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Mucosa-associated lymphoid tissue lymphoma on right lower eyelid previously diagnosed as lymphoid hyperplasia

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.66-70
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.

Experience of Patients' Having Hypertension and Diabetes Participation in Health Care (고혈압 및 당뇨병 환자의 건강관련 의사결정 참여경험)

  • Lee, Jihae
    • The Journal of the Korea Contents Association
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    • v.21 no.3
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    • pp.552-560
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    • 2021
  • This study attempted to explore the experience of patients' having hypertension and diabetes participation in health care. 11 chronic patients who regularly visited community health centers for more than a year participated in this study. The data was collected through individual interviews and analyzed by thematic analysis method. As a result, 6 sub-themes and 3 themes derived from the data. The themes were 'Trying to utilize short consultation time efficiently', 'Answering within narrow limits to healthcare provider', 'Being lack of continuous motivation for health care'. The result showed the need for nurses to provide accurate and sufficient health information and motivate patients in supportive manner to encourage chronic patients' participation in health care.

Development of a Korean chatbot system that enables emotional communication with users in real time (사용자와 실시간으로 감성적 소통이 가능한 한국어 챗봇 시스템 개발)

  • Baek, Sungdae;Lee, Minho
    • Journal of Sensor Science and Technology
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    • v.30 no.6
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    • pp.429-435
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    • 2021
  • In this study, the creation of emotional dialogue was investigated within the process of developing a robot's natural language understanding and emotional dialogue processing. Unlike an English-based dataset, which is the mainstay of natural language processing, the Korean-based dataset has several shortcomings. Therefore, in a situation where the Korean language base is insufficient, the Korean dataset should be dealt with in detail, and in particular, the unique characteristics of the language should be considered. Hence, the first step is to base this study on a specific Korean dataset consisting of conversations on emotional topics. Subsequently, a model was built that learns to extract the continuous dialogue features from a pre-trained language model to generate sentences while maintaining the context of the dialogue. To validate the model, a chatbot system was implemented and meaningful results were obtained by collecting the external subjects and conducting experiments. As a result, the proposed model was influenced by the dataset in which the conversation topic was consultation, to facilitate free and emotional communication with users as if they were consulting with a chatbot. The results were analyzed to identify and explain the advantages and disadvantages of the current model. Finally, as a necessary element to reach the aforementioned ultimate research goal, a discussion is presented on the areas for future studies.

Positive Factors for Return to Work After Accidents: Health Awareness, Consultation with Doctors, and Personal Characteristics of Workers

  • Kang, Dongsuk
    • Safety and Health at Work
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    • v.13 no.1
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    • pp.32-39
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    • 2022
  • Background: Industrial accidents can determine the overall level and quality of the work environment in industries and companies that contribute to national economic development. Korea has transformed the country from an international aid recipient to a donor country, but it has ranked first among the Organisation for Economic Co-operation and Development member countries in the number of fatal industrial accidents. Little has been known about the policy effects in terms of the workers' insurance for their industrial accidents and rehabilitation. This study raises two research questions about the influence of workers' personal characteristics and vocational rehabilitation services on their return to workplaces. Methods: The study implements weighted logistic regression analysis using propensity score matching. This research utilizes the relevant dataset (3,924 persons) of Korea's industrial accident and insurance. Results: The findings show that the level of workers' awareness of health recovery and their counseling for rehabilitation by physicians had positive effects on their return to work. Environmental factors such as workers' job stability at the time of industrial accidents and the temporal effects of industrial accidents (e.g., the level of disability, their age) had negative impacts on their return to work. Conclusions: These findings have policy implications that the concentration of rehabilitation services for patients who have been mildly affected by industrial accidents would be effective in the short and medium term. The findings also highlight the necessity of ongoing policies about workers' vocational recovery with concrete evidence about policy impacts.

