• Title/Summary/Keyword: Advanced general hospital

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A Clinical Study on Recent Causing Agents of Chemical Burns (화학 화상의 최근 원인 물질에 관한 임상적 연구)

  • Shin, Chi Ho;Yu, Sung Hoon;Kim, Ji Hoon;Kim, Dong Chul
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.7-12
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    • 2020
  • Purpose: Due to rapid changes in the industrial structure in last decade, the wider various types of chemical agents were introduced. Burn surgeons should be well-informed with rapid changes of chemical burns. We present the recent incidence trends of causing agents of chemical burns. Methods: From 2010 to 2019, 92 chemical burn victims were included in this study. A retrospective study was made about the type, distribution and incidence of the causing agents of chemical burns. Initial treatments of most chemical burn wounds are copious saline irrigation by tap water, except hydrofluoric acid burn cases managed by 10% calcium gluconate injection. In alkali chemical burns on extremity, if thin eschars appear in postburn 2~3 days, acute early surgical escharectomy and split thickness skin graft were done. Results: More than 9 types of major chemicals causing chemical burns were surveyed, and the most common causing agent of chemical burns was Hydrofluoric acid (23.9%) followed by Acetic acid (19.6%) and Sodium hydroxide (8.7%). Conclusion: From 2010 to 2019, changes in the causing agent of chemical burns are that the types of major causing agents of chemical burns have increased and the distribution and incidence of causing agents have changed compared to previous reports. According to this study, more than 9 types of major chemicals causing chemical burns were surveyed, and the most common causing agent of chemical burns was Hydrofluoric acid (23.9%) followed by Acetic acid, Sodium hydroxide.

A Study on the Architectural Planning of the Rehabilitation Department in General Hospital (종합병원 재활의학부의 건축계획에 관한 연구)

  • Yoon, Soo-Jin;Chai, Choul-Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.13 no.4
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    • pp.47-54
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    • 2007
  • As we make every effort to improve our health, the needs and interests of the rehabilitation medicine is increasing. And as society gets more advanced and as the quality of life become higher, rehabilitation department will be important for general hospital and we need the certain guidelines about it. In this study, selected 8 general hospitals in the metropolitan area are analyzed by the analysis of drawings and comparison. The important architectural planning of rehabilitation department are the connection with orthopedics and neurosurgery and the position for convenience approach. Rehabilitation department has 0.63~1.07% of general hospital area. And the rehabilitation department is divided into four branches - medical service space, office space, public space and support space. As the number of programs in the rehabilitation department is increasing, the planning will be considered for the flexible use. And this study proposed the programs, necessary spaces, space composition and basic planning of "rehabilitation department".

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Endoscopic removal of common bile duct stones in nonagenarians: a tertiary center experience

  • Mustafa Jalal;Amaan Khan;Sijjad Ijaz;Mohammed Gariballa;Yasser El-Sherif;Amer Al-Joudeh
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.92-99
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    • 2023
  • Background/Aims: There are few studies assessed the efficacy and mortality of endoscopic retrograde cholangiopancreatography (ERCP) for the removal of common bile duct (CBD) stones in the elderly aged ≥90 years. We aimed to assess the safety and efficacy of endoscopic removal of CBD stones in nonagenarians. Methods: We retrospectively reviewed ERCP reports for CBD stone removal. The endoscopic and therapeutic outcomes were collected. The length of stay (LOS), the total number of adverse events, and mortality rate were compared between groups. Results: A total of 125 nonagenarians were compared with 1,370 controls (65-89 years old individuals). The mean LOS for nonagenarians was significantly higher than in controls (13.6 days vs. 6.5 days). Completed intended treatment was similar in the nonagenarians and controls (89.8% and 89.5%, respectively). The overall complication rate did not differ between the groups. However, nonagenarians had a higher incidence of post-ERCP pneumonia (3.9%). None of the nonagenarians were readmitted to the hospital within 7 days. Four nonagenarians (3.2%) and 25 (1.8%) controls died within 30 days. Conclusions: Advanced age alone did not affect the decision to perform the procedure. However, prompt diagnosis and treatment of post-ERCP pneumonia in nonagenarians could improve the outcomes and reduce mortality.

