• Title/Summary/Keyword: Regional Medical Center

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Environmental Investigation of a Long-term Care Hospital with Respect to COVID-19

  • Park, Min Woo;Shin, Seung Hwan;Cha, Jeong Ok;Lim, Hyeon Jeong;Kim, Jun Nyun
    • Journal of Environmental Health Sciences
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    • v.46 no.5
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    • pp.599-609
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    • 2020
  • Objectives: Coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan, China, and has rapidly become a global pandemic with over 26.4 million confirmed cases and approximately 871,000 fatalities worldwide as of this writing. In the Republic of Korea, disease clusters frequently occurred in long-term care hospitals where the majority of residents are elderly with underlying medical conditions. Despite the fact that public health authorities and local community health centers have put tremendous efforts into preventing the spread of disease, positive cases have continued to occur. Thus, the Korea Centers for Disease Control & Prevention rapid response team decided to conduct an environmental investigation of a long-term care hospital to identify whether environmental contamination has remained and contributed to the spread of COVID-19. Methods: An environmental investigation was conducted at Hospital A. The characteristics of the facility and its HVAC system were assessed by checking the layout and interviewing the people in charge. A total of 64 surface samples were collected from areas of concern, including patient rooms, toilets, elevators, and nurses' station. These samples were tested by a regional health and environmental research institute using real-time reverse transcription polymerase chain reaction. Results: All samples from Hospital A were confirmed to be negative. Through interviews with high-level personnel at the regional community health center, we found that extensive disinfection is frequently performed on potentially contaminated areas in Hospital A in accordance with government guidelines. Conclusion: The environmental control measures implemented in Hospital A had been sufficient for mitigating the risk of further infection, suggesting that such measures may also be effective for other long-term health care facilities.

Colorectal Cancer Patient Characteristics, Treatment and Survival in Oman - a Single Center Study

  • Kumar, Shiyam;Burney, Ikram A;Zahid, Khawaja Farhan;Souza, Philomena Charlotte D;Belushi, Muna AL;Mufti, Taha Dawood;Meki, Waeil AL;Furrukh, Muhammad;Moundhri, Mansour S AL
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4853-4858
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    • 2015
  • Background: Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. Materials and Methods: Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. Results: A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of $2^{nd}$ line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. Conclusions: The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.

Change in the Spatial Structure of Commercial Areas in Daegu (대구시 상업지역의 구조 변화)

  • Kim, Ta-Yeul;Jin, Won-Hyung
    • Journal of the Korean association of regional geographers
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    • v.14 no.4
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    • pp.367-381
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    • 2008
  • The purpose of this paper is to analyze the change in the distribution and hierarchical structure of commercial land use. Tools for analyzing the spatial structure are index of concentration, coefficient of localization and location quotient. This research is applied to Daegu, focusing on the period 1985-2003. During the 1985-2003 period, the growth rate of commercial land use volume amounted to 330%, compared with a population growth rate of 118%. The biggest component of commercial land use is the retail sector. As the lodging, medical, transportation-warehouse and entertainment sectors have the propensity for concentration and comprise the specialized commercial areas in the suburbs, the other sectors arc evenly distributed. Jung-gu has functioned as a downtown core in the hierarchical structure of commercial areas. So, in the structure of commercial land use, Daegu has continued to be a single nuclear structure. But, Dongdaegu Station influence area has evolved into the second order center since 2000. This is the sign of change in spatial structure from single-nuclear pattern to multi nuclear pattern.

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Gradual Reperfusion Lowers the Incidence of Reperfusion-Induced Ventricular Fibrillation in a Cat Model of Regional Ischemia

  • Kim, You-Ho;Na, Heung-Sik;Nam, Hyun-Jung;Hur, Gyu-Young;Lee, Seung-Whan;Park, Sung-Sook;Hong, Seung-Kil
    • The Korean Journal of Physiology and Pharmacology
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    • v.3 no.1
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    • pp.47-52
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    • 1999
  • Blood flow restoration to ischemic zone of the heart is essential to salvage of ischemic tissue. However, there is a large body of evidence documenting that the reperfusion can induce reperfusion injury like reperfusion-induced malignant arrhythmias. In the present study, employing a cat model of regional cardiac ischemia, we examined if reperfusion rendered in a gradual fashion could lower the incidence of reperfusion-induced ventricular fibrillation (VF), which usually precipitated within a few to several tens of seconds after abrupt reperfusion. The experiments were conducted with male mongrel cats (n=46, 2.5-5 kg). The animals in the control and 30 MIN groups were subjected to an episode of 20- and 30-min left anterior descending coronary artery occlusion, respectively, followed by abrupt reperfusion. The animals in 5 G and 10 G groups received gradual reperfusion over a 5- and 10-min period, respectively, following a 20-min occlusion. The proportion of animals that exhibited VF during the reperfusion phase was 11/15 in the control, 7/10 in the 30 MIN, 5/10 in the 5 G and 2/11 in the 10 G groups. The incidence of VF in the 10 G group was significantly lower than that in the control or 30 MIN group subjected to abrupt reperfusion. These results suggest that the gradual reperfusion is a useful procedure against reperfusion-induced VF.

