• Title/Summary/Keyword: Regional Medical Center

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FLT3-ITD Mutations in Acute Myeloid Leukemia Patients in Northeast Thailand

  • Kumsaen, Piyawan;Fucharoen, Goonnapa;Sirijerachai, Chittima;Chainansamit, Su-on;Wisanuyothin, Nittaya;Kuwatjanakul, Pichayanan;Wiangnon, Surapon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4395-4399
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    • 2016
  • The FLT3-ITD mutation is one of the most frequent genetic abnormalities in acute myeloid leukemia (AML) where it is associated with a poor prognosis. The FLT3-ITD mutation could, therefore, be a potential molecular prognostic marker important for risk-stratified treatment options. We amplified the FLT3 gene at exon 14 and 15 in 52 AML patients (aged between 2 months and 74 years) from 4 referral centers (a university hospital and 3 regional hospitals in Northeast Thailand), using a simple PCR method. FLT3-ITD mutations were found in 10 patients (19.2%), being more common in adults than in children (21.1% vs. 14.3%) and more prevalent in patients with acute promyelocytic leukemia (AML-M3) than AML-non M3 (4 of 10 AML-M3 vs. 6 of 42 AML-non M3 patients). Duplication sequences varied in size-between 27 and 171 nucleotides (median=63.5) and in their location. FLT3-ITD mutations with common duplication sequences accounted for a significant percentage in AML patients in northeastern Thailand. This simple PCR method is feasible for routine laboratory practice and these data could help tailor use of the national protocol for AML.

Relationship Between Body Image and Self-esteem in Patients with Chronic Renal Failure (만성신부전증 환자의 신체상과 자아존중감의 관계)

  • Sohn Sue-Kyung;Lee Myung-Hwa;Song Myung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.2
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    • pp.160-171
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    • 2001
  • Purpose: The purpose of study was to identify the relationship between body image and self-esteem in patients with chronic renal failure. Method The subjects of study were 97 patients with chronic renal failure who were outpatients at K medical center. B hospital, H hospital in Busan. Data were collected from Nov 15th to Dec. 17th, 1999. The instruments used for study were the Body Cathexis Scale and Rogenberg's Self-esteem Scale. Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, and Pearson's correlation coefficients. Result: 1 The mean score for body image was $137.46{\pm}22.21$, the mean mark $2.92{\pm}0.47$, and the mean score of self-esteem was $30.80{\pm}8.76$, the mean mark $3.08{\pm}0.87$. 2. There was a significant difference in the score for body image according to educational level (F=5.189, P=.002) and type of residence (F=6.095. P=.001). 3. There was a significant difference in the score for self-esteem according to age (F=3.615, P=.009), educational level (F= 4.772, P=.004), marital status (F=3.498 P=.019) and presence of children (F=2.511, P=.014). 4. Body image in patients with chronic renal failure patients showed significant correlation with self-esteem (r=.519, P=.000). Conclusion: From this study, a relationship between body image and self-esteem in patients with chronic renal failure was identified. Therefore, nursing interventions are needed to promote body image and self esteem in patients with chronic renal patients.

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Sympatric Distribution of Three Human Taenia Tapeworms Collected between 1935 and 2005 in Korea

  • Jeon, Hyeong-Kyu;Kim, Kyu-Heon;Chai, Jong-Yil;Yang, Hyun-Jong;Rim, Han-Jong;Eom, Kee-Seon S.
    • Parasites, Hosts and Diseases
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    • v.46 no.4
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    • pp.235-241
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    • 2008
  • Taeniasis has been known as one of the prevalent parasitic infections in Korea. Until recently, Taenia saginata had long been considered a dominant, and widely distributed species but epidemiological profiles of human Taenia species in Korea still remain unclear. In order to better understand distribution patterns of human Taenia tapeworms in Korea, partial nucleotide sequences of mitochondrial cox1 and ITS2 (internal transcribed spacer 2) were determined, along with morphological examinations, on 68 Taenia specimens obtained from university museum collections deposited since 1935. Genomic DNA was extracted from formalin-preserved specimens. Phylogenetic relationships among the genotypes (cox1 haplotype) detected in this study were inferred using the neighbor-joining method as a tree building method. Morphological and genetic analyses identified 3 specimens as T. solium, 51 specimens as T. asiatica, and 14 specimens as T. saginata. Our results indicate that all 3 Taenia tapeworms are sympatrically distributed in Korea with T. asiatica dominating over T. saginata and T. solium.

A Study of Predicting the Severity Following Glufosinate Ammonium Containing Herbicide Poisoning Experienced in Single Emergency Medical Institution (단일 응급의료기관에서 경험한 글루포시네이트 암모니움 포함 제초제 중독 후 중증도 예측에 관한 연구)

  • Lee, Doo Sung;Choi, Kyoung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.7-13
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    • 2019
  • Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

Utility of Spinal Injury Diagnosis Using C-Spine Lateral X-Ray and Chest, Abdomen and Pelvis Computed Tomography in Major Trauma Patients with Impaired Consciousness

  • Jang, Yoon Soo;So, Byung Hak;Jeong, Won Jung;Cha, Kyung Man;Kim, Hyung Min
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.151-158
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    • 2018
  • Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

Association between single-person households in the elderly and unmet medical need (고령층 1인 가구 여부와 미충족의료의 연관성)

