• Title/Summary/Keyword: Local medical center

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Primary renal fibrosarcoma with local invasion into the mesenteric membrane of a mongrel dog

  • Park, Hyun-Ah;Jeong, Chang-Woo;Kim, Gui-Soo;Kim, Han-Jun;Do, SunHee;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.55 no.1
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    • pp.65-69
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    • 2015
  • A 14-year-old, 7.4 kg, neutered male mongrel dog presented with vomiting, anorexia, and hematuria starting 3 days prior to admission. Serum biochemical profiles indicated severe azotemia. Computed tomography revealed loss of normal left kidney structure. The organ was 1.5 to 2 times larger than the right kidney with mixed attenuation. Histopathologic examination was performed after nephrectomy. The renal mass and mesenteric membrane were positive for vimentin and stained blue with Masson's trichrome. In conclusion, this was a rare occurrence of primary renal fibrosarcoma, most likely originated from the renal capsule, with local invasion into the mesenteric membrane.

A Study on Self-sufficiency for Hospital Injury Inpatients in Korea (우리나라 의료기관 입원손상환자의 자체충족도에 관한 연구)

  • Lee, Hee-Won;Park, Jong-Ho;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5779-5788
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    • 2011
  • This study was conducted to comprehend the current status of regional self-sufficiency of Hospital injury inpatients and, based on this, to prepare some measures for improving the self-sufficiency. For this purpose, 2005 & 2008 Patient Survey data, regional medical utilization data of National Health Insurance Corporation, yearbook of Central Emergency Medical Center and evaluation results of emergency medical institutions were obtained. Frequency analysis, cross-tabulation, decision tree and logistic regression techniques were used in the analysis of data. Self-sufficiency in 'metropolitan city/Do' area was lowest for Chungcheongnam-do for the year 2005 and 2008, followed by Gyeongsangbuk-do, Gyeonggi-do and Jeollanam-do. As for the self-sufficiency in 'Si/Gun/Gu' area with regard to local medical supply, for both 2005 and 2008, It was higher when general hospital, district emergency medical center, regional emergency medical center and regional emergency medical institution existed in the residential area. It was also found that, the higher the quality level of local emergency medical institution, the higher the self-sufficiency. It was confirmed that, when promoting the national policy for injury patients, priority should be placed on 'Do' area where the level of emergency medical supply was low, and that enhancing the quality level of emergency medical institutions was helpful for the improvement of self-sufficiency.

Hypofractionated Radiotherapy for Small-sized Hepatocellular Carcinoma as Salvage Therapy: Sustained Local Control and Safety (작은 크기의 재발성 간세포암에 대한 구제치료로 소분할 방사선치료: 국소 제어율과 안전성)

  • Bae, Sun-Hyun;Park, Hee-Chul;Lim, Do-Hoon;Lee, Jung-Ae;Choi, Moon-Seok;Lee, Joon-Hyoek;Koh, Kwang-Cheol;Paik, Seung-Woon;Yoo, Byung-Chul
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.85-90
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    • 2010
  • Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.

A Case Study on the Operation and Management Simulation of Pension Insurance House in Later Life : In the Case of Muju Rural Village (노후연금보험주택의 운영과 관리 시뮬레이션 사례연구 : 무주군의 전원마을 모델을 중심으로)

  • Hong, Hyung-Ock;Kim, Jung-In
    • Journal of Families and Better Life
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    • v.27 no.1
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    • pp.61-71
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    • 2009
  • The purpose of this study was to resolve the issues of inferior housing environment and the population decrease in rural community by improving the environment and attracting urban inhabitants. A simulation on the costs and the local programs was operated from a point of view that Pension Insurance House with Long-term Lease and a plan for the program in connection with local resources should be accompanied to attract urban inhabitants. The study was carried out through mainly documents analysis and specialists' opinions. The simulation results are as follows. Firstly, the pre-existing rural housing development projects have only emphasized the hardware, while underestimated the post-management with operating programs. The software should be underlined when Pension Insurance House is developed. Secondly, as a result of the simulation on construction expenditure and the operating and maintenance cost for 30 years, about 82.3 million Wons are necessary residential expenses for 15 years per unit. Thirdly, in case of MUJU County, it has made the most of its pre-existing institutions. It's medical institutions provide medical care system with health education, facilities related leisure and culture offer recreational programs and the local community center and its program of each town helps new habitants adopt to the rural life. Additionally, the employment project of a local welfare center allow people living in a rural community to continue their careers with their talents and interests through local class programs for a life worth living. Lastly, guide for getting information of rural life, local community gathering and preliminary education should be carried out to reduce expectant tenants' incompatibility and assist them settle down early. The community program expansion is also required at the local government level.

