• Title/Summary/Keyword: Local medical center

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When do we need more than local compression to control intraoral haemorrhage?

  • Sohn, Jun-Bae;Lee, Ho;Han, Yoon-Sic;Jung, Da-Un;Sim, Hye-Young;Kim, Hee-Sun;Oh, Sohee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.343-350
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    • 2019
  • Objectives: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. Materials and Methods: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. Results: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). Conclusion: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

Construction of Local Terminology Dictionary in NM Imaging Report Forms

  • Hwang, Kyung-Hoon;Jeong, Ji-Young;Park, Kuk-Yang
    • Proceedings of the Korea Information Processing Society Conference
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    • 2010.04a
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    • pp.352-352
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    • 2010
  • It is difficult to settle the well-designed local terminology for imaging report in the hospital information system (HIS). One of the major reasons is the local terminology with poor contents have been used in the hospital. Thus, we mapped the locally used terms in nuclear medicine imaging report to the SNOMED-CT, which had been widely used in the electronic medical record system, for implementation of hospital information system. Preliminary construction of terminology dictionary was done by mapping of local terms to SNOMED-CT and LexCare Suite. Further study may be warranted.

Adverse effects following dental local anesthesia: a literature review

  • Ho, Jean-Pierre T.F.;van Riet, Tom C.T.;Afrian, Youssef;Chin Jen Sem, Kevin T.H.;Spijker, Rene;de Lange, Jan;Lindeboom, Jerome A.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.6
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    • pp.507-525
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    • 2021
  • Local anesthesia is indispensable in dentistry. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. However, adverse effects are possible, of which dentists should be aware of. This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. The types of papers, what is reported, and how they are reported were reviewed. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. The titles and abstracts were independently screened by two reviewers. The analysis was narrative, and no meta-analysis was performed. This study included 78 articles. Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. Multiple adverse effects of dental local anesthesia have been reported in the literature. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. Therefore, high-quality research on this topic is needed. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

  • Lee, Hyebin;Park, Hee Chul;Park, Won;Choi, Doo Ho;Kim, Young-Il;Park, Young Suk;Park, Joon Oh;Chun, Ho-Kyung;Lee, Woo-Yong;Kim, Hee Cheol;Yun, Seong Hyeon;Cho, Yong Beom;Park, Yoon Ah
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.117-123
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    • 2012
  • Purpose: Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. Materials and Methods: We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. Results: The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Conclusion: Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

Construction of Local Data Dictionary in the Field of Nuclear Medicine

  • Hwang, Kyung-Hoon;Lee, Haejun
    • Proceedings of the Korea Information Processing Society Conference
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    • 2010.11a
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    • pp.465-465
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    • 2010
  • A controlled medical vocabulary is a vital component of medical information management because it enables computers to use information meaningfully and different institutions to share the medical data. There are currently many standard medical vocabularies - SNOMED-CT, ICD-10, UMLS, GALEN, MED, etc, but none is universally accepted as an optimal controlled medical vocabulary for application to medical information system. Moreover, it is difficult to settle the well-designed local data dictionary consisting of controlled medical vocabularies for the individual hospital information system (HIS). One of the major reasons is the local terminology with poor contents have been used in the hospital. Thus, as a trial, the local controlled vocabulary referencing system has being constructed in a limited medical field - nuclear medicine. We selected practical nuclear medicine terms from interpretation reports and electronic medical records, and removed ambiguity and redundancy, mapping the selected terms to standard medical vocabularies. Relationship and hierarchy structure between terms have being made, referring to standard medical vocabularies. Further studies may be warranted.

Community Welfare and Oriental-Korean Medicine for the Aged People (지역사회복지의 관점에서 고령화 시대에 대비하는 한의사의 역할에 대한 연구)

  • Lee, Hai-Woong;Kim, Hoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.168-179
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    • 2006
  • Background and Aim : As the aged society is coming, people pay attention to it and the government is also increasing subsidy into the welfare of the aged. As a branch of social welfare, community welfare is familiar and close to local residents. We could open up a new field in community welfare for oriental medicine and oriental medical doctor(OMD). Materials and Method : Analyzing the worts of community welfare center, we tried to find ways for OMDs to take part in there. We focused m community care and home care service of community welfare center and community health center. Result : Free oriental medical services are offered in many places, but a lot of them are temporary and hard to continue due to financial problem and lack of specialist. Local residents want to know about oriental medicine but few OMDs are willing to participate, thereforen, unqualified lectures of such as hand acupuncture, moxibustion, meridian massage prevail among them. This leads to illegal oriental medical services in the name of volunteer medical work. Conclusion The system is needed that local OMD association take part in community welfare of oriental medical service and care with community welfare center and community health center. Local volunteer medical services and researches of medical policy can help increase the chance for OMDs to go into social welfare system of the aged.

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Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

  • Lee, Ji-Eun;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Jung-Ae;Rim, Chai-Hong;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.30 no.2
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    • pp.62-69
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    • 2012
  • Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

A Retrospective Analysis of Treatment-Related Prognostic Factors for Local Recurrence after Primary Radiation Therapy for Patients with Primary T1N0 Glottic Cancer (T1N0 성문암의 방사선치료관련 예후 인자 분석)

  • Kim Su-Ssan;Kim Sang-Yoon;Nam Soon-Yuhl;Choi Seung-Ho;Cho Kyung-Ja;Kim Jong-Hoon;Ahn Seung-Do;Shin Seong-Soo;Song Si-Yeol;Choi Eun-Kyung;Lee Sang-Wook
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.34-40
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    • 2003
  • Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.

A Research on the improvement measures about Community-based Korean medical public health service in public service center (보건소 한방지역보건사업의 개선방안에 대한 연구)

  • Choi, Kwang-Jin;Kim, Hong-Jun;Ahn, Sang-Woo
    • Korean Journal of Oriental Medicine
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    • v.10 no.1
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    • pp.107-117
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    • 2004
  • Each Local public heal public health service center is in difficult situation on programing and performing of local public health service. The purpose of research is to inquire of the present state of local public health service and search long-term developmental methods. The first, in order to accomplish this purpose, I distributed questionnaires to Korean medical doctors, who are worked in public health service center and researched that. The second, based on these findings, I proposed planning for upcoming project for activating local public health service on Korean medicine.

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Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?

  • Son, Ho Sung;Lee, Sung Ho;Darlong, Laleng Mawia;Jung, Jae Seong;Sun, Kyung;Kim, Kwang Taik;Kim, Hee Jung;Lee, Kanghoon;Lee, Seung Hun;Lee, Jong Tae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.124-128
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    • 2014
  • Background: A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. Methods: We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. Results: The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. Conclusion: Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.