• Title/Summary/Keyword: Regional Medical Center

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Classic Floating Elbow in Adults: A Case Series

  • Cho, Chul-Hyun;Min, Kyung-Keun
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.8-12
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    • 2015
  • Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

Fast Real-Time Cardiac MRI: a Review of Current Techniques and Future Directions

  • Wang, Xiaoqing;Uecker, Martin;Feng, Li
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.252-265
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    • 2021
  • Cardiac magnetic resonance imaging (MRI) serves as a clinical gold-standard non-invasive imaging technique for the assessment of global and regional cardiac function. Conventional cardiac MRI is limited by the long acquisition time, the need for ECG gating and/or long breathhold, and insufficient spatiotemporal resolution. Real-time cardiac cine MRI refers to high spatiotemporal cardiac imaging using data acquired continuously without synchronization or binning, and therefore of potential interest in overcoming the limitations of conventional cardiac MRI. Novel acquisition and reconstruction techniques must be employed to facilitate real-time cardiac MRI. The goal of this study is to discuss methods that have been developed for real-time cardiac MRI. In particular, we classified existing techniques into two categories based on the use of non-iterative and iterative reconstruction. In addition, we present several research trends in this direction, including deep learning-based image reconstruction and other advanced real-time cardiac MRI strategies that reconstruct images acquired from real-time free-breathing techniques.

A Comparative Study to Evaluate a Simple Method for the Management of Postoperative Bleeding Following Palatoplasty

  • Rossell-Perry, Percy;Schneider, William J.;Gavino-Gutierrez, Arquimedes M.
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.263-266
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    • 2013
  • Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate.

Pheochromocytoma with Brain Metastasis: A Extremely Rare Case in Worldwide

  • Cho, Yun Seong;Ryu, Hyang Joo;Kim, Se Hoon;Kang, Seok-Gu
    • Brain Tumor Research and Treatment
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    • v.6 no.2
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    • pp.101-104
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    • 2018
  • Pheochromocytoma (PCC) is a neuroendocrine tumor that mainly arises from the medulla of the adrenal gland. Some PCCs become malignant and metastasize to other organs. For example, it typically involves skeletal system, liver, lung, and regional lymph nodes. However, only a few cases of PCC with brain metastasis have been reported worldwide. We report a case of metastatic brain tumor from PCC in South Korea in 2016. A 52-year-old man presented with headache, dizziness and motor aphasia. He had a medical history of PCC with multi-organ metastasis, previously underwent several operations, and was treated with chemotherapy and radiotherapy. Brain MRIs showed a brain tumor on the left parietal lobe. Postoperative pathology confirmed that the metastatic brain tumor derived from malignant PCC. This is the first report PCC with brain metastasis in South Korea.

Geographic Distribution and Epidemiology of Lung Cancer During 2011 in Zhejiang Province of China

  • Lin, Xia-Lu;Chen, Yan;Gong, Wei-Wei;Wu, Zhao-Fan;Zou, Bao-Bo;Zhao, Jin-Shun;Gu, Hua;Jiang, Jian-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5299-5303
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    • 2014
  • Background: To explore etiology for providing scientific clues for the prevention of lung cancer. Materials and Methods: Data for lung cancer incidence and meteorological geographic factors from 25 counties in Zhejiang province of China during 2011 were studied. Stepwise multiple regression and correlation analysis were performed to analyze the geographic distribution and epidemiology of lung cancer. Results: 8,291 new cases (5,998 in males and 2,293 females) of lung cancer during 2011 in Zhejiang province were reported in the 25 studied counties. Reported and standardized incidence rates for lung cancer were 58.0 and 47.0 per 100,000 population, respectively. The incidence of lung cancer increased with age. Geographic distribution analysis shows that the standardized incidence rates of lung cancer in northeastern Zhejiang province were higher than in the southwestern part, such as in Nanhu, Fuyang, Wuxing and Yuyao counties, where the rates were more than 50 per 100,000 population. In the southwestern Zhejiang province, for instance, in Yueqing, Xianju and Jiande counties, the standardized incidence rates of lung cancer were lower than 37 per 100,000 population. Spearman correlation tests showed that forest coverage rate, air quality index (AQI), and annual precipitation level are associated with the incidence of lung cancer. Conclusions: Lung cancer in Zhejiang province shows obvious regional differences. High incidence appears associated with low forest coverage rate, poor air quality and low annual precipitation. Therefore, increasing the forest coverage rate and controlling air pollution may play an important role in lung cancer prevention.

