Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
Journal of Chest Surgery
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v.39
no.8
s.265
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pp.633-636
/
2006
The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.
Objectives The aim of this study is to analyze the patients who have low back pain through registry. Methods We registered patients with low back pain who visited department of korean rehabilitation medicine in university hospitals on study. We collected data from 116 subjects consisted of 51 inpatients and 65 outpatients and ruled out 8 who didn't have pattern identification data at the point of inpatient or outpatient visit so we analyzed 108 in total. We used Pearson's product moment correlation to find correlationship among variables, and analyzed statistical data using Phyton scipy library stats package. Results We set general features, region of the pain, physical examination, ROM, questionnaire results, pattern identification as variables and draw a conclusion by analyzing these variables. Conclusions Registry aimed at low back pain patients was established in department of korean rehabilitation medicine of university hospitals and exploratory analysis based on data were made. Through the registry, we expect that more advanced studies will be performed; for example, executing research which verifies effectiveness and stability of korean medical treatment or developing tools to fill the gap between pattern identification and disease identification.
Journal of Korean Academy of Nursing Administration
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v.5
no.1
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pp.113-136
/
1999
There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.
Park, Hye-Jung;Shin, Kyeong-Cheol;Moon, Young-Chul;Chung, Jin-Hong;Lee, Kwan-Ho;Sung, Cha-Kyung;Lee, Hyun-Woo
Journal of Yeungnam Medical Science
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v.16
no.2
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pp.208-218
/
1999
Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.
Introduction: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokines including parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occur in patients with or without bone metastases. The present study aimed to describe the effect of chemotherapy treatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia. Methods: We carried a review of medical records of breast and lung cancer patients hospitalized in years 2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia. Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis or during cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapy types and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levels at first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latest chemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data, logistic regression test for categorical variables, and Spearman correlation test, linear regression and the paired sample t tests for continuous data. Results: Of a total 1,023 of breast cancer and 814 lung cancer patients identified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lung cancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia (10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl). Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia; in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, and gemcitabine+cisplatin in lung cancer. Conclusion: Chemotherapy decreases calcium levels in breast and lung cancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.
Gastric cancer continues to be a leading cause of cancer death. The majority of patients with gastric adenocarcinoma in China present with advanced disease. Ruling out unresectable cancers from an unnecessary "open" exploration is very important. The aim of this study was to assess the value of five-port anatomical laparoscopic exploration in T4 gastric cancer in comparison with three-port laparoscopic exploration and laparotomy exploration. We conducted a retrospective study on 126 patients with T4 stage scheduled for D2 curative gastrectomy based on computed tomography (CT) staging at Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, from Apr. 2011 to Apr. 2013. Laparotomy exploration (Group I), three-port laparoscopic exploration (Group II) or five-port anatomical laparoscopic exploration (Group III) were performed prior to radical gastrectomy. Accuracy rate for feasibility of D2 curative gastrectomy in laparotomy exploration and five-port anatomical laparoscopic exploration groups was higher than that in the three-port laparoscopic exploration group. Five-port anatomical laparoscopic exploration group had the highest accuracy resection rate (Group I vs Group II vs Group III,92.6% vs78.6% vs 97.7%; p<0.05) and shorter length of hospitalization (Group I vs Group II vs Group III, $9.58{\pm}4.17$ vs $6.13{\pm}2.85$ vs $5.00{\pm}1.81$; p<0.001). Three-port laparoscopic exploration has low accuracy rate for assessing feasibility of D2 curative gastrectomy and five-port anatomical laparoscopic exploration should be performed on patients with T4 gastric cancer.