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

  • Yu, Jeong Il;Yoo, Gyu Sang;Cho, Sungkoo;Jung, Sang Hoon;Han, Youngyih;Park, Seyjoon;Lee, Boram;Kang, Wonseok;Sinn, Dong Hyun;Paik, Yong-Han;Gwak, Geum-Youn;Choi, Moon Seok;Lee, Joon Hyeok;Koh, Kwang Cheol;Paik, Seung Woon;Park, Hee Chul
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.25-34
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    • 2018
  • Purpose: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety. Materials and Methods: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of $62-92GyE_{10}$. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively. Conclusion: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

Surgical Outcomes of Malignant Primary Cardiac Tumor: A 20-Year Study at a Single Center

  • Ryu, Seung Woo;Jeon, Bo Bae;Kim, Ho Jin;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.361-367
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    • 2020
  • Background: Malignant primary cardiac tumors are extremely rare, but have a poor prognosis. This study evaluated the surgical outcomes of patients with this disease. Methods: Forty patients who underwent surgery for malignant primary cardiac tumors between January 1998 and December 2018 were enrolled. Participants were divided into 3 groups based on resection margins (R0, 14 patients; R1, 11 patients; and R2, 11 patients) and their surgical outcomes were compared. Heart transplantation was performed in 4 patients with unresectable tumors. Results: Early mortality was reported in 2 cases (5%) due to postoperative bleeding and cerebral hemorrhage secondary to brain metastasis. The 1- and 2-year survival rates were 67.5% and 42.5%, respectively. The median survival time of the patients was 20.3 months (range, 9.2-37.6 months). The median survival time was 48.7, 20.3, and 4.8 months in patients with R0, R1, and R2 resections, respectively (p=0.023). Tumor recurrence occurred in 21 patients (61.7%), including 4 cases of local recurrence and 17 cases of distant metastasis. In patients who underwent heart transplantation, the median survival time was 29.5 months, with 3 cases of distant metastasis. Conclusion: Although surgery for malignant primary cardiac tumors has a poor prognosis, complete resection of the tumor may improve surgical outcomes.

Individualized Determination of Lower Margin in Pelvic Radiation Field after Low Anterior Resection for Rectal Cancer Resulted in Equivalent Local Control and Radiation Volume Reduction Compared with Traditional Method (하전방 절제술을 시행한 직장암 환자에서 방사선조사 영역 하연의 개별화)

  • Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.194-199
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    • 2000
  • Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

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Primary visit, transfer, and re-transfer to emergency department in patients with severe emergency diseases in Chungnam (충남에서 발생한 중증응급환자의 응급의료기관 일차 방문, 전원 및 재전원 현황)

  • Choi, Il Kug;Choi, Han Joo;Lee, Hae Jung
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.399-407
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    • 2018
  • Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

Quality Improvement Activities to Reduce the Neonatal Infection in a Hospital (일 병원에서의 신생아 감염 감소를 위한 활동사례)

  • Sung, Mi Hae;Baik, Seung Nam;Hong, Hae Sung;Wee, Hyun Joo;An, Ji Won;Kim, Soon Hee;Kim, Hyo Mi
    • Quality Improvement in Health Care
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    • v.6 no.1_2
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    • pp.120-134
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    • 1999
  • Background : This study was conducted to reduce the neonatal infection rate in nursery. Methods : 50 items, structural problems in NICU were selected by open questionnaire and categorized into 11 similar items. 38 items were picked out among them and then categorized into 6 similar items. We carried out quality improvement focusing around 6 items. Results : The high achievement of goal in CQI Activities was shown in hand washing for reducing infection of NICU after July. The local infection in IV site was not found and hand washing and gowning of protectors were achieved by 100%. Conclusion : Neonatal infection rate was reduced through the quality improvement activities, but structural problem of Hospital still remained.

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A case of colonic lymphoid tissue invasion by Gymnophalloides seoi in a Korean man

  • SEO Min;CHUN Hokyung;AHN Geunghwan;JANG Kee-Taek;GUK Sang-Mee;CHAI Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.44 no.1 s.137
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    • pp.87-89
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    • 2006
  • A 55-year old Korean man, living in Mokpo-city, Jeollanam-do, Republic of Korea, visited a local clinic complaining of right upper quadrant pain and indigestion. At colonoscopy, he was diagnosed as having a carcinoma of the ascending colon, and thus, a palliative right hemicolectomy was performed. Subsequently, an adult fluke of Gymnophalloides seoi was incidentally found in a surgical pathology specimen of the lymph node around the colon. The worm was found to have invaded gut lymphoid tissue, with characteristic morphologies of a large oral sucker, a small ventral sucker, and a ventral pit surrounded by strong muscle fibers. This is the first reported case of mucosal tissue invasion by G. seoi in the human intestinal tract.