• Title/Summary/Keyword: Hospital unit

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Childhood Cancer Incidence and Survival 1985-2009, Khon Kaen, Thailand

  • Wiangnon, Surapon;Jetsrisuparb, Arunee;Komvilaisak, Patcharee;Suwanrungruang, Krittika
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7989-7993
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    • 2014
  • Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-based incidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period. Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0-15 years, diagnosed as having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012. The childhood cancers were classified into 12 diagnostic groups, according to the International Classification of Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer was investigated using the KKCR population-based registration data and overall survival calculated using the Kaplan Meier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered. The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0-4 years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360, ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79, ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months (95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-year overall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3) lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors, (9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%, (6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood cancer is lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, liver tumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival for CNS tumors, neuroblastoma and germ cell tumors is comparable.

Exophytic Verrucous Hyperplasia of the Oral Cavity - Application of Standardized Criteria for Diagnosis from a Consensus Report

  • Zain, Rosnah Binti;Kallarakkal, Thomas George;Ramanathan, Anand;Kim, Jin;Tilakaratne, WM;Takata, Takashi;Warnakulasuriya, Saman;Hazarey, Vinay Kumar;Rich, Alison;Hussaini, Haizal Mohd;Jalil, Ajura
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4491-4501
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    • 2016
  • Verruco-papillary lesions (VPLs) of the oral cavity described in the literature involve a spectrum of conditions including squamous papilloma, verruca vulgaris, focal epithelial hyperplasia, condyloma, proliferative verrucous leukoplakia and verrucous carcinoma. A majority of the VPLs are slow growing, benign in nature and have a viral aetiology. Virus associated benign mucosal outgrowths are not too difficult to diagnose either clinically or by microscopy. Apart from virus-associated lesions, VPLs harboring malignant potential or behaviour such as verrucous carcinoma, proliferative verrucous leukoplakia, oral verrucous hyperplasia (OVH), oral papillary squamous cell carcinoma (PSCC) and oral conventional squamous cell carcinoma with papillary features (CSCC) need to be further clarified for better understanding of their predictable biologic behavior and appropriate treatment. Current understanding of potentially malignant VPLs is perplexing and is primarily attributed to the use of confusing and unsatisfactory terminology. In particular, the condition referred to as oral verrucous hyperplasia (OVH) poses a major diagnostic challenge. OVH represents a histopathological entity whose clinical features are not well recognised and is usually clinically indistinguishable from a verrucous carcinoma and a PSCC or a CSCC. A consensus report published by an expert working group from South Asia as an outcome of the 'First Asian Regional Meeting on the Terminology and Criteria for Verruco-papillary Lesions of the Oral Cavity' held in Kuala Lumpur, Malaysia, recognised the clinical description of these OVH as a new entity named 'Exophytic Verrucous Hyperplasia'. Previously described clinical features of OVH such as the 'blunt' or 'sharp' variants; and the 'mass' or 'plaque' variants can now collectively fall under this newly described entity. This paper discusses in detail the application of the standardized criteria guidelines of 'Exophytic Verrucous Hyperplasia' as published by the expert group which will enable clinicians and pathologists to uniformly interpret their pool of OVH cases and facilitate a better understanding of OVH malignant potential.

영적간호중재가 호스피스 환자의 영적안녕과 우울에 미치는 효과

  • Song, Mi-Ok
    • Korean Journal of Hospice Care
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    • v.3 no.1
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    • pp.42-55
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    • 2003
  • Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on spiritual well-being and depression level of the hospice patients. Method: The subjects for this study were collected from 62 patients who were admitted in the hospice care unit from July 28, 2002 to October 31, 2002 in D city K hospital. Subjects were 31 members of the experimental group and 31 members of the control group. It was devised with a nonequivalent control group pretest-posttest design. The spiritual nursing intervention was given by using the therapeutic use of self, Scripture, prayer, Hymn and music, use of church community involvement and refer to pastors according to assessment of patients' spiritual need for 3 weeks(total 12 times and 1 hour per each intervention). Sangsoon Choi(1990) and Jungho Kang(1996)'s spiritual well-being scale, which was modified from Palautzian and Ellison(1982)'s spiritual well-being scale, was used to investigate patients' spiritual well-being. To investigate level of depression, OkHyun Song(1977)'s Depression Scale, which was modified from Zung(1965)'s Depression Inventory, was used. Data were analyzed by x2-test, t-test, Repeated measures ANOVA with SPSS/Win 10.0 program. Results: 1.The 1st hypothesis, 'total spiritual well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.28, p=0.015, Interaction: p=0.000). 2.The 1-1st sub-hypothesis, 'religious well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=12.75, p=0.001, Interaction: p=0.000). 3.The 1-2nd sub-hypothesis, 'existential well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.87, p=0.016, Interaction: p=0.000). 4.The 2nd hypothesis, 'depression level in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive the spiritual nursing intervention' was supported(F=10.45, p=0.002, Interaction: p=0.000). Conclusion: From the above results, spiritual nursing intervention was an effective program to improve spiritual well-being state and decrease depression level for the hospice patients. In the future, when the spiritual intervention, which the researcher developed, applied on nursing field, the hospice patients can have comprehensive well being including spiritual well being and peaceful dying life.