Ayyildiz, Simel;Soylu, Elif Hilal;ide, Semra;Kilic, Selim;Sipahi, Cumhur;Piskin, Bulent;Gokce, Hasan Suat
The Journal of Advanced Prosthodontics
/
v.5
no.4
/
pp.471-478
/
2013
PURPOSE. The aim of the study was to evaluate the effect of annealing on the nanostructure and hardness of Co-Cr metal ceramic samples that were fabricated with a direct metal laser sintering (DMLS) technique. MATERIALS AND METHODS. Five groups of Co-Cr dental alloy samples were manufactured in a rectangular form measuring $4{\times}2{\times}2$ mm. Samples fabricated by a conventional casting technique (Group I) and prefabricated milling blanks (Group II) were examined as conventional technique groups. The DMLS samples were randomly divided into three groups as not annealed (Group III), annealed in argon atmosphere (Group IV), or annealed in oxygen atmosphere (Group V). The nanostructure was examined with the small-angle X-ray scattering method. The Rockwell hardness test was used to measure the hardness changes in each group, and the means and standard deviations were statistically analyzed by one-way ANOVA for comparison of continuous variables and Tukey's HSD test was used for post hoc analysis. P values of <.05 were accepted as statistically significant. RESULTS. The general nanostructures of the samples were composed of small spherical entities stacked atop one another in dendritic form. All groups also displayed different hardness values depending on the manufacturing technique. The annealing procedure and environment directly affected both the nanostructure and hardness of the Co-Cr alloy. Group III exhibited a non-homogeneous structure and increased hardness ($48.16{\pm}3.02$ HRC) because the annealing process was incomplete and the inner stress was not relieved. Annealing in argon atmosphere of Group IV not only relieved the inner stresses but also decreased the hardness ($27.40{\pm}3.98$ HRC). The results of fitting function presented that Group IV was the most homogeneous product as the minimum bilayer thickness was measured (7.11 ${\AA}$). CONCLUSION. After the manufacturing with DMLS technique, annealing in argon atmosphere is an essential process for Co-Cr metal ceramic substructures. The dentists should be familiar with the materials that are used in clinic for prosthodontics treatments.
In the tele-medical system, the broadband network for multimedia telecommunication and the multimedia terminal equipment for the remote access of the tele-medical information are essential. Especially, the tele-medical terminal equipment should provide the multimedia GUI environment in order to support the similar medical process by the tele-medical system. In this paper, we present a multimedia GUI (Graphic User Interface) for a Multimedia Tele-Medical System (TeleMedi_GUI) based on ATM/B-ISDN. In the tele-medical system, one workstation is used for the multimedia data server that is supporting multiple client terminals that are connected by the ATM network. The client terminals are based on Multimedia Personal Computers, and provide the remote access environment of the tele-medical database. We also developed the remote access protocols among the clients and the server to access multimedia medical information of the multimedia server. With using the TeleMedi_GUI, the doctors can examine and treat patients efficiently, using image data like X-ray/CT and voice data such as the S-ray diagnosis. The result of this paper can be applied to the following areas: 1) the implementation of the advanced medical service system interconnecting the small-scale health center and general hospitals, 2) the development of a fully computerized medical information system within the hospital.
Journal of the Korean Society of Food Science and Nutrition
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v.35
no.3
/
pp.383-387
/
2006
Microbiological hazard analysis of foodservice facilities and utensils of 6 hospitals in the Honam region was evaluated. In the microaerosol evaluation, the microbial counts of dinning table, kitchen, and freezer were comparatively high, and it indicated the microbial contamination of these facilities should be effectively managed. In the microbiological hazard analysis evaluation of cooking utensils and appliances, the total plate counts of cutting boards, knife, and meal plates were comparatively high but did not reveal significance. The counts of coliforms, Staphylococcus aureus and Escherichia coli, were lower than the general limit of microbial contamination, and the microbiological safety of the cooking utensils and appliances were satisfactory. In the microbial safety evaluation of side dishes, microbial counts of heat-cooked foods were generally low and microbiological hazards of these side dishes were comparatively low.
Hong, Ji Yeon;Chae, JungMi;Song, Mi Ra;Kim, Eun Mi
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.8
/
pp.162-170
/
2017
This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.
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