PURPOSE: This study aimed to set priorities for improving the medical device distribution structure and to suggest an innovative improvement plan for the distribution structure using the analytic hierarchy process (AHP) method, focusing on stakeholders in the medical device industry. METHODS: This study conducted a survey with 35 specialists using the AHP method, which is a multiple-criteria decisionmaking methodology, in order to set priorities for improvement plans to address the problems faced by the medical device distribution structure. RESULTS: The AHP analysis showed that supply stability was the most important factor, followed by greater transparency, efficiency, smart supply, and cost reduction. CONCLUSIONS: It is necessary to establish a stable supply system and manage crises through supply stability, as well as to provide opportunities for fair trade through greater transparency. As steps towards those goals, we propose establishing a unique device identification system, an information disclosure system, online distribution, and a group purchasing organization system in Korea.
Disclosure ; Group Purchasing ; Korea ; Methods ; Online Systems ; Specialization

A variety of benzylidenethiazole analogs have been demonstrated to inhibit 5-lipoxygenase (5-LOX). Here we report the anti-atherogenic potential of 5-(4-hydroxy-2,3,5-trimethylbenzylidene) thiazolidin-2,4-dione (HMB-TZD), a benzylidenethiazole analog, and its potential mechanism of action in LDL receptor-deficient (Ldlr-/-) mice. HMB-TZD Treatment reduced leukotriene B4 (LTB4) production significantly in RAW264.7 macrophages and SVEC4-10 endothelial cells. Macrophages or endothelial cells pre-incubated with HMB-TZD for 2 h and then stimulated with lipopolysaccharide or tumor necrosis factor-alpha (TNF-alpha) displayed reduced cytokine production. Also, HMB-TZD reduced cell migration and adhesion in accordance with decreased proinflammatory molecule production in vitro and ex vivo. HMB-TZD treatment of 8-week-old male Ldlr-/- mice resulted in significantly reduced atherosclerotic lesions without a change to plasma lipid profiles. Moreover, aortic expression of pro-atherogenic molecules involved in the recruitment of monocytes to the aortic wall, including TNF-alpha , MCP-1, and VCAM-1, was downregulated. HMB-TZD also reduced macrophage infiltration into atherosclerotic lesions. In conclusion, HMB-TZD ameliorates atherosclerotic lesion formation possibly by reducing the expression of proinflammatory molecules and monocyte/macrophage recruitment to the lesion. These results suggest that HMB-TZD, and benzylidenethiazole analogs in general, may have therapeutic potential as treatments for atherosclerosis.
Animals ; Atherosclerosis/*drug therapy ; Cell Adhesion/drug effects ; Cell Line ; Cell Movement/drug effects ; Chemokine CCL2/metabolism ; Dinoprostone/metabolism ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leukotriene B4/metabolism ; Macrophages/cytology/drug effects ; Male ; Mice ; Monocytes/cytology/*drug effects ; Random Allocation ; Receptors, LDL/deficiency/genetics ; Thiazolidinediones/*therapeutic use ; Tumor Necrosis Factor-alpha/pharmacology

PURPOSE: To report two cases of conjunctival mucosa-associated lymphoid tissue (MALT) lymphomas treated with cryotherapy. CASE SUMMARY: Two patients with MALT lymphoma of the conjunctiva were treated by carbon dioxide cryotherapy under topical anesthesia using 0.5% proparacaine hydrochloride (Alcaine(R), Alcon). Cryotherapy was repeated in recurrent lesions up to three times. One patient was free of the tumor for 18 months of follow-up after the third cryotherapy was performed. The second patient had complete disease arrest for 9 months after the third cryotherapy. Neither patient experienced complications during the follow-up period. CONCLUSIONS: Cryotherapy is a comparatively easy treatment tool with fewer complications for patients, making it preferable from a patient's perspective as well. Cryotherapy may be a useful treatment modality in patients with MALT lymphomas localized to the conjunctiva.
Anesthesia ; Carbon Dioxide ; Conjunctiva ; Cryotherapy ; Follow-Up Studies ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Propoxycaine

