• Title/Summary/Keyword: Patient location

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A Chest Compression CPR Study Performed on a Main Stretcher : Comparative study between C-step and Over the Belly

  • Gyu-Sik Shim;Song-Yi Han
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.5
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    • pp.123-129
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    • 2024
  • CPR is very important to paramedics, but the chest compression performed while on the move main stretcher is less accurate. The purpose of this study is to find out the difference between performing chest compression on the side of the main stretcher using C-step and on the patient's over the belly in order to increase the effect of CPR on the main object while on the move. As a result of the study, the appropriate depth (t=4.132, p=.000) and speed (t=7.177, p=.000) were shown in the group to which the C-step was applied, and the accuracy was higher (t=6.774, p=.000). In addition, it was found that there were few location defects (t=-5.197, p=.000) and too shallow errors (t=-2.948, p=.008) in the group to which the C-step was applied. In conclusion, mounting a C-step on the main stretcher seems to help improve the quality of chest compression, and it is thought that this will increase the efficiency of chest compression.

Scintigraphic Findings of Nineteen Cases of Ectopic Thyroid (이소갑상선 19예의 신티그라피 소견)

  • Cho, In-Ho;Yoon, Hyun-Dae;Won, Kyu-Chang;Lee, Chan-Woo;Lee, Hyoung-Woo;Lee, Hyun-Woo;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.183-190
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    • 1993
  • Abnomalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid may be asymptomatic, local obstructive, hemorrhagic or other complication may occur. Radinuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required. In order to evaluate the features of ectopic thyroid, we investigated the scintigraphic findings, thyroid function test and clinical symptoms of 19 patients with ectopic thyroid. 1) Th frequency of ectopic thyroid was about 5.3 times more common in female than in male. Then patients were mostly below 30 years old (79%). 2) The frequency of location of ectopic thyroid were as follows: 10 cases in the tongue base, 1 case in suprahyoid, 5 cases in infrahyoid and 3 cases over 2 areas. 3) The thyroid function test was done in 16 cases of the ectopic thyroid patients. The hypothyroidism was detected in 7 cases, subclinical hypothyroidism in 4 cases and normal thyroid function in 5 cases. 4) The rate of hypothyroidism is 90% in the lingual thyroid and 33% in the others. The thyroid dysfunction was related with the location of the ectopic thyroid (p < 0.05). 5) The clinical manifestations include a mass in the tongue base, the foreignbody sensation of a throat and a swallowing difficulty in lingual thyroid. The palpable mass was the chief complaint in the others. 6) We prescribed the thyroid hormone to 10 cases with hypothyroidism. The ectopic thyroid was removed in 2 cases with normal thyroid function. The rest is following up through OPD. We must consider the possibility of the ectopic thyroid and take the thyroid scan when the patient has a mass in the tongue base, the sublingual and the prelaryngeal area. Then we have to check the thyroid function and follow up when the ectopic thyroid is diagnosed, because the patient with normal thyroid function can result in the hypothyroidism. Except these, we must mind of the possibility of occurence of the cancer in the ectopic thyroid tissue.

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A Study of Image Quality Improvement Through Changes in Posture and Kernel Value in Neck CT Scanning (경부 CT검사 시 Kernel 값과 검사자세 변화를 통한 화질개선에 관한 연구)

  • Kim, Hyeon-Ju;Chung, Woo-Jun;Cho, Jae-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.59-66
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    • 2011
  • There is a difficulty because of classifying the anatomical structure in the neck CT scan by the beam hardening artifact no more than disease and it including the 6, 7 number cervical spine and intervertebral disk. In case of enforcing the neck CT scan cause of the inner diameter of beam artifact tried to be inquired by the image evaluation according to the change of the image evaluation according to the direction of the shoulder joint applying the variation method of a posture and location and Kernel value and it was most appropriate, the lion tax and Kernel value try to be searched for through an experiment. Somatom Sensation 16 (Siemens, Enlarge, Germany) equipment was used in a patient 30 people coming to the hospital for the neck CT scan. A workstation used the AW 4.4 version (GE, USA). According to a direction and location of the shoulder joint, the patient posture gave a change to the direction of the shoulder joint as the group S it gave a change as three postures and placed the both arms comfortably and helps a group N and augmented unipolar left in the wealthy merchant and group P it memorized the both hands and ordered the eversion and drops below to the utmost and enforced a scan. By using a reconstructing method as the second opinion, it gave and reconstructed the Kernel value a change based on scan data with B 10 (very smooth), B 20 (smooth), B 30 (medium smooth), B 40 (medium), B 50 (medium sharp), B 60 (sharp), and B 70 (very sharp). By using image data which gave the change of the examination posture and change of the Kernel value and are obtained, we analyzed through the noise value measurement and image evaluation of. The outside wire eversion orders the both hands and the examination posture is cost in the neck CT scan with the group P it drops below to the utmost. And in case of when reconstructing with B 40 (medium) or B 50 (medium sharp) being most analyzed into the inappropriate posture and Kernel value and applying the Kernel value to a clinical, it is considered to be very useful.