Radiographic changes of mandibular cortical bone in bisphosphonate drug holiday

  • Lee, Dae-Hoon;Seo, Ja-In;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.4
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    • pp.219-224
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    • 2022
  • Objectives: There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods: This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T0), 12 months after (T1), and 18 months after (T2) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton's method. Paired t-tests were used to analyze differences over time. Results: The difference in indices (mental index and panoramic mandibular index) between T0 and T1 was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T1 and T2 was statistically significant (paired t-test, P<0.05). Conclusion: The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.

The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department (Six Sigma 활동을 통한 중증외상환자의 응급실 체류시간 개선 활동)

  • Kim, Hyun-Soo;Kim, Ok-Jun;Choi, Sung-Wook;Kim, Eui-Chung;Park, Young-Tae;Ko, Tae-I;Cho, Yun-Kyung
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.119-127
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    • 2010
  • Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

Development and Analysis of Community Based Independent Home Care Nursing Service (지역사회중심의 독립형 가정간호 시범사업소 운영체계 개발 및 운영결과 분석)

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1455-1466
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    • 2000
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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A Study on the Rate of Breast-feeding Practice by Education and Continuous Telephone Follow-up (모유수유 교육과 분만 후 지속적인 전화상담에 따른 모유수유 실천률 조사)

  • Yoo, Eun-Kwang;Kim, Myoung-Hee;Seo, Won-Shim
    • Women's Health Nursing
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    • v.8 no.3
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    • pp.424-434
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    • 2002
  • Background & purpose Since the 1970's the rate of breast-feeding has decreased significantly. The Korean National Institute of Health reported that the rate of breastfeeding was 68.9% in 1982 and 14.1% in 1997. There are many influencing factors including: the lack of education and information on breast feeding, lack of faith in breast feeding, increment of the rate of working, lack of encouragement by supporters in difficult situations, and nurses' low level of knowledge about breast feeding. Such a lack of knowledge and support of breast-feeding at home by family members create another dilemma to the problem of breast-feeding. If problems arise and family members are unable to provide assistance due to the deficiency of knowledge, mothers show a tendency to abandon breast-feeding. The purpose of this research is to find out the rate of breast-feeding practice by time sequence of 1 week, 6 weeks and 12 weeks after birth and influencing factors on breast-feeding practice centered on the postpartal women who were 3discharged from one hospital, which is located in Seoul and provides simple breast-feeding education and continuous postnatal telephone consultation. Methodology The subjects of this research were 54 women who gave birth in a hospital located in Seoul from 1 March 2000 to 31 April 2000. After birth the subjects were educated individually about breast-feeding and telephone consultations were conducted. On the 1st week, 6th week, and 12th week, the subjects were surveyed about their breast-feeding practice rates and methods by telephone. Results 1) Complete breast-feeding rate: Within one week after birth, the subjects showed 64.2% complete breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks, 34.1%. 2) Partial breast-feeding rate: Within one week after birth, the subjects showed 32.1% partial breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks 15.1%. 3) Complete bottle-feeding rate Within one week after birth, the subjects showed 1.9% complete bottle-feeding rate. Within 6 weeks of giving birth 15.1%, and 12 weeks 17.0%. These results show that individual education about breast-feeding and continuous postnatal telephone consultation influenced on the practice of breast-feeding. On considering the reality of the hospital situation in which nurses could not operate education program due to the work-load, it is necessary to find out selectively those mothers who are unable to breast feed and provide education individually and continuous support by telephone follow up. Futhermore, the active role of lactation nurse specialist and their efficient management of breast-feeding for the successful practice is required.

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Review of Allowable Condition of the Discretionary not Covered Service (임의비급여 허용요건에 관한 검토)

  • Park, Tae-Shin
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.11-38
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    • 2012
  • The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

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Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model

  • Kim, Pil Soo;Choi, Chang Hwa;Han, In Ho;Lee, Jung Hwan;Choi, Hyuk Jin;Lee, Jae Il
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.398-404
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    • 2019
  • Objective : Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. Methods : Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-of-flight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. Results : The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). Conclusion : The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.