This study carried out a covariance-structural analysis to verify formed causations between general variables and the influences of Medical Social Work Service of officers and NCOs in Korean Community Military Hospitals. The subjects were 7 hospitals, 337 military hospital executives in rear area, and the results of the survey are as below. First, about empowerment level, culture in the organization turned out to be the primary direct influential factor, and personal, organizational, and functional character were influential factor. There was no indirect influential factor present. Second, in Medical Social Work Service, empowerment level was significant on direct effect. In case of personal character indirect effect was important. It showed that the significant influence factor that affects Medical Social Work Service in total effectiveness is personal character and empowerment level. It's productive to suggest the possibility of application of furnish the outcome as a basic data for Military Medical Social Work Service revitalization plan. On the basis of the result, we propose several suggestions for Military Medical Social Work Service as follow. First, to educate empowerment increase program of officers and NCOs in Military Hospital, specific system which allows entrust education to a certain civil education institution or KAMTSW(Korean Academy of Military Social Welfare) is required. Second, need to provide the medical social work service that matches with Military Hospital and distinct from usual hospital. Last, for specific study we expect various follow-up researches on the basis of this study, which can develop concrete empowerment model by inquiring research, would come out.
Kim, Mi-Hye;Lee, Hong-Yeul;Nam, Ki-Ho;Lim, Jae-Min;Jung, Bock-Hyun;Ryu, Dae-Sick
Tuberculosis and Respiratory Diseases
/
v.68
no.2
/
pp.67-73
/
2010
Background: In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers' pneumoconiosis (CWP) is unknown. Methods: Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review. Results: Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF. Conclusion: Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.
Recently, a variety of arthroscopic techniques have been reported for the treatment of the displaced tibial eminence fracture. The purpose of this study was to describe details of arthroscopic technique using pull-out wire and to evaluate the results. Eleven patients with irreducible type II and type III tibial eminence fractures underwent the arthroscopic reduction and internal fixation using double strand pull-out wiring. The anterior cruciate ligament tibial drill guide was utilized for the reduction of fracture and passage of the guide pins. The tibial eminence fracture was firmly fixed with double strand 26-gauge pull-out wire(0.45mm diameter). Fracture union was achieved at 7.2 weeks (range, six to eight weeks) after operation. All cases were united at the last follow-up. Subjectively, nine patients had no pain and no restriction of daily activities. Two patients with combined injuries had limitation of knee motion(10 to 130 degrees, respectively) and one patient showed mild anterior laxity. Early rehabilitation was enabled without loss of reduction and breakage of pull-out wire. The arthroscopic reduction and internal fixation using pull-out wire showed good results including early rehabilitation, early fracture union, minimal morbidity, and no requirement of the second operation for hard ware removal.
In this article, three cases of speciality hospitals, Songdo hospital, Bucheon Sejong Hospital, and Wooridul Hospital, are described and analyzed. They have shown outstanding performances and have high reputations. Success factors are drawn out from the cases: innovative founder, technological innovation, team medicine, and customer satisfaction. Implications and limitations are discussed, and suggestions for the future studies are suggested.
Journal of The Korea Institute of Healthcare Architecture
/
v.4
no.6
/
pp.67-76
/
1998
The purpose of this study is to estimate the number of the consulation rooms for the O.P.D. in General Hospital. To estimate optimal number of consulation rooms, it has to be considered the factors of population density, neighboring medical supply, condition of location, and the number of bed etc. And the figure of Out-Patients has to be expected as exact as possible. In calculation of consulation rooms, existing hospital planning has been considered only the number of bed, without considering many other factors. According to it, the number of consulation rooms was calculated by consulation and then work out the total number of consulation rooms for the O.P.D.. Therefore this method has been had a lot of problems But. this study considered four factors, and calculated the total number of consulation rooms for O.P.D. and then worked out the number of consulation rooms by O.P.D.
Gall bladder carcinoma is the most common cancer of biliary tree, characterized by rapid progression and a very high mortality rate. Detection at an early stage, however, is indicative of a very good prognosis and prolonged survival. The practice of histopathological examination of gall bladder specimens removed for clinically benign conditions and its usefulness has been a subject of controversy. The present prospective study was carried out over a period of four years in order to find out the incidence of unsuspected gallbladder carcinoma in cholecystectomy specimens received in our histopathology laboratory and to analyze their clinico-pathological features. A total of 4,115 cases were examined. Incidentally detected cases comprised 0.44%, which accounted for 72% of all gall bladder carcinomas detected. The majority were in an early, surgically resectable stage. From the results of this study we recommend that in India and other countries with relatively high incidences of gall bladder carcinoma, all cholecystectomy specimens should be submitted to histopathology laboratory, as this is the only means by which malignancies can be detected at an early, potentially curable stage.