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On Feasibility of Ambulatory KDRGs for the Classification of Health Insurance Claims (KDRG를 이용한 건강보험 외래 진료비 분류 타당성)

  • 박하영;박기동;신영수
    • Health Policy and Management
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    • v.13 no.1
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    • pp.98-115
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    • 2003
  • Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4% of KDRGs had a CV of charges from tertiary care hospitals less than 100% and 95.43% of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80% for non-outlier claims from tertiary care hospitals, 51.98% for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

Heart Rate Variability in Patients with Coronary Artery Disease (관상동맥질환 환자의 심박동변이도)

  • Kim Wuon-Shik;Bae Jang-Ho;Choi Hyoung-Min;Lee Sang-Tae
    • Science of Emotion and Sensibility
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    • v.8 no.2
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    • pp.95-101
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    • 2005
  • This study is based on previous information regarding reduced cardiac vagal activity in patients with coronary artery disease(CAD), on reduced variance(SDNN : standard deviation of all normal RR intervals), low-frequency power(LF), and the complexity of heart rate variability(HRV) in patients with chronic heart failure(CHF), and on the normalized high-frequency power of HRV is the highest in the right lateral decubitus position among 3 recumbent postures in patients with CAD, However, nothing is known about the nonlinear dynamics of HRV for the 3 recumbent postures in patients with CAD. To investigate the linear and non-linear characteristics of HRV in patients with CAD, 29 patients as CAD group and 23 patients as control group were studied. Electrocardiogram(ECG) with lead II channel was measured on these patients for 3 recumbent postures in random order. The HRV from ECG was analyzed with linear method(for time and frequency domains) and nonlinear method. The lower the high-frequency power in normalized unit(nHF) in the supine or left lateral decubitous position, the higher the increase in nHF when the position was changed from supine or left lateral decubitous to right lateral decubitous. Among the 3 recumbent postures in patients with severe CAD, the right lateral decubitus position was observed to induce the highest vagal modulation, the lowest sympathetic modulation, and the highest complexity of human physiology system.

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A Study on the Appropriate Reconstruction of the CBCT Images of Mandibular Canals (CBCT 영상에서 구치부의 하악관 형태에 따른 재구성 방법 연구)

  • Jeong, Cheon-Soo;Mo, Eun-Hee;Lee, Gee-Heun;Han, Beom-Hee;Kim, Seung-Chul;Kim, Jung-Sam;Lim, Cheong-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.369-375
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    • 2011
  • In dental radiography, panoramic views cause distortion and thus may bring about inaccurate results in the process of quantitative analysis. In this connection, there has recently been an increasing use of cone beam computed tomography (CBCT) that is known to provide high-resolution images and positional information. In this study, a dental computed tomography unit, 'DCT-90-P IMPLAGRAPHY (Vatech, Korea)', was applied to 20 patients for 24 seconds respectively, with a tube voltage of 85kVp and a tube current of 7mA. The data of CBCT were three-dimensionally reconstructed by use of a computer program, and were histomorphometrically analyzed. The results showed that the diameter of mandibular canal is less distorted at a certain inclination of the mandibular body. The image tends to seem more distended in proportion to the distance between the subject and film. Also, the image tends to be affected according as it is out of focus. In conclusion, it requires that the image should be reconstructed in light of anatomic position and structure.

Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation

  • Kim, Won-Young;Kim, Mi-Hyun;Jo, Eun-Jung;Eom, Jung Seop;Mok, Jeongha;Kim, Ki Uk;Park, Hye-Kyung;Lee, Min Ki;Lee, Kwangha
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.247-255
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    • 2018
  • Background: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. Methods: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to ${\beta}$ coefficient values. Results: Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ${\geq}65$ years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ${\geq}3$, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores. Conclusion: The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.