A Study on Positioning of Nursing Service Image in General Hospital;Centering around 5 General Hospitals in Seoul (종합병원의 간호 서비스 이미지 포지셔닝 연구;서울시내 5개 병원을 중심으로)

  • Lim, Ji-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.369-388
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    • 1999
  • This study is a descriptive research to establish a positioning strategy of nursing service image, making a perception map on each hospital's nursing service image and ranking construct factors of nursing service image. The results in this study were as follows; 1. The rank of construct factors of nursing service image which were thought important by subjects was the first 'Kindness', the second 'Reliability', the third 'Professional Knowledge', the fourth 'Responsibility', and the fifth 'Advanced Nursing Skill'. 2. The perception map for nursing service image on each hospital showed a hierarchial structure and positioned the first B hospital, the second C hospital, the third D hospital, the fourth A hospital, and the fifth E hospital. The perception map for construct factors of nursing service image and hospitals showed the first dimension : 'Reliability', the second dimension : Kindness', the third dimension : 'Mission', 'Accuracy', 'Neat Appearance', and 'Ethical Aspect', and the fourth dimension : 'Client Advocate', 'Humanistic Consideration', 'Professional Knowledge', 'Responsibility', and 'Advanced Nursing Skill'. 3. The findings of subject's characteristics which affected degree of likeness on each hospital nursing service image to make a marketing strategy were as follows : In A hospital D hospital, and E hospital, the subject group whose hospital dates were under 1 week, education level was upper graduate university, and age was between 40's and 50's, were appeared to have low nursing service image on following construct factors : 'Kindness', 'Reliability', 'Responsibility', 'Mission', 'Neat Appearance', and 'Humanistic Consideration'. In B hospital and C hospital the subject group whose hospital dates were under 1 week or over 5 weeks, sex was woman, and age was 20' s or 40's, having a admission experience on subject hospitals, were appeared to have low nursing service image on following construct factors : 'Professional Knowledge', 'Advanced Nursing Skill', 'Ethical Aspect', and 'Humanistic Consideration'. As the based on above results, nursing managers can use positioning method to develope a marketing strategy for nursing service image.

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The Risk of Bleeding in Liver Transplant Patients and Dental Considerations (간이식 환자의 출혈 경향과 치과적 고려 사항)

  • Park, Wonse;Baik, Yoon-Jae;Doh, Re-Mee;Kim, Kee-Deog;Jung, Bock-Young;Pang, Nan-Sim;Yun, Hee-Jung;You, Tae-Min
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.3
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    • pp.157-163
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    • 2012
  • Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

  • Kyungjin Lee;Seo-Yul Kim;Kyeong-Mee Park;Sujin Yang;Kee-Deog Kim;Wonse Park
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.9-17
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    • 2023
  • Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

Taiwan Neurosurgical Spine Society: The New Shining Star

  • Kuo, Yi-Hsuan;Wu, Jau-Ching;Huang, Wen-Cheng;Huang, Ming-Chao;Lee, E-Jian;Cheng, Henrich
    • Neurospine
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    • v.15 no.4
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    • pp.285-295
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    • 2018
  • As spine surgery flourished in Taiwan and neurosurgeons became more involved in spine surgery towards the end of the 20th century, the Taiwan Neurosurgical Spine Society (TNSS), earlier named the Taiwan Neurospinal Society, was established on March 11, 2001. As its main founder, Dr. Chun-I Huang was elected as the first president of the TNSS. The goals of the TNSS were to promote research, to hold academic seminars, to participate in international conferences, and to exchange clinical experiences. The mission of the TNSS was successful, and the profession of spine surgery in Taiwan advanced during the first decade of the 21st century, culminating in the TNSS joining ASIA SPINE in 2010. Since its establishment, the TNSS has always been supportive of collaboration and communication with the Korean Spinal Neurosurgery Society and the Neurospinal Society of Japan. Through periodical meetings, supported by the TNSS, surgeons worldwide have enjoyed a platform of sharing and mutual learning. To further promote academic research, the TNSS has officially supported the journal Neurospine since 2018. With extensive efforts from local and international surgeons, the TNSS will continue to adhere to its mission and to advance the profession of spine surgery.

