Purpose: Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. Materials and Methods: A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Results: Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Conclusions: Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.
PURPOSE. The aim of this study was to determine the absolute value of the root/crown ratio (R/C ratio) using panoramic radiographs (PRGs) in a healthy Korean population. MATERIALS AND METHODS. In total, 99 patient radiographs (of 50 males and 49 females subjects; aged 16 to 24 years old) were examined, and 2,770 teeth were analyzed. Crown lengths and root lengths were measured with modified Lind's measurements using PACS tools by two examiners in two separate sessions two months apart. All data were analyzed using SPSS. The independent t-test was used to assess for gender differences, and the paired t-test was used to compare both arches with a significance level of P<.05. RESULTS. The mean R/C ratios varied from 1.29 to 1.89 (male: 1.28-1.84; females: 1.31-1.94). The highest R/C ratios were recorded for the mandibular canines (1.89), followed by the maxillary canines (1.79). The lowest R/C ratios were recorded for the maxillary second molars (1.31). In comparison with the maxillary teeth (1.29-1.78), the mandibular teeth yielded the higher R/C ratio (1.47-1.89), and this difference was significant in the females (P<.05). The difference between the genders was not statistically significant, except for the maxillary central incisors, mandibular canines and mandibular first premolars. CONCLUSION. These data may enhance the understanding of the clinical R/C ratio as a useful guideline for determining the status of teeth and the ethnic difference.
1. Objectives and Methods It has been examined 703 papers of Sasang Constitution Society published from 1989 to 2007. Among them, the study methods have been classified focused on 332 papers related to clinical research and the method of constitution diagnosis and subjects have been researched to research the reality of the clinical research of Sasang Constitutional Medicine. 2. Results 1. The rest studies are the most which can not be classified by existing study method among 332 clinical studies. 2. The study of patient control group is 17 cases and the clinical experiment is one case, so highly well-grounded studies have not been performed. 3. The most method of constitution diagnosis is the constitution diagnosis by experts and by QSCC. 4. The number of constitution diagnosis method performed in the research institution is within 2. They are 254 cases(89.5%). 5. The studies which utilize more than 3 constitution methods are 22 cases and the studies that use medical rash are 7cases(31.8) 6. The 215 cases that subjects are less than 100 are the most and 100${\sim}$500 subjects are 71 cases. 500${\sim}$10000 subjects are 33 cases and more than 1000 subjects are 15 cases. 3. Conclusions Therefore, it is needed to increase the rate of highly well-grounded studies and set the standard criteria by providing constitution diagnosis guideline.
Objectives : ShangHanLun is a clinical guideline, and its core is in the part of Six-meridian Diseases. In recent philological sutdies, independent textual analysis of Shanghanlun is essential to define the scope of research. Methods : By the textual study, I defined the Shanghanlun clinic model. And I researched about medical range of Shanghanlun, and relations between Shanghanlun and JinGuiYaoLue, and between Shanghanlun and Huangdineijing. Results : In six topic sentences, the word '-之爲' means 'a process'. In provisions following topic sentences, the word '者' means 'a person'. So Shanghanlun is describing processing factors of Six-meridian Diseases and related human changes with clinical therapy. In the philological studies, meaning of '傷寒' was possibly just the 3rd provision of the greater yang disease part. Practically Shanghanlun's study range is over the concept of Cold damage today. Additionally Jinguiyaolue deals diseases, but Shanghanlun deals human. Gangpyeong-Shanghanlun's phrases can be separated into five part, and oldest part is independent of Huangdineijing. Conclusions : So we need to set a new and independent clinic model of Shanghanlun to verify it. The Shanghanlun's clinic model has a 3 steps. 1st step is to find 6 type defined symptoms, which act as processing factors of Six-meridian Diseases. 2nd step is to confirm a human changes after a Disease appeared. 3rd step is to treat a patient as a provision suggests. Philologically Shanghanlun's clinic range is not limited by the word '傷寒'. And many concepts in Shanghanlun should be independent of Huangdineijing.
Background : The nationwide tuberculosis registry system in Korea has been operated with the dual reporting system - public health center (PHC) and private medical services (PMS) - since 2000. While three-fifths of the registered cases in 2002 was reported by PMS, it was reported that the success rate of patients at PMS was lower than that at PHC. To identify the problems of the patients' management at the PMS as well as the PHC in a community is the aim of this paper. Methods : The subject was selected from the registered cases of the pulmonary tuberculosis in Jejudo, 2002. The needed items for this study were gathered by the reviewing the medical charts directly. Results : Of the 262 patients included in the subject, 92 cases (35%) were treated initially at PMS. The sputum smear as an essentially diagnostic test was carried out with 69.2% at private clinics compared with 98.2% at PHC. The success rate of the treatment at PMS was 59.8% so that it had a statistically significant difference from that at PHC (80.0%; p<0.01). Conclusion : These results showed that there were several problems in diagnosis and treatment for the patient of pulmonary tuberculosis at PMS. To improve the success rate of the treatment at PMS, the nationwide clinical guideline for control of pulmonary tuberculosis should be systematically disseminated and strongly recommended at PMS by the government.
Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.
Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.
Kim, Kyung-A;Lee, Ji-Won;Park, Jeong-Ho;Kim, Byoung-Ho;Ahn, Hyo-Won;Kim, Su-Jung
The korean journal of orthodontics
/
v.47
no.3
/
pp.195-206
/
2017
Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.
Lim, Ok-Jeong;Lee, Ok Sang;Yun, Hye-Sul;Choe, Kevin Kyungsik;Lim, Sung Cil
YAKHAK HOEJI
/
v.57
no.2
/
pp.101-109
/
2013
Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.
Ruitenburg, Martijn M.;Frings-Dresen, Monique H.W.;Sluiter, Judith K.
Safety and Health at Work
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v.7
no.1
/
pp.18-31
/
2016
Background: A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content. Methods: Based on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications. Results: Information from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness. Conclusion: The process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.
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