The Clinical Outcome of Dedifferentiated Chondrosarcoma (역분화 연골육종의 임상 결과)

  • Kong, Chang-Bae;Lee, Seung Yong;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.164-171
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    • 2019
  • Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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A Study of the Construction of Nursing Theory in Korean Culture - View of Medicine- (한국문화에 따른 간호정립을 위한 기초조사연구 III -의료관을 중심으로-)

  • Park, Jeong-Sook;Ok, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.143-162
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    • 1998
  • This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

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Prognostic Factors in Liposarcomas: A Retrospective Study of 52 Patients (지방육종의 예후 인자: 52예 후향적 연구)

  • Chung, Yang-Guk;Kang, Yong-Koo;Bahk, Won-Jong;Rhee, Seung-Koo;Lee, An-Hi;Park, Jung-Mee;Kim, Min-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.14-20
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    • 2010
  • Purpose: To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas. Materials and Methods: Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation. Results: The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis. Conclusion: Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.

Diagnostic Value of Transbronchial Lung Biopsy -Including Diagnostic Yield According to Tumor-bronchus Relationship- (경기관지폐생검의 진단적 가치 -병변과 기관지의 관계에 따른 진단율을 포함한 연구-)

  • Kang, Tae-Kyong;Cha, Seung-Ick;Park, Jae-Yong;Chae, Sang-Chul;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.438-447
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    • 2000
  • Background : Transbronchial lung biopsy (TBLB) is a relatively simple and convenient procedure to obtain lung tissue from a patient with diffuse or localized lesion on chest radiographs, whose disease cannot be diagnosed through routine tests. The authors tried to evaluate the diagnostic value of TBLB, especially, the concordance between CT scan and TBLB with respect to the location of the lesion and diagnostic yield according to tumor-bronchus relationship. Method : We reviewed the medical records, plain chest films, and chest CT scans of 278 patients who underwent TBLB at Kyungpook National University Hospital between January 1996 and June 1998. Results : One hundred and sixteen (41.7 %) patients were diagnosed by TBLB. Diagnostic yield of TBLB of malignant tumors tended to be higher than that of benign diseases (64.7% versus 53.9%, p=0.09). Of primary lung cancers, TBLB was more diagnostic in adenocarcinoma and small-cell carcinoma than other cell types (p<0.01) and, of benign diseases, more diagnostic in tuberculosis than in non-tuberculous diseases (p<0.05). There was no significant difference in the diagnostic rate according to the location of the tumor. The diagnostic rate tended to increase with the size of tumor (p=0.06). The diagnootic rate of TBLB did not differ according to the pattern of lesion in benign diseases. However, in malignant diseases TBLB was more diagnostic in diffuse/multiple nodular lesions than in localized lesions(p<0.05). According to the tumor-bronchus relationship, TBLB was more diagnootic in type I/II groups than in other types. CT scan and TBLB showed a strong correlation with respect to the localization of the lesion (r=0.994, p<0.01). Conclusion : The above results show that TBLB is useful in the diagnosis of lung disease. CT scan and TBLB showed a strong correlation in determining the location of the lesion. Diagnostic yield of TBLB is higher in lesions with 'bronchus sign' (type I and II). TBLB and other diagnootic methods such as transthoracic needle aspiration are expected to complement one another in the diagnosis of lung diseases.

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Outcome of Conservative Treatment of the Zone I, II 5th Metatarsal Base Fracture under Early Weight-Bearing (제5 중족골 제1, 2 구역 골절의 조기 체중부하의 비수술적 치료 결과)

  • Gwak, Heui-Chul;Park, Dae-Hyun;Kim, Jung-Han;Lee, Chang-Rack;Kwon, Yong-Uk;Kim, Dong-Seok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.150-156
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    • 2021
  • Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

DIFFERENT WAYS OF SURGICAL MANAGEMENT FOR CHILDREN WITH CONFOUND ODONTOMA IN THE MANDIBLE (아동의 하악골에 발생한 복합 치아종의 외과적 처치에 관한 증례보고)

  • Chung, Woo-Sung;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.499-506
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    • 1999
  • The odontoma is relatively a common benign odontogenic tumor and caused by overgrowth of odontogenic tissues. The recent classification by World Health Organization divides odontoma into 2 groups such as compound odontoma and complex odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. The etiology of odontoma is unknown and almost asymptomatic. So, it usually is found in routine radiographic examination, and most common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth. It can occurs almost anywhere in jaws. It is desirable that odontoma should be removed by surgical enucleation including follicle and surrounding soft tissues. Considering the age and behavioral cooperation of patient, the development of permanent dentition, the location of odontoma in jaw, the need for the concomitant operative dentistry, operation is performed in outpatient department with/without sedation or under general anesthesia with endotracheal intubation. In this case report, 2 patients with compound odontoma were treated by surgical enucleation including follicle and surrounding soft tissues. One patient, about 5 years old, was treated under general anesthesia and concomitant operative dentistry was performed. The other patient, about 11 years old, was treated under local anesthesia in outpatient department. In 2 cases, after 4 months, surgical defects were filled with new bone and normalization of eruption path of impacted permanent teeth was observed.

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