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Metabolic Topography of Parkinsonism

  • Kim, Jae-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.141-151
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    • 2007
  • Parkinson's disease is one of the most frequent neurodegenerative diseases, which mainly affects the elderly. Parkinson's disease is often difficult to differentiate from atypical parkinson diorder such as progressive supranuclear palsy, multiple system atrophy, dementia with Lewy body, and corticobasal ganglionic degeneration, based on the clinical findings because of the similarity of phenotypes and lack of diagnostic markers. The accurate diagnosis of Parkinson's disease and atypical Parkinson disorders is not only important for deciding on treatment regimens and providing prognosis, but also it is critical for studies designed to investigate etiology and pathogenesis of parkinsonism and to develop new therapeutic strategies. Although degeneration of the nigrostriatal dopamine system results in marked loss of striatal dopamine content in most of the diseases causing parkinsonism, pathologic studies revealed different topographies of the neuronal cell loss in Parkisonism. Since the regional cerebral glucose metabolism is a marker of integrated local synaptic activity and as such is sensitive to both direct neuronal/synaptic damage and secondary functional disruption at synapses distant from the primary site of pathology, an assessment of the regional cerebral glucose metabolism with F-18 FDG PET is useful in the differential diagnosis of parkinsonism and evaluating the pathophysiology of parkisonism.

A Study on the Spatiotemporal Characteristics of a Hazard-based Index using the Pollutant Release and Transfer Register Data (화학물질 배출·이동량 자료를 이용한 유해기반 지수의 시공간 특성 연구)

  • Kim, Shijin;Lim, Yu-ra;Bae, Hyun-Joo
    • Journal of Environmental Health Sciences
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    • v.47 no.2
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    • pp.144-154
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    • 2021
  • Objectives: This study was intended to identify hazard contribution by region, media, and chemical by calculating a hazard-based index using pollutant release and transfer register (PRTR) data. Methods: PRTR data for the period 2011 to 2016 was analyzed to examine the regional trends in toxic releases in terms of quantity and to create a corresponding hazard-based index. For the hazard-based index, the Risk-Screening Environmental Indicators (RSEI) Model was used. Results: The results of the trend analysis show that total releases decreased slightly, but health hazard levels increased consistently. According to the outcome of regional contribution analysis of the hazard-based index, Chungcheongnam-do, Jeollabuk-do and Gyeonggi-do Provinces showed a high ratio in the index for air and water release pollutants, while Gyeongsangbuk-do and Gyeongsangnam-do Provinces showed a high ratio in the index of soil release and waste transfer pollutants. Also, as a result of the analysis of the top ranked substances in the hazard-based index, it was found that chromium, cobalt and its compounds, and ethylene oxide contributed greatly to air release substances, while chromium, benzene, and lead and its compounds contributed greatly to water release substances. Conclusion: These results showed considerable disparities between total release and health hazard levels, especially in the analysis of contribution by regions and by chemical substance. Therefore, the hazard-based index should be used both to support a more comprehensive and robust approach to screening of chemicals for environmental health policy and for management.

Relationship Between Blood Mercury Concentration and Waist-to-Hip Ratio in Elderly Korean Individuals Living in Coastal Areas

  • You, Chang-Hun;Kim, Byoung-Gwon;Kim, Jung-Man;Yu, Seung-Do;Kim, Yu-Mi;Kim, Rock-Bum;Hong, Young-Seoub
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.5
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    • pp.218-225
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    • 2011
  • Objectives: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. Methods: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. Results: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) ${\mu}g$/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) ${\mu}g$/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] ${\mu}g$/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. Conclusions: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.

Total and Partial Prevalence of Cancer Across Kerman Province, Iran, in 2014, Using an Adapted Generalized Network Scale-Up Method

  • Vardanjani, Hossein Molavi;Baneshi, Mohammad Reza;Haghdoost, AliAkbar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5493-5498
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    • 2015
  • Due to the lack of nationwide population-based cancer registration, the total cancer prevalence in Iran is unknown. Our previous work in which we used a basic network scale-up (NSU) method, failed to provide plausible estimates of total cancer prevalence in Kerman. The aim of the present study was to estimate total and partial prevalence of cancer in southeastern Iran using an adapted version of the generalized network scale-up method. A survey was conducted in 2014 using multi-stage cluster sampling. A total of 1995 face-to-face gender-matched interviews were performed based on an adapted version of the NSU questionnaire. Interviewees were asked about their family cancer history. Total and partial prevalence were estimated using a generalized NSU estimator. The Monte Carlo method was adopted for the estimation of upper/lower bounds of the uncertainty range of point estimates. One-yr, 2-3 yr, and 4-5 yr prevalence (per 100,000 people) was respectively estimated at 78 (95%CI, 66, 90), 128 (95%CI, 118, 147), and 59 (95%CI, 49, 70) for women, and 48 (95%CI, 38, 58), 78 (95%CI, 66, 91), and 42 (95%CI, 32, 52) for men. The 5-yr prevalence of all cancers was estimated at 0.18 percent for men, and 0.27 percent for women. This study showed that the generalized familial network scale-up method is capable of estimating cancer prevalence, with acceptable precision.

Spiritual Care Guide in HospiceㆍPalliative Care

  • Kyung-Ah Kang;Do-Bong Kim;Su-Jin Koh;Myung-Hee Park;Hye Yoon Park;Deuk Hyoung Yoon;Soo-Jin Yoon;Su-Jeong Lee;JI-Eun Choi;Hyoung-Suk Han;Jiyoung Chun
    • Journal of Hospice and Palliative Care
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    • v.26 no.4
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    • pp.149-159
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    • 2023
  • The Spiritual Care Guide in HospiceㆍPalliative Care is evidence-based and focuses on the universal and integral aspects of human spirituality-such as meaning and purpose, interconnectedness, and transcendence-which go beyond any specific religion. This guide was crafted to improve the spiritual well-being of adult patients aged 19 and older, as well as their families, who are receiving end-of-life care. The provision of spiritual care in hospice and palliative settings aims to assist patients and their families in finding life's meaning and purpose, restoring love and relationships, and helping them come to terms with death while maintaining hope. It is recommended that spiritual needs and the interventions provided are periodically reassessed and evaluated, with the findings recorded. Additionally, hospice and palliative care