• Title/Summary/Keyword: Non-emergency

Search Result 632, Processing Time 0.031 seconds

Clinical Significance of Smudge Cells in Peripheral Blood Smears in Hematological Malignancies and Other Diseases

  • Chang, Chih-Chun;Sun, Jen-Tang;Liou, Tse-Hsuan;Kuo, Chin-Fu;Bei, Chia-Hao;Lin, Sheng-Jun;Tsai, Wei-Ting;Tan, N-Chi;Liou, Ching-Biau;Su, Ming-Jang;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.4
    • /
    • pp.1847-1850
    • /
    • 2016
  • Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age

  • Lee, In Sul;Park, Young Jin;Jin, Mi Hyeon;Park, Ji Young;Lee, Hae Jeong;Kim, Sung Hoon;Lee, Ju Suk;Kim, Cheol Hong;Kim, Young Don;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
    • /
    • v.61 no.9
    • /
    • pp.285-290
    • /
    • 2018
  • Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

The Study on Design of Semiconductor Detector for Checking the Position of a Radioactive Source in an NDT (비파괴검사 분야에서 방사선원의 위치 확인을 위한 반도체 검출기 설계에 관한 연구)

  • Kim, Kyo-Tae;Kim, Joo-Hee;Han, Moo-Jae;Heo, Ye-Ji;Ahn, Ki-Jung;Park, Sung-Kwang
    • Journal of the Korean Society of Radiology
    • /
    • v.11 no.3
    • /
    • pp.171-175
    • /
    • 2017
  • In the non-destructive inspection field, we invest a lot of time and resources in developing the radiation source system to ensure the safety of the workers. However, the probability of accidents is still high. In order to prevent potential radiation accidents in advance, it is necessary to directly verify the position of the radiation source, but the research is still insufficient. In this study, we developed a monitoring system that can detect the position of the radiation source in the source guide tube in the gamma-ray irradiator. The characteristics of the radiation detector are estimated by monte carlo simulation. As a result, the radiation detector for Ir-192 gamma-ray energy was analyzed to have secondary electron equilibrium at $150{\mu}m$ regardless of the semiconductor material. Also, it is expected that the gamma ray response characteristic is the best in $HgI_2$. These results are expected to be used as a basis for determining the optimal thickness of the radiation detector located in the detection part of the future monitoring system. In addition, when developing a monitoring system based on this, radiation workers can easily recognize the danger and secure safety, as well as prevent and preemptively respond to potential radiation accidents.

Effects of Fertilization and Mulching on Yield and Quality of Peusedanum japonicum THUNBERG (시비(施肥)와 피복(被覆)이 갯기름나물(식방풍)의 수량(收量) 및 품질(品質)에 미치는 영향(影響))

  • Park, No-Kwuan;Lee, Suk-Hee;Chung, Sang-Hwan;Park, Seon-Do;Choi, Boo-Sull;Lee, Won-Sik
    • Korean Journal of Medicinal Crop Science
    • /
    • v.3 no.1
    • /
    • pp.16-20
    • /
    • 1995
  • This study was carried out to know the effects of $N,\:P_2O_5,\:K_2O$ application and mulching materials on the yield and quality of Peusedanum japonicum. And conducted from 1990 to 1992 in the south region. The emergency rate by mulching materials was 80% on non-mulching, 74% on black P.E mulching, but 49% on the transparent P.E mulching. The yield of dried root on the transparent P.E mulching was increased 7% compared to non-mulching. The decreasing rate of yield was increased with the sequence of $N>P_2O_5>K_2O_5$. The significant negative correlation was obtained between the content of ash and nitrogen application, and the significant positive correation between the content of ash and potassium application. The contents of ash, acid insolubleash, and $C_2H_5\:OH$ OH extract were not affected by the treat-ment of mulching materials. When Peusedanum japonicum was cultivated in the south region for one year, optimum application of fertilizers was $N-P_2O_5-K_2O_5=21-13-10kg/10a.$

  • PDF

Correlation between Self-evaluation Factor and Academic Achievement of Medical Students according to Introduction of Explanation Meeting in Cadaveric Dissection (해부설명회의 도입에 따른 의학전문대학원생들의 자기 평가 요인과 학업성취도 상관관계 분석)