Prenatal diagnosis of interchromosomal insertion of Y chromosome heterochromatin in a family

  • Lee, Bom-Yi;Park, Ju-Yeon;Lee, Yeon-Woo;Oh, Ah-Rum;Lee, Shin-Young;Park, So-Yeon;Ryu, Hyun-Mee;Lee, Si-Won
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.62-66
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    • 2017
  • Interchromosomal insertion of Y chromosome heterochromatin in an autosome was identified in a fetus and a family. A fetal karyotype was analyzed as 46,XX,dup(7)(?q22q21.1) in a referred amniocentesis at 16 weeks of gestation for advanced maternal age. In the familial karyotype analyses for identification of der(7), the mother, the first daughter and the maternal grandmother showed the same der(7) as the fetus's. CBG-banding was positive at 7q22 region of der(7) that indicated inserted material was originated from heterochromatin. The origin of heterochromatic insertion region in der(7) of the fetus and the mother was found in Yq12 region by fluorescent in situ hybridization with a DYZ1 probe. In the specific analysis of Y chromosomal heterochromatic region of ins(7;Y) of the mother, 15 sequence tagged sites from Yp11.3 region including SRY to Yq11.223 region was not detected. Final karyotypes of the mother, the first daughter and the maternal grandmother were reported as 46,XX,der(7)ins(7;Y)(q21.3;q12q12). All female carriers of ins(7;Y) in the family showed normal phenotype and the mother and the maternal grandmother were fertile. A healthy girl was born at term. We report a rare case of familial interchromosomal insertion of Y chromosome heterochromatin detected only in female family members with normal phenotype that was diagnosed prenatally.

Platelet-Derived Growth Factor Receptor-α Subunit Targeting Suppresses Metastasis in Advanced Thyroid Cancer In Vitro and In Vivo

  • Lin, Ching-Ling;Tsai, Ming-Lin;Chen, Yu-hsin;Liu, Wei-Ni;Lin, Chun-Yu;Hsu, Kai-Wen;Huang, Chien-Yu;Chang, Yu-Jia;Wei, Po-Li;Chen, Shu-Huey;Huang, Li-Chi;Lee, Chia-Hwa
    • Biomolecules & Therapeutics
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    • v.29 no.5
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    • pp.551-561
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    • 2021
  • Thyroid cancer is the most common endocrine malignancy. Patients with well-differentiated thyroid cancers, such as papillary and follicular cancers, have a favorable prognosis. However, poorly differentiated thyroid cancers, such as medullary, squamous and anaplastic advanced thyroid cancers, are very aggressive and insensitive to radioiodine treatment. Thus, novel therapies that attenuate metastasis are urgently needed. We found that both PDGFC and PDGFRA are predominantly expressed in thyroid cancers and that the survival rate is significantly lower in patients with high PDGFRA expression. This finding indicates the important role of PDGF/PDGFR signaling in thyroid cancer development. Next, we established a SW579 squamous thyroid cancer cell line with 95.6% PDGFRA gene insertion and deletions (indels) through CRISPR/Cas9. Protein and invasion analysis showed a dramatic loss in EMT marker expression and metastatic ability. Furthermore, xenograft tumors derived from PDGFRA geneedited SW579 cells exhibited a minor decrease in tumor growth. However, distant lung metastasis was completely abolished upon PDGFRA gene editing, implying that PDGFRA could be an effective target to inhibit distant metastasis in advanced thyroid cancers. To translate this finding to the clinic, we used the most relevant multikinase inhibitor, imatinib, to inhibit PDGFRA signaling. The results showed that imatinib significantly suppressed cell growth, induced cell cycle arrest and cell death in SW579 cells. Our developed noninvasive apoptosis detection sensor (NIADS) indicated that imatinib induced cell apoptosis through caspase-3 activation. In conclusion, we believe that developing a specific and selective targeted therapy for PDGFRA would effectively suppress PDGFRA-mediated cancer aggressiveness in advanced thyroid cancers.

Use of radiotherapy in patients with palliative double bypass for locally advanced pancreatic adenocarcinoma

  • Glinka, Juan;Diaz, Federico;Alva, Augusto;Mazza, Oscar;Claria, Rodrigo Sanchez;Ardiles, Victoria;Santibanes, Eduardo de;Pekolj, Juan;Santibanes, Martin de
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.210-217
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    • 2018
  • Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.