Effect of Spiritual Nursing Intervention on Spiritual Well being and Depression of Hospice Patients (영적간호중재가 호스피스 환자의 영적안녕과 우울에 미치는 효과)

  • Song, Mi-Ok;Kim, Jung-Nam
    • Research in Community and Public Health Nursing
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    • v.15 no.1
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    • pp.132-144
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    • 2004
  • Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on the spiritual well being and depression levels of hospice patients. Method: The data for this study were collected from 62 patients who were admitted to the hospice care unit from July 28, 2002 to October 31, 2002 in D city K hospital. Subjects were 31 members of the experimental group and 31 members of the control group. It was devised with a nonequivalent control group pretest posttest design. The spiritual nursing intervention was given by using the therapeutic use of self. Scripture. prayer. Hymn and music. use of church community involvement and referrals to pastors according to the assessment of patients' spiritual needs for 3 weeks(total 12 times and 1 hour per each intervention). Sangsoon Choi (1990) and Jungho Kang(1996)'s spiritual well being scale. which was modified from Palautzian and Ellison (1982)'s spiritual well being scale, was used to investigate patients' spiritual well being. To investigate the level of depression. OkHyun Song(1977)'s Depression Scale, which was modified from Zung(1965)'s Depression Inventory, was used. Data were analyzed by $x^2$-test. t-test. and repeated measures ANOVA with SPSS/Win 10.0 program. Results: 1. The 1st hypothesis. 'total spiritual well being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported (F=6.28, p=0.015, Interaction: p=0.000). 2. The 1 lst sub hypothesis, 'religious well being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=12.75, p=0.001 Interaction: p=0.000). 3. The 1 2nd sub hypothesis, 'existential well being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.87, p=0.016, Interaction: p=0.000). 4. The 2nd hypothesis, 'depression level in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive the spiritual nursing intervention' was supported (F=10.45, p=0.002, Interaction: p=0.000). Conclusion: From the above results, spiritual nursing intervention was an effective program to improve the spiritual well being state and decrease the depression levels of the hospice patients. In the future, with spiritual intervention. which the researcher developed, is applied in the nursing field, the hospice patients can have comprehensive well being including spiritual well being and die peacefully.

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The Needs for Discharge Education and Educational Performance of Nurses Perceived by Premature Infants Mothers In the ICT Medical Service (ICT 의료시설 기반에서 미숙아 어머니의 퇴원 교육 요구도와 간호사의 교육수행 정도)

  • Kim, Soo-Heui;Choi, Seong-Woo;Ryu, So-Yeon;Han, Mi-Ah
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.7
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    • pp.707-716
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    • 2016
  • The current research focused on the needs for discharge education and the educational performance of nurses perceived by mothers of premature infants. The subjects for the current research were 54 mothers of premature infants hospitalized in the neonatal intensive care unit at K general hospital in G metropolitan city. The data was collected between June 9, 2014 and September 30, 2014 through self-recording surveys. The needs for discharge education were $4.21{\pm}0.60$ and the perceived educational performance of nurses was $3.95{\pm}0.73$. There was a significant difference between the needs for discharge education and the perceived educational performance in abnormal symptom monitoring and management ($0.55{\pm}0.97$, p=0.001), excrement management ($0.45{\pm}1.11$, p=0.004) and growth development ($0.41{\pm}1.08$, p=0.007). The needs for discharge education was significantly different according to delivery type (vaginal delivery: $4.41{\pm}0.47$, caesarean section: $4.03{\pm}0.47$, p=0.040) and birth order (first: $4.37{\pm}0.53$, second: $4.25{\pm}0.51$, over third: $3.75{\pm}0.72$, p=0.031). Perceived educational performance of nurses was significantly different according to baby sitter (yes: $4.15{\pm}0.66$, no: $3.48{\pm}0.67$, p=0.002). ]

The Effectiveness of Clinical Sterilization Methods in Dental Air/water Syringes (임상적으로 유용한 치과용 Air/water syringe의 소독법)

  • Shin, Seyoung;Yang, Yeonmi;Kim, Miah;Kim, Jaegon;Baik, Byeongju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.268-273
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    • 2013
  • This study aims to investigate contamination level and effective clinical disinfection methods of dental air/water syringes (AWS) by using microbial incubation. This study used AWS of ten dental unit chairs of Hospital. Total 180 samples were obtained. There are six groups of samples: non-sterilized (group 1), sanitized with wet-gauze (group 2), sanitized with 78% ethanol sponge for 10 seconds (group 3), sanitized with 78% ethanol sponge for 20 seconds (group 4), sanitized with 1 : 100 diluted High Level Disinfectant$^{(R)}$ (group 5), autoclaved (group 6). Group 1 and 2 showed statistically significant level of CFUs than Group 4, 5 and 6 (p < 0.05). Group 4, 5 and 6 did not show any noticeable CFU. Sanitizing AWS tips with ethanol and High level Disinfectant$^{(R)}$ proves to be a useful and practical method for preventing cross-infections.