose, growth hormone and insulin between the groups, but showed significant changes in free fatty acids and growth hormone between points of measurement. Significant increases in VAS were seen with moderate exercise in both groups, with the inactivity group expressing greater hunger than the activity group. CONCLUSIONS: This study found that inactive persons were hungrier than active persons after moderate exercise. This information might be useful to staff and participants of weight loss programs.
Appetite ; Energy Metabolism ; Exercise ; Fatty Acids, Nonesterified ; Glucose ; Growth Hormone ; Humans ; Hunger ; Insulin ; Life Style ; Male ; Motor Activity ; Oxygen ; Running ; Weight Reduction Programs ; Surveys and Questionnaires

BACKGROUND: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. METHODS: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. RESULTS: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. CONCLUSIONS: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.
Anticonvulsants ; Electric Stimulation Therapy ; Follow-Up Studies ; Glomerular Filtration Rate ; Health Resorts ; Humans ; Kidney ; Kidney Diseases ; Neuralgia, Postherpetic ; Pain, Intractable ; Renal Insufficiency, Chronic ; Spinal Cord ; Spinal Cord Stimulation

Nonossifying fibromas are not uncommon, but those described in the rib are unique. We report the case of a 15-year-old patient with symptoms of chest wall pain for 5 days who underwent a video-assisted thoracoscopic rib resection for a 2.5-cm rib mass. Unexpectedly, pathological results revealed a nonossifying fibroma of the rib. The results showed excellent cosmesis and new bone formation because of the preservation of the overlying periosteum.
Adolescent ; Fibroma* ; Humans ; Osteogenesis ; Periosteum* ; Ribs* ; Thoracic Surgery, Video-Assisted* ; Thoracic Wall

In order to evaluate the efficacy of adenosine triphosphate (ATP) in the reduction of left ventricular afterload, we studied the hemodynamic and intrapulmonary shunt effects of intravenous ATP during ethrane-N2O anesthesia. Hemodynamic measurements and arterial and mixed venous blood gas analyses were made in ten patients before (baseline) and 10 min after. ATP infusion at 80,60,120 and 250 mcg/kg/min, respective. The results were as follows: 1) ATP produced a rapid and stable reduction in mean arterial pressure resulting from a marked decrease in systemic vascular resistance. 2) Cardiac index increased significantly by 14, 47 and 72% from baseline value after intravenous infusion of ATP at rates of 60, 120 and 250 mcg/kg/min, respectively. 3) Stroke volume index, heart rate, mean pulmonary arterial pressure, pulmonary capillary wedge pressure and central venous pressure increased significantly, whereas systemic vasular resistance and pulmonary vascular resistance decreased significantly in a dose related fashion during ATP infusion. 4) Intrapulmonary ehunt fraction increased from 5.67% to 6.73, 8.28, 9.85 and 13.38% after intra- venous infusion of ATP at rates of 30, 60, 120 and 250 mcg/kg/min, respectively. 5) Arterial oxygen tension decreased significantly after ATP infusion. These results suggest that ATP might be of value in augmentation of cardiac performance in patients with low cardiac output with high peripheral vascular resistance.
Adenosine Triphosphate* ; Adenosine* ; Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Cardiac Output, Low ; Central Venous Pressure ; Enflurane* ; Heart Rate ; Hemodynamics* ; Humans ; Infusions, Intravenous ; Lung ; Oxygen ; Pulmonary Wedge Pressure ; Stroke Volume ; Vascular Resistance

PURPOSE: The purpose of this study was to suggest agenda priorities for nursing service R&D (Research and Development) related policies development. METHODS: Two steps in developing the agendas and priorities were performed in this descriptive study. First, nursing service R&D agendas were extracted through needs assessment of nursing researchers and practitioners. Then, the priority of agendas was set by Analytic Hierarchy Process by ten experts who were representatives of nursing and other healthcare professionals. RESULTS: Six core areas and forty-six nursing service R&D agendas were developed. The priority of agendas was different according to the evaluation criteria depending on weight value of nursing services. CONCLUSION: In order to select and promote nursing service R&D projects within national healthcare policy, nursing service R&D policy should be proposed with consideration to the importance of the criteria in reflecting characteristics of nursing care. By strengthening R&D capabilities for quality improvement and sensitive awareness of national directions for healthcare R&D policies, nursing service R&D can be appropriately promoted.
Delivery of Health Care ; Needs Assessment ; Nursing ; Nursing Care ; Nursing Research ; Nursing Services* ; Quality Improvement

The Proteus syndrome is a recently described congenital harmatosis consisting of numerous clinical features of great variety. Mainly affected are the musculoskeletal system, primarily by hemihypertrophy, macrodactyly, exostoses and kyphoscoliosis, and the skin and the subcutaneous tissue, primarily by pigmented nevi and subcutaneous tumors. These findings are diagnostic features of Proteus syndrome. We report typical manifestations of Proteus syndrome in a 12-year-old boy with brief review of literature.
Child ; Exostoses ; Humans ; Male ; Musculoskeletal System ; Nevus, Pigmented ; Proteus Syndrome* ; Proteus* ; Skin ; Subcutaneous Tissue

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have faced multiple physical and psychological challenges while carrying out their duties. In this study, we examined the experiences of specific groups of HCWs during the pandemic. Methods: From 18 November to 30 December 2020, we conducted a qualitative study using semi-structured, face-to-face interviews with four groups of 14 HCWs in three cities (Seoul, Daegu, and Gwangju) in South Korea. The HCWs who participated in the focus groups included physicians, nurses, medical practitioners, and cleaning staff who directly or indirectly cared for patients during the COVID-19 epidemic. Interviews were transcribed verbatim and analyzed using the consensual qualitative research approach. Results: Our qualitative data analysis revealed four main domains: work-related struggles, personal life-related struggles, psychological stress, and health-related struggles. Health care providers were challenged by working in critical situations and were overwhelmed by heavy workloads, fear of infection, lifestyle changes, and psychological and physical struggles. Conclusion Our findings could serve as a foundation for establishing health care systems and policies that help HCWs cope with occupational stress, thus increasing their ability to adapt to the ongoing COVID-19 pandemic.