PURPOSE: This study was conducted to find out the effects of hospice care by evaluating the spiritual well-being and quality of life in the hospice and nonhospice patients. METHOD: The research design was composed of descriptive study. The data were collected using the questionnaire with interview from 30 hospice patients at three hospice institutes and 30 nonhospice patients at two general hospitals. The tools used for this study were 14-item questionnaire regarding general characteristics, a revised Spiritual Well-being Survey(Paloutzion and Ellision, 1982) and 22-item of revised Mcgill Quality of Life questionnaire. RESULT: The spiritual well-being of the hospice patients was higher than that of nonhospice patients(F=5.52, p=0.023). The global quality of life of the hospice patients was higher than that of nonhospice patients(F=8.84, p=0.004). There was a significant positive correlation between spiritual well-being and quality of life of the hospice patients and non hospice patients. CONCLUSION: The hospice care effects on spiritual well-being and quality of life of the terminal cancer patients.
Academies and Institutes ; Hospice Care ; Hospices* ; Hospitals, General ; Humans ; Quality of Life* ; Research Design ; Surveys and Questionnaires

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.
Data Collection ; Delivery of Health Care ; Education, Nursing ; Humans ; Nursing* ; Reward ; Social Responsibility

PURPOSE: To describe the angiographic findings of patients with recurrent hemoptysis after bronchial artery embolization (BAE) according to the point at which relapse occurred. MATERIALS AND METHODS: From 125 patients who underwent BAE due to hemoptysis between 1996 and 2000, we selected 18 of 23 who underwent additional BAE due to recurrent bleeding after initial BAE . Depending on the point at which relapse occurred, they were divided into two groups (I and II, according to whether additional BAE was performed within two weeks of initial BAE or more than two weeks after this). We retrospectively compared the two groups in terms of angiographic findings, number of embolized arteries, and character of feeding arteries at initial and additional BAE. RESULTS: Nine patients in group I (additional BAE: n=10) and nine in group II (additional BAE: n=13) were admitted for recurrent hemoptysis within two weeks of initial BAE and more than two weeks after this, respectively. In group I(n=29) and II(n=31), angiography demonstrated two direct and 27 indirect, and two direct and 29 indirect signs of hemorrhage, respectively. No statistically significant differences were observed (x2=0.005, p=0.945). Among the embolized feeder ressels in group I (n=30) there were 20 bronchial artery and 10 non bronchial systemic collaterals, while for group II(n=35), the corresponding totals were 21 and 14. Again, no statistically significant differences were encountered(x2=0.308; p=0.579). In group I, feeders were newly developed in one case(10%), previously embolized in five(50%), and missed in four(40%), while in group two the corresponding figures were none, twelve(92.3%), and one(7.7%). No significant differences were noted, though the incidence of previously embolized feeders in Group II was very high (x2=5.383, p=0.068). CONCLUSION: Among patients in whom hemoptysis after BAE recurred at different times, the angiographic findings and number of embolized arteries were not significantly different, but differences in the nature of the feeder were noted. Patients in whom hemoptysis recurred more than two weeks after BAE showed more recanalization of previously embolized feeders than those in whom there was recurrence within two weeks.
Angiography ; Arteries ; Bronchial Arteries ; Hemoptysis* ; Hemorrhage* ; Humans ; Incidence ; Recurrence ; Retrospective Studies

BACKGROUND: An alternative approach to oral PUVA therapy for psoriasis, psoralen bath plus UVA therapy(bath PUVA therapy) that avoids the adverse effects associated with oral PUVA therapy has increasingly been used during recent years. OBJECTIVE: This study was performed to evaluate the efficacy and safety of bath-8-MOP-UVA therapy in the treatment of psoriasis. METHODS: Twenty patients were enrolled in this study after determination of the minimal phototoxic doses(MPD). We evaluated the total treatment number, duration, final UVA dose and total cumulative UVA dose of bath-8-MOP-UVA therapy to reach grade 4 response and categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy. We measured the PASI score at two week intervals. Blood samples were obtained from all twenty patients 2 hours after bath-8-MOP and plasma levels of 8-MOP were quantified by a reverse phase high performance liquid chromatography. RESULTS: The following results were obtained from this study. 1. Phototoxicity testing with bath-8-MOP-UVA elicited mean MPD value of 3.5+/-1.3J/cm2. 2. The mean PASI score at 10 weeks was significantly decreased to 5.8+/-1.3 from baseline PASI score 20.1+/-4.3. 3. Among 20 patients, clearing was shown in 13 patients(65%), 6 patients(30%) were improved and 1 patients(5%) showed failure. 4. In clearing and improvement groups, the mean treatment number, duration, final dose of UVA and total cumulative UVA dose reaching grade 4 were 19.3+/-5.4, 49.9+/-13.5days, 5.2+/-1.3J/cm2 and 68.6+/-30.1J/cm2, respectively. 5. Five patients experienced side-effects. Two patients had intense tan, one withdrawing because of it and the other continued treatment. Three had pruritus that was controlled on oral antihistamines. Phototoxic or other classic adverse effects of oral PUVA therapy, such as nausea, vomiting and headaches, were not observed in any of our 20 patients. 6. All twenty patients had an undetectable plasma 8-MOP level. The lower limit of detection level was 20ng/ml. CONCLUSION: Bath-8-MOP-UVA therapy for psoriasis is a very effective and safe alternative to oral PUVA therapy.
Baths ; Chromatography, Liquid ; Dermatitis, Phototoxic ; Ficusin ; Headache ; Histamine Antagonists ; Humans ; Limit of Detection ; Methoxsalen ; Nausea ; Plasma ; Pruritus ; Psoriasis* ; PUVA Therapy ; Triacetoneamine-N-Oxyl ; Vomiting

