• Title/Summary/Keyword: Local medical center

Search Result 821, Processing Time 0.03 seconds

The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan (지역보건의료계획 수립에 있어 지역의료보험자료의 활용가능성)

  • Lee, Sang-Yi;Kim, Chul-Woung;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
    • /
    • v.30 no.4 s.59
    • /
    • pp.870-883
    • /
    • 1997
  • The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

  • PDF

Prognostic significance of adjuvant radiation therapy in adenocarcinoma of the cecum

  • Hosseini, Sare;Bananzadeh, Ali Mohammad;Mohammadianpanah, Mohammad;Salek, Roham;Taghizadeh-Kermani, Ali
    • Radiation Oncology Journal
    • /
    • v.36 no.1
    • /
    • pp.45-53
    • /
    • 2018
  • Purpose: Local recurrence is a common failure pattern in adenocarcinoma of the cecum. This study aimed to investigate the potential role of adjuvant radiation therapy on oncologic outcomes of patients with adenocarcinoma of the cecum. Materials and Methods: This retrospective study was carried out at three large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of 162 patients with adenocarcinoma of the cecum that were treated and followed up between 2000 and 2013. All the patients had undergone a right hemicolectomy and received chemotherapy with (n = 48) or without (n = 114) adjuvant radiation therapy. Results: The subjects were 65 females and 97 males with a median age of 56 years (range, 17 to 90 years) at diagnosis. The 5-year local control (LC), disease free survival (DFS), and overall survival (OS) rates were 72.7%, 57.2%, and 62.6% respectively. In a multivariate analysis, age, tumor stage, node stage, and adjuvant radiation therapy were determined to be independent prognostic factors. Age more than 55 years (hazard ratio [HR] = 1.0; 95% confidence interval [CI], 0.06-0.32; p = 0.003), T4 stage (HR = 6.8; 95% CI, 3.07-15.36; p < 0.001), node positive disease (HR = 4.2; 95% CI, 1.94-9.13; p < 0.001), and the absence of adjuvant radiation therapy (HR = 3.0; 95% CI, 1.39-6.46; p = 0.005) had a negative influence on OS. Conclusion: Adjuvant radiation therapy significantly improves DFS and OS in patients with adenocarcinoma of the cecum.

Excellent treatment outcomes in children younger than 18 months with stage 4 MYCN nonamplified neuroblastoma

  • Kim, Chiwoo;Choi, Young Bae;Lee, Ji Won;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
    • /
    • v.61 no.2
    • /
    • pp.53-58
    • /
    • 2018
  • Purpose: Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma. Methods: We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens. Results: The most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17-91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ${\geq}3$ late adverse effects. Conclusion: Patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.

Vitalization Measures of the Class for Qi-gong Gymnastics in the Public Health Center (보건소 한방지역보건사업 중 기공체조교실의 현황 파악 및 활성화 방안)

  • Han, Chang-Hyun;Jung, Dae-Sun;Park, Soo-Jin;Kwon, Young-Kyu
    • Korean Journal of Oriental Medicine
    • /
    • v.13 no.1 s.19
    • /
    • pp.115-124
    • /
    • 2007
  • Objectives : The study investigated the actual condition of the class for Qi-gong gymnastics among health promotion service programs using oriental medicines, which the public health center has been conducting for local residents. Method : Of a total of 964 oriental medical physician in public health center across the country, it examined 27 places consisting of public health centers and public health sub-centers, and public hospitals, all of which were running the class for Qi-gong gymnastics. Then, it carried out the tele research of those oriental medical physicians in charge of the class there. Result : As a result, area that is enforcing the Class for Qi-gong Gymnastics was expose each attempt that difference is particularly, and appeared by thing which form and practice law that operate the classroom are various. Also, in many cases, the oriental medical physicians instructed the gymnastics directly instead of inviting an external lecturer. Conclusions : In conclusion, based on the contents surveyed, by making the well-organized system of the class for Qi-gong excercise; by developing the common excercise and texts; and by publicizing and educating the oriental medical physicians engaged in public health, that the Class for Qi-gong Gymnastics is real in health promotion of local residents.

  • PDF

A Case of Recurrent Dermatofibrosarcoma of the Scalp

  • Jo, Tae-Yeon;Kim, Sang-Dae;Kim, Se-Hoon;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
    • /
    • v.37 no.3
    • /
    • pp.241-243
    • /
    • 2005
  • We report a case of recurrent dermatofibrosarcoma in a 30-years-old woman who had undergone operations three times during 60 months and had received post-operative radiotherapy. On neurological examination, no neurological deficits were noticed. In brain magnetic resonance image(MRI), there was right parieto-occipital scalp mass with high signal in T2-weighted image, low signal in T1-weighted image with homogeneous enhancement. The removal was done including about 2cm uninvolved margins and pathologic examination of the lesion revealed dermatofibrosarcoma protuberans(DFSP). The prognostic factors of local recurrence may be related to surgical margins for resection; the length from the grossly intact margins, and the microscopically controlled excision in margins.