Morphologic and Genetic Identification of Diphyllobothrium nihonkaiense in Korea

  • Jeon, Hyeong-Kyu;Kim, Kyu-Heon;Huh, Sun;Chai, Jong-Yil;Min, Duk-Young;Rim, Han-Jong;Eom, Kee-Seon S.
    • Parasites, Hosts and Diseases
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    • v.47 no.4
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    • pp.369-375
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    • 2009
  • Diphyllobothrium nihonkaiense was first described by Yamane in 1986 but the taxonomical features have been obscure due to lack of critical morphologic criteria in its larval and adult stages. In Korea, this tapeworm had long been known as Diphyllobothrium latum. In this study, we observed 62 specimens collected from Korean residents and analyzed them by morphological features and nucleotide sequences of mitochondrial cox1 gene as well as the ITS1 region. Adult tapeworms were examined after carmine or trichrome stain. Longitudinal sections of the gravid proglottids showed an obtuse angle of about 150 degree between the cirrus sac and seminal vesicle. This angle is known as a major differential point compared with that of D. latum. Nucleotide sequence differences between D. latum and the specimens from Koreans represented 17.3% in mitochondrial DNA cox1 gene. Sequence divergence of ITS1 among 4 Korean isolates was 0.3% and similarity was 99.7% with D. nihonkaiense and D. klebanovskii. All of the Korean specimens analyzed in this study were identified as being D. nihonkaiense (n = 62). We propose its Korean name as "Dong-hae-gin-chon-chung" which means 'long tapeworm of the East Sea' for this newly analyzed diphyllobothriid tapeworm in Korea.

Characteristics of non-emergent patients at emergency departments (응급실을 이용하는 비응급환자의 실태와 특성)

  • Chung, Seol-Hee;Yoon, Han-Deok;Na, Baeg-Ju
    • Health Policy and Management
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    • v.16 no.4
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    • pp.128-146
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    • 2006
  • The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

Usage Status and Regional Variations of Acupotomy in a Korean Medicine Clinic: A Single-Center, Retrospective Analysis of Medical Records

  • Kang, Kyungho;Hwang, Jihyeon;Chu, Hongmin;Lee, Young-ung;Chae, Hyocheong;Lee, Jeong-youn;Lim, Kwanghwan;Jung, Sehun;Park, Seongjun;Choi, Seong-Hun;Mun, Ju hyeon;Kim, Jaehyo;Ryu, Myungseok
    • Journal of Acupuncture Research
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    • v.39 no.1
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    • pp.36-39
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    • 2022
  • Background: Acupotomy is a type of acupuncture where a scalpel-shaped needle (miniscalpel needle) is used instead of a normal acupuncture needle to exfoliate adhesion sites or to relax entrapped regions. This study aimed to identify the descriptive characteristics of patients who received acupotomy treatment at a single Korean Medicine Clinic. Methods: This retrospective review analyzed the medical charts of patients who had received acupotomy at least once from August 2017 to December 2019 at a single Korean Medicine Clinic. The demographic characteristics, chief complaints, acupotomy treatment sites, and principal diagnosis codes were analyzed. Results: We identified 551 outpatients; the average age was 52 ± 14.26 years and 49.9% were male. The patients underwent an average of 8.47 sessions of acupotomy. Altogether, 35.91% of the acupotomy treatments were administered to the spinal regions, of which 60.01% were in the lumbar region. The codes related to the lumbar spinal condition/disease which were used most frequently. The chief complaints were dizziness, lumbar spinal stenosis, and Dupuytren's contracture in patients over 60 years of age. Conclusion: This is the 1st analysis of acupotomy treatment patterns in Korea to date. Acupotomy is primarily administered in the treatment of spinal conditions/diseases, especially for those involving the lumbar region. Future studies are necessary to determine the clinical outcomes of patients who receive acupotomy treatment and the safety of this treatment.

Job Analysis of Coordinator Working in the Regional Cardiocerebrovascular Center (권역별 심뇌혈관질환센터 코디네이터 직무분석)

  • Cho, Kyung-Sook;Kwon, Sung-Bok;Lee, Kun Sei;Son, Haeng-Mi
    • Journal of muscle and joint health
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    • v.21 no.2
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    • pp.153-163
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    • 2014
  • Purpose: This study was to analyze the job of coordinators working in the regional cardiocerebrovascular center. Methods: Using Developing a Curriculum (DACUM) method, the role of coordinators was defined and their duties and tasks were identified. The developed duties and tasks were classified and validated according to importance, difficulty, and frequency of the job. Results: A coordinator is defined as a clinical nurse specialist affiliated in a cardiocerebrovascular center. The coordinator is responsible for managing the major critical pathway to provide adequate medical service and providing education to the patient with myocardial infarction and cerebrovascular attack admitted via emergency room for prevention and management of disease. Ten duties and sixty-nine tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks showed as A, B, C respectively. Based on determinant coefficient of the task, the highest ranked task was 'analysis for variation of CP' and the lowest was'investing the articles in stock'. Conclusion: The results of study showed that coordinators were doing various duties and tasks and they felt burden from their work and were in confusion. The results of this study can be used to develop training programs for coordinators and evaluation-scale of the coordinators' job performance as the basic data.

Initial Experiences of Extracorporeal Membrane Oxygenation for Trauma Patients at a Single Regional Trauma Center in South Korea

  • Ko, Ji Wool;Park, Il Hwan;Byun, Chun Sung;Jang, Sung Woo;Jun, Pil Young
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.162-169
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    • 2021
  • Purpose: For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods: We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients' characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results: The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions: If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.