PURPOSE: The purpose of this study was to evaluate the HRCT findings of bronchial asthma during maintenance bronchodilator therapy and to determine whether there were irreversible bronchial changes occurred in pediatric patients with this condition. MATERIALS AND METHODS: HRCT findings of the lung in 21 asthmatic children [14 boys and 7 girls aged between 3.5 and 13.8 (mean : 7.7) years] who were receiving maintenance bronchodilator therapy were retrospectively studied. At the time of CT examination, 16 were receiving nonsteroid bronchodilator therapy only, and five were receiving both bronchodilator and steroid therapy. Thirteen patients were defined as allergic and eight were nonallergic. The clinical severity of chronic asthma was graded as severe in seven cases, and moderate in 14. The duration of the disease ranged from 4 months to 6 years (mean 3.2 years). HRCT was performed in 19 cases for evalvation of the atelectasis, hyperinflation, and prominent bronchovascular bundles seen on plain radiographs, and in two cases for evaluation following acute exacerbation. A CT W-2000 scanner (Hitachi Medical Co. Tokyo, Japan) was used during the end inspiratory phase, and in addition, ten patients were scanned during the expiratory phase. Scans were reviewed for evidence of bronchial thickening, bronchiectasis, emphysema, abnormal density, mucus plugs, and other morphological abnormalities. The presence of bronchial wall thickening or air trapping was evaluated according to the duration, severity and type of asthma. RESULTS: Among the 21 patients, 7(33.3%) had normal HRCT findings, while in 14 (66.7%), bronchial wall thickening was demonstrated. Eleven of the 14 patients with bronchial wall thickening (78.6%) also had air trapping. No patient was suffering from bronchiectasis or emphysema. There were no statistically significant correlations between the presence of bronchial wall thickening or air trapping and the duration of the disease, its severity, or type of asthma. There was, however, a statistically significant correlation between bronchial wall thickening and air trapping (p < . 0 5 ). CONCLUSION: In asthmatic children who were under maintenance therapy, the most frequent HRCT findings were bronchial wall thickening and air trapping, with significant correlation between the presence of these two phenomena. No destructive lesion such as bronchiectasis or emphysema was found in these asthmatic children, however, and this is probably due to the short duration of the disease, and different disease processes.
Asthma ; Bronchiectasis ; Child* ; Emphysema ; Female ; Humans ; Lung ; Mucus ; Pulmonary Atelectasis ; Retrospective Studies

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure

Socialization is the process of moving from one social role to another by gaining knowledge, skills and behaviors to participate in a group. Nurses who graduate from nursing school, enter the work force, and develop a career undergo socialization as they become insiders in the hospital. This study was designed to identify experiences of the nurses' socialization process in the hospital setting. The subjects were 6 nurses. Data were collected by recording and transcribing interviews and analyzed in the framework of grounded theory as mapped out by Strauss and Corbin(1990). The core category in the analysis of the experiences of nurses' socialization process was "being beyond". In the process of data analysis, 22 categories were identified. These categories were again grouped into 13. Based upon these results, it is recommended that development of resocialization models to establish nursing identity are necessary.
Nursing ; Schools, Nursing ; Socialization* ; Statistics as Topic