  • Bon Hee Gu;Min Soo kim;Hyeon Ji Lee;Jae Hyun Kim
    • Korea Journal of Hospital Management
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    • v.29 no.1
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    • pp.46-55
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    • 2024
  • Objective: This study was conducted to provide basic data for the establishment of effective health policies for the unmet medical experience that may occur among the elderly depending on whether they live in a singleperson household or not. Methodology: This study used data from the 8th National Health and Nutrition Examination Survey (2019-2020) and excluded cases with missing values in variables for the total number of respondent participants of 15,469. Finally, 2,850 subjects aged 65 or older were selected for final analysis. This study examined the relationship between experiences of unmet medical needs, attempting to confirm the relationship between single-person households and unmet medical needs through subgroup analysis considering gender, age, and household income. Results: According to the results, in the case of single-person households, the odds ratio (OR) for unmet medical needs was significantly higher at 1.60 times (95% CI: 1.16-2.21). Upon conducting subgroup analyses for gender, age, and household income quintiles, the OR was significantly higher at 2.24 times (95% CI: 1.14-4.41) for males and 1.48 times (95% CI: 1.02-2.14) for females, statistically significant in both cases. For individuals aged 65-69, the OR was significantly higher at 1.90 times (95% CI: 1.04-3.47), but for those aged 70-74 and over 75, it was not statistically significant. In the case of households with 'low' income, the OR was higher at 1.62 times (95% CI: 1.16-2.26), and for 'middle' income, it was significantly higher at 3.21 times (95% CI: 1.08-9.51). Conclusion: This study confirmed that the experience of unmet medical care is high among men who make up single-person households and low-income seniors. Therefore, this study suggests that policies to expand medical services and support welfare for single-person households should be established to resolve these problems, showing that health policies that take into account individual and regional characteristics are needed to improve medical accessibility for single-person households.

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Spinal cord stimulation in chronic pain: technical advances

  • Isagulyan, Emil;Slavin, Konstantin;Konovalov, Nikolay;Dorochov, Eugeny;Tomsky, Alexey;Dekopov, Andrey;Makashova, Elizaveta;Isagulyan, David;Genov, Pavel
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.99-107
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    • 2020
  • Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

A study on the selection of candidates for public bases according to the spatial distribution characteristics Automated External Defibrillator in Daegu City (대구시 자동심장충격기 공간분포 특성에 따른 공공 거점후보지 선정 연구)

  • Beak, Seong Ryul;Kim, Jun Hyun
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.6
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    • pp.599-610
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    • 2020
  • The AED (Automated External Defibrillator) is not evaluated for spatial accuracy and temporal availability even if it is located within a building or a specific area that needed necessary to partition by spatial analysis and location allocation analysis. As a result of the analysis, the spatial analysis was performed using the existing public data of AED with applied the GIS location analysis method. A public institution (119 safety center, police box) was selected as a candidate for a public AED base that can operate 24 hours a day, 365 days a year according to the characteristics of each residential area. In addition, Thiessen Polygons were created for each candidate site and divided by regions. In the analysis of the service was analyzed regional in terms of accessibility to emergency medical services in consideration of the characteristics of AED, that emergency vehicles could arrive within 4 minutes of the time required for emergency medical treatment in most areas of the study area, but it did not areas outside of the city center. As a result, It was found that the operation of the AED base service center centered on vehicles of public institutions is effective for responding to AED patients at night and weekend hours. 19 Safety Center under and police box the jurisdiction of Daegu City to establish an AED service center for public institutions, location-based distance, attribute analysis, and minimization of overlapping areas that the method of using a vehicle appeared more efficient than using the existing walking type AED.

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

  • Kim, Hyung Tae;Kim, Sae Young;Byun, Gyung Jo;Shin, Byung Chul;Lee, Jin Young;Choi, Eun Joo;Choi, Jong Bum;Hong, Ji Hee;Choi, Seung Won;Kim, Yeon Dong
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.287-295
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    • 2017
  • Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results: Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions: Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.

The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription (징병 신체 검사시 집단 흉부 간접 방사선 촬영의 폐결핵 관련한 진단적 유용성)

  • Park, Sung Bin;Choi, Byeong-Kyoo;Ha, Keun Woo;Seo, Joon Beom
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.356-360
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    • 2005
  • Background : This study examined the clinical utility of using indirect chest radiography during a physical examination of new conscripts for determine the presence of pulmonary tuberculosis. Methods : Over an eight-month period, this study examined 25386 people who underwent a physical examination after conscription. The abnormal findings on mass miniature radiography were followed-up using direct chest radiography. The positive predictive value of mass miniature radiography and direct chest radiography was compared. The incidence, degree of infiltration and clinical outcome of active pulmonary tuberculosis were also evaluated during a follow-up examination. Results : The positive rate of mass miniature radiography was 1.19% (n=302). Various lesions were identified: Parenchymal lesions (n=109), mediastinal lesions (n=6), cardiovascular lesions (n=45), pleural lesions (n=49), bony lesions (n=90) and miscellaneous lesions (n=7). The incidence of active pulmonary tuberculosis by mass miniature radiography was 0.26% (n=67). The first diagnosis was made in 50 people; active pulmonary tuberculosis (n=42), pneumonia (n=1), a mediastinal mass (n=1), a rib fracture (n=2) and a pneumothorax (n=4). Most cases of active pulmonary tuberculosis were mildly infiltrated and either improved or were cured by the follow-up examination. Conclusion : Although mass miniature radiography in a physical examination after conscription has limitations, but it is a useful means for detecting the presence of early disease, particularly in active pulmonary tuberculosis.