Liver transplantation (LT) is the only treatment for end stage of liver failure. In Korea, annually it has been performed 1,300 cases. Most of LTs are performed in large volumes centers. More than half of centers performing LT in Korea are low volume hospital and started a LT program recently. We present our four-year experiences and outcomes of anesthesia for LT since 2013.

Anesthetic and surgical outcomes of 49 consecutive patients who received LT (living donor LT, 21 cases; deceased donor LT, 28 cases) between April 2013 and April 2017 were analyzed retrospectively.

All patients were adult, with the mean age of 53.5±9.2 years. The most common cause of original liver diseases was hepatitis B virus-related liver cirrhosis (40.8%). The mean MELD (Model for End-stage Liver Disease) score was 18.8±10.7. Postreperfusion syndrome was observed in 34.7%, which were all controlled by calcium, norepinephrine, ephedrine and epinephrine. The mean postoperative intensive care unit stay of deceased donor LT recipients (13.6±9.0 days) was significantly longer than that of living donor LT recipients (8.0±3.3 days). There was no intraoperative mortality in patients receiving LT. Thirty-day post-transplant survival rate was 93.8% and 3-year survival rate was 88.6 %. The most common postoperative complication was pneumonia.

We have started LT successfully with multidisciplinary team's steady effort. Adaptation and setting up LT protocol, adequate equipment, proper training at established transplant centers are essential to begin a successful LT program.

This study attempts to explore the adapting behaviors of medical professions in information society, focusing on nurses' responses to the changes driven by the implementation of information system in four general hospitals. In addition to the general status of the information in the hospitals, we analyze four dimensions of the adapting behaviors of nursed in the implementation process of the hospital work. These are 1) changes in the jobs and functions of the nurses ; 2) changes in their autonomy and status; 3)changes in human relations ; and 4) the quality of medical services.

Both quantitative and qualitative data were collected from two university-affiliated hospitals and two private general hospitals in Seoul. The quantitative data contain the responses of 92 nurses from four hospitals and we performed an in-depth-interview with 12 nurse to complement the quantitative data.

1) The implementation of information system in the sample hospitals are limited to the computerization of the administrative part of the medical care.

2) This limited computerization of the hospital works does not seem to increase the efficiency of nursing itself, but rather put mote burden on nurses doing double jobs of handwriting and computerization.

3) The autonomy of nurses and their relate status has not been noticeably changed in the process. Nurses, however, reported to have conflicts with other professions over the job distributions.

4) The computerization of the hospital works tend to reduce an unnecessary face-to-face interaction, which is expected to facilitate communications in the hospital. But there are still conflicts among medical professions over the boundary of their duties and responsibilities.

5) Nurse pointed out that the positive effects of the computerization on the quality of service are limited to shorten the time of care.

The results of this study confirms our hypothesis that the information system would change jobs and functions, autonomy and status, human relations, and quality of sevices in nursing. Some of the changes are positive although the implementation of information system is expected to put more burden on nursing for a while. Most nurses, however, expected the computerization will provide better services to the patients in the long run.

The objective of this study was to evaluate the use and the effect of an automated external defibrillator(AEDs) by emergency medical technicians(EMTs) in prehospital cardiac arrest.

After application of exclusion criteria, 293 patients who transported to emergency center of our hospital after cardiac arrest in consecutive 36 months from Jan, 1, 2003 to Dec, 31, 2005 were included in this study. We reviewed the 119 rescue service records and the hospital chart of the patients including, demographic data, types of eletrocardiogram(ECG) rhythms, witness of arrest, cause of arrest, basic life support(BLS), use of AED, transport time, time intervals from cardiac arrest to the advanced cardiac life support(ACLS), and return of spontaneous circulation(ROSC).

The mean age was 56.1±21.8 years with 185 males and 108 females. Time intervals from cardiac arrest to ACLS were 27.2±18.1 minutes and 259 patients(88.4%) were transported by EMTs. AEDs were used by EMTs in 119 patients(45.9%) and 20 patients(8.6%) were defibrillated. After ACLS, 17 patients experienced ROSC and 2 patients survived until discharge. There were no statistical differences in the ROSC rate between the patients transported by EMTs and those by non-EMTs(p=0.067), between the group of AED used and of no-AED used(p=0.116).

The use of AEDs by EMTs was still low and the effect of AEDs and BLS by EMTs were not significant in ROSC.

The purpose of this study is investigating variables affecting the numbers of clinical laboratory tests.

Data about the number of clinical laboratory tests, hospital characteristics, and the number of patients between January 1999 and December 1999 was collected. Data resources were Statistical Yearbook, Standardization Audit by Korean Hospital Association and Internal Data Set of each hospital. Hospital characteristics were hospital ownership, tertiary care hospital, duration since opening, licensed hospital beds, the rates of medical inpatient and outpatient. Multiple regression analysis was applied to find factors affecting the number of clinical laboratory tests. Models for WBC, RBC, Hb, Hct, PLT, LDC, PT, PTT, AST, ALT, and GLU were statistically adequate.

As the results, hospital ownership, duration since opening, licensed hospital beds, the rate of medical outpatient were statistically significant. Private hospitals showed higher numbers than public hospitals, hospitals within 5 years since opening showed higher numbers than others. The licensed hospital beds was positively correlated with the numbers of the tests, whereas the rates of medical outpatient was negatively correlated.

In conclusion, hospital characteristics affect the numbers of clinical laboratory tests. It could be a clue why the costs of medical services were different among medical facilities.

Helicobacter(H.) pylori is a major etiological factor in chronic gastritis, peptic ulcer and gastric adenocarcinoma. The mode and route of transmission of H. pylori are still uncertain, but there is a strong evidence for person-to-person transmission via the oro-oral or gastro-oral route or via the fecal-oral route. Persons involved in patient care are likely to be at higher risk of H. pylori infection than the general population if H. pylori is transmitted from person-to-person. However, detailed studies about the occupational risk in hospital workers are scarce, especially in Korea which is a high prevalent area of H. pylori infection. The purpose of this study was to determine whether different groups of hospital workers are at increased risk of acquiring H. pylori.

The staff members were assigned to four groups : 1) medical staff(n=39), 2) nursing staff(n=267), 3) medical technicians and pharmacists(n=48), 4) nonmedical staff(n=163). Serum antibodies for H. pylori were measured by ELISA GAP IgG Helicobacter pylori kit(Bio-Rad Lab, USA)(cut-off value ; 15 U/mL).

The overall seropositivity was 70.4%(364/517). The seroprevalence of H. pylori was 64% in group I, 69.7% in group II, 66.7% in group III, and 74.2% in group IV(not significant). Seroprevalence increased by a little with age, but it was not statistically significant. There was no difference of seroprevalence between men(75%) and women(68.6%).

It was thought that the prevalence of H. pylori infection in Korean hospital workers is high and since there was no difference of seropositivity between medical and non-medical staffs, occupational exposure to patients does not increase the rate of infection with H. pylori.