A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.
Background: This study was performed to identify the incidence of screw in-type lateral anchor pull-out in patients older than 60 years who underwent rotator cuff repair for large to massive rotator cuff tear (RCT). Methods: We reviewed 25 patients over 60 who were diagnosed with large to massive RCT and underwent arthroscopic rotator cuff repair in our hospital from March 2017 to February 2021. Preoperative tear size (anterior to posterior, medial to lateral) was measured via preoperative magnetic resonance imaging (MRI). All 25 patients underwent MRI scanning on postoperative day 1 and at 3 months after surgery. The change of anchor position was measured in axial views on MRI images postoperative day 1 and 3 months after surgery. And it was statistically compared according to bone mineral density (BMD), sex, and number of lateral anchors. Results: Two MRIs (postoperative day 1 and 3 months) in 25 patients were compared. Anchor pull-out occurred in six patients during 3 months (6.7%), and the mean pull-out length difference was 1.56 mm (range, 0.16-2.58 mm). There was no significant difference in the number of pull-out anchors, degree of pull-out difference by comparing BMD (A, BMD≤-2.5; B, BMD>-2.5), sex, or number of anchors used in each surgery (C, two anchors; D, three anchors) (p>0.05). Conclusions: Pull-out of screw in-type anchors was rarely observed and the mean pull-out length difference was negligibly small in our study. The screw in-type lateral anchor seems to be a decent option without concern of anchor pull-out even in elderly patients.
Clinical observation was done on 496cases of the Out-patients and 136cases of the In-patients more than 65 years of age in Department of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from March 1991 to February 1992. The results were as follows; 1. The ratio of senile (more than 65 years of age) was 16.4% in total Out-patients, was 38.1% in total In-patients. 2. The ratio of male to female was 1:1.1 in the Out-patients, In-patients was 1.2:1. The age distribution showed the large number in the 65-69 year group, the female more than the male in 70 th's group. 3. The diagnostic distribution was noted in the Out-patients as follows, Respiratory Dis. 50.6%, Cardiovascular Dis 16.4%, Brain Neurogic Dis. 14.5%, Gastrointestinal Dis. 8.1%. in the In-patients. Brain Neurogic Dis. was 76.5%, Cardiovascular Dis was 19.8%. 4. The ratio of the season distribution in the Out-patients was as follows, spring 40.2%, winter 21.2%, summer 20.9%, in the In-patients. winter was 35.9%, autumn was 25.0%, spring was 19.9%. 5. The utilization of therapeutic clinic before coming the Oriental Medical Hospital in Dong Guk Univ, was as follows, the ratio of the Out-patients was noted a hospital or clinic was 57.1%, no-treatment 22.9%, a oriental medical hospital or clinic was 8.3%. In the admission was noted no-treatment was 38.3%, a oriental medical hospital or clinic was 35.3%. 6. The ratio of the periods from onset to Out-patients department was noted within 5days was 7.3%, over 1 year was 52.6%. In the admission was noted within 1 day was 41.9%, within 7 days was 71.8%. 7. The ratio of the therapeutic periods in the Out-patients department was noted within 10 days was 48.3%, over 60 days was 7.1%. 8. The ratio of the admission periods was noted within 10 days was 45.6%, the median of the admissio was 10.8 days. Brain Neurogic Dis's median was 20.2 days. 9. The therapeutic result was noted the case of improvement was 75.7% in the admission. 10. The ratio of the Out-patients department after discharging was 53.7%, in the case of Brain Neurogic Dis. was 60.7%.
Kim, Jong-Min;Kim, Hyung-Gyu;Park, Byeong-Mun;Song, Kyeong-Seop;Jung, Sung-Hoon;Noh, Haeng-Kee;Yoon, Jong-Joo
Journal of the Korean Arthroscopy Society
/
v.13
no.3
/
pp.254-258
/
2009
Tibial eminence fracture is caused by distortion, excessive flexion and extension, varus and valgus injury of the knee joint in the form of avulsion fracture. A failure over the exact anatomical reduction of fragment can lead to instability and limitation of joint motion. Recently, a variety of arthroscopic assisted reduction and fixation technique have been used. In the tibial eminence fracture, we created an arthroscopic pull-out wire fixation technique using a cannulated screw that is easy and more convenient than in the conventional technique. So we report this technique with a review of current literatures.
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