Successful Treatment of Infantile Fibrosarcoma Spinal Metastasis by Chemotherapy and Stereotactic Hypofractionated Radiotherapy

  • Lo, Cheng-Hsiang;Cheng, Shin-Nan;Lin, Kuen-Tze;Jen, Yee-Min
    • Journal of Korean Neurosurgical Society
    • /
    • v.54 no.6
    • /
    • pp.528-531
    • /
    • 2013
  • We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife$^{(R)}$ stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

Effect of Stellate Ganglion Block with Morphine on Causalgia -A case report- (작열통환자에서 Morphine을 이용한 성상신경절 차단 효과 -증례 보고-)

  • Kim, Eun-Mi;Yoon, Sung-Geun;Park, Myung-Hyea;Kwak, Ho-Sung
    • The Korean Journal of Pain
    • /
    • v.11 no.1
    • /
    • pp.109-112
    • /
    • 1998
  • The sympathetic nervous system has been implicated as an important factor contributing to causalgia. Basis on reports of presence of opioid receptors in sympathetic autonomic ganglia, including human stellate ganglion, we administered morphine in stellate ganglion block for a patient with causalgia. The patient suffering from brachial plexus injury treated with stellate ganglion block in conjunction with physical therapy. Stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine, or 0.25% bupivacaine 8 ml, with morpine 1 mg. Patient's symptoms were dramatically improved after 13 stellate ganglion blocks.

  • PDF

Visually Indistinguishable Intractable Neuroma Management after Below Knee Amputation: A Case Report (하퇴부 절단술 후 육안적으로 발견하기 어려운 난치성 신경종 처치: 증례 보고)

  • Shin, Seong Kee;Kim, Ki Chun;Roh, Youngju;Kim, Jongkyu
    • Journal of Korean Foot and Ankle Society
    • /
    • v.23 no.4
    • /
    • pp.212-215
    • /
    • 2019
  • Symptomatic neuromas after amputation can be troublesome to treat and make it difficult to properly fit a brace. Surgical management is required when conservative management such as prosthetic socket modification or local injections fail. However, small cutaneous nerves adhere to adjacent soft tissue and they are difficult to locate. The authors suggest that ultrasonography guided tattoo localization using a charcoal suspension is useful to find a visually indistinguishable neuroma.

Giant basal cell carcinoma of the left lateral neck

  • Baik, Bongsoo;Park, Sulki;Ji, Soyoung;Kim, Sunyoung
    • Archives of Craniofacial Surgery
    • /
    • v.22 no.3
    • /
    • pp.173-176
    • /
    • 2021
  • Basal cell carcinoma is a malignant epithelial neoplasm of the skin and the most common human skin cancer. It is generally associated with a good prognosis. In this case report, a giant basal cell carcinoma of the nodulo-ulcerative type showing wide ulceration with marginal multiple small nodules, is presented. It was trapezoidal in shape, having dimensions of 7 cm at the greatest basal width, 6 cm vertically with different anterior and posterior margin dimensions, and 5 cm horizontally at the top margin. After wide excision of the lesion including 5-10 mm safety margins, the wound was reconstructed with a local skin flap and split-thickness skin graft. The reconstructed wound healed well without recurrence for 1 year.

Recent Advances in Allergen-Specific Immunotherapy in Humans: A Systematic Review

  • Sang Pyo Lee;Yoo Seob Shin;Sung-Yoon Kang;Tae-Bum Kim;Sang Min Lee
    • IMMUNE NETWORK
    • /
    • v.22 no.1
    • /
    • pp.12.1-12.13
    • /
    • 2022
  • Allergen-specific immunotherapy (AIT) is presumed to modulate the natural course of allergic disease by inducing immune tolerance. However, conventional AITs, such as subcutaneous immunotherapy and sublingual immunotherapy, require long treatment durations and often provoke local or systemic hypersensitivity reactions. Therefore, only <5% of allergy patients receive AIT as second-line therapy. Novel administration routes, such as intralymphatic, intradermal and epicutaneous immunotherapies, and synthetic recombinant allergen preparations have been evaluated to overcome these limitations. We will review the updated views of diverse AIT methods, and discuss the limitations and opportunities of the AITs for the treatment of allergic diseases in humans.