  • Park, Jeong-Hyun;Kim, Jee-Hee;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.11 no.7
    • /
    • pp.2475-2482
    • /
    • 2010
  • This study aimed to evaluate correlation between self-evaluation factors(satisfaction, linkage with major, suitability of management, verbal and non-verbal communication) and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The study was carried out that medical students(n=57) explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting,, medical students filled out a questionnaire on impact of self-evaluation factors and communication. We analyzed these factors and their scores using frequency analysis, T-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, only verbal communication factor was closely related to their academic achievement(p<0.05). The verbal and non-verbal communication also had a high correlation of 0.673(p<0.01). The explanation meeting provided chance to learn further with positive attitude to medical students and motivated them academically. Additionally, they realized that communication skill played a key role in transmitting medical knowledge to others. Therefore, introduction of communication-based explanation meeting would be very useful tool in improving educational efficiency.

The National Hospice Care Service Development in Korea (한국형 호스피스 케어 개발을 위한 기초 조사 연구)

  • Lee, Soo-Woo;Lee, Eun-Ok;Ahn, Hyo-Seog;Heo, Dae-Seock;Kim, Dal-Sook;Kim, Hyun-Sook;Lee, Hiye-Ja
    • The Korean Nurse
    • /
    • v.36 no.3
    • /
    • pp.49-69
    • /
    • 1997
  • The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

  • PDF

The Japan Health Physics Society Guideline on Dose Monitoring for the Lens of the Eye

  • Yokoyama, Sumi;Tsujimura, Norio;Hashimoto, Makoto;Yoshitomi, Hiroshi;Kato, Masahiro;Kurosawa, Tadahiro;Tatsuzaki, Hideo;Sekiguchi, Hiroshi;Koguchi, Yasuhiro;Ono, Koji;Akiyoshi, Masahumi;Kunugita, Naoki;Natsuhori, Masahiro;Natsume, Yoshinori;Nabatame, Kuniaki;Kawashima, Tsunenori;Takagi, Shunji;Ohno, Kazuko;Iwai, Satoshi
    • Journal of Radiation Protection and Research
    • /
    • v.47 no.1
    • /
    • pp.1-7
    • /
    • 2022
  • Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.

Hepatitis B Vaccination Coverage and Related Factors among Aged 19 or Older in Republic of Korea (한국 19세 이상 성인들의 B형간염 백신 접종률 및 관련 요인)

  • Lee, Sok Goo;Jeon, So Youn
    • Journal of agricultural medicine and community health
    • /
    • v.47 no.2
    • /
    • pp.99-108
    • /
    • 2022
  • Objectives: This study aimed to identify the vaccination coverage for hepatitis B among aged 19 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The survey was conducted through a Mixed-Mode Random Digit Dialing Survey (RDD) method. The survey included hepatitis B vaccination status, reasons of vaccination and non-vaccination, sources of information on vaccination, and other related factors. Results: The vaccination coverage for hepatitis B among adults 19 years of age and older were 38.0%, 32.5%, and 26.9% for the first, second, and third doses. A related factors with high rate of hepatitis B vaccination was women, younger than 65 years of age, rural residents, having a job, highly educated, health insurance subscribers, living with spouse, family members living together. In addition, the vaccination rate was higher in those who was aware of the states recommended adult vaccination, were explained by a doctor about the need for adult vaccination, kept their vaccination records, and recognized that it helped prevent infectious diseases, and had seen promotional materials. Conclusions: In the future, it is necessary to check the antibody retention rate along with the hepatitis B vaccination coverage of adults on a regular basis. In addition, in order to accurately and quickly identify the hepatitis B vaccination coverage, it is necessary to prepare a plan to improve the computerized registration rate to manage adult vaccination records.

The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery

  • Min Ho Lee;Seu-Ryang Jang;Tae-Kyu Lee
    • Journal of Korean Neurosurgical Society
    • /
    • v.66 no.5
    • /
    • pp.573-581
    • /
    • 2023
  • Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

The Effect of Franchisor's On-going Support Services on Franchisee's Relationship Quality and Business Performance in the Foodservice Industry (외식 프랜차이즈 가맹본부의 사후 지원서비스가 가맹점의 관계품질과 경영성과에 미치는 영향)

  • Lee, Jae-Han;Lee, Yong-Ki;Han, Kyu-Chul
    • Journal of Distribution Research
    • /
    • v.15 no.3
    • /
    • pp.1-34
    • /
    • 2010
  • Introduction The purpose of this research is to develop overall model which involves the effect of ongoing support services by franchisor on franchisee's relationship quality(trust, satisfaction, and commitment) and business performance(financial and non-financial performance), and to investigate the relationships among trust, satisfaction, commitment, financial and non-financial performance. This study also suggests franchise business or franchise system should be based on long-term orientation between franchisor and franchisee rather than short-term orientation, or transactional relationship, and proposes the most effective way of providing on-going support services by franchisor with franchisee thru symbiotic relationship among franchisor and franchisee Research Model and Hypothesis The research model as Figure 1 shows the variables on-going support services which affect the relationship quality between franchisor and franchisee such as trust, satisfaction, and commitment, and also analyze the effects of relationship quality on business performance including financial and non-financial performance We established 12 hypotheses to test as follows; Relationship between on-going support services and trust H1: On-going support services factors (product category & price, logistics service, promotion, information providing & problem solving capability, supervisor's support, and education & training support) have positive effect on franchisee's trust. Relationship between on-going support services and satisfaction H2: On-going support services factors (product category & price, logistics service, promotion, information providing & problem solving capability, supervisor's support, and education & training support) have positive effect on franchisee's satisfaction. Relationship between on-going support services and commitment H3: On-going support services factors (product category & price, logistics service, promotion, information providing & problem solving capability, supervisor's support, and education & training support) have positive effect on franchisee's commitment. Relationship among relationship quality: trust, satisfaction, and commitment H4: Franchisee's trust has positive effect on franchisee's satisfaction. H5: Franchisee's trust has positive effect on franchisee's commitment. H6: Franchisee's satisfaction has positive effect on franchisee's commitment. Relationship between relationship quality and business performance H7: Franchisee's trust has positive effect on franchisee's financial performance. H8: Franchisee's trust has positive effect on franchisee's non-financial performance. H9: Franchisee's satisfaction has positive effect on franchisee's financial performance. H10: Franchisee's satisfaction has positive effect on franchisee's non-financial performance. H11: Franchisee's commitment has positive effect on franchisee's financial performance. H12: Franchisee's commitment has positive effect on franchisee's non-financial performance. Method The on-going support services were defined as an organized system of continuous supporting services by franchisor for the purpose of satisfying the expectation of franchisee based on long-term orientation and classified into six constructs such as product category & price, logistics service, promotion, providing information & problem solving capability, supervisor's support, and education & training support. The six constructs were measured agreement using a 7-point Likert-type scale (1 = strongly disagree to 7 = strongly agree)as follows. The product category & price was measured by four items: menu variety, price of food material provided by franchisor, and support for developing new menu. The logistics service was measured by six items: distribution system of franchisor, return policy for provided food materials, timeliness, inventory control level of franchisor, accuracy of order, and flexibility of emergency order. The promotion was measured by five items: differentiated promotion activities, brand image of franchisor, promotion effect such as customer increase, long-term plan of promotion, and micro-marketing concept in promotion. The providing information & problem solving capability was measured by information providing of new products, information of competitors, information of cost reduction, and efforts for solving problems in franchisee's operations. The supervisor's support was measured by supervisor operations, frequency of visiting franchisee, support by data analysis, processing the suggestions by franchisee, diagnosis and solutions for the franchisee's operations, and support for increasing sales in franchisee. Finally, the of education & training support was measured by recipe training by specialist, service training for store people, systemized training program, and tax & human resources support services. Analysis and results The data were analyzed using Amos. Figure 2 and Table 1 present the result of the structural equation model. Implications The results of this research are as follows: Firstly, the factors of product category, information providing and problem solving capacity influence only franchisee's satisfaction and commitment. Secondly, logistic services and supervising factors influence only trust and satisfaction. Thirdly, continuing education and training factors influence only franchisee's trust and commitment. Fourthly, sales promotion factor influences all the relationship quality representing trust, satisfaction, and commitment. Fifthly, regarding relationship among relationship quality, trust positively influences satisfaction, however, does not directly influence commitment, but satisfaction positively affects commitment. Therefore, satisfaction plays a mediating role between trust and commitment. Sixthly, trust positively influence only financial performance, and satisfaction and commitment influence positively both financial and non-financial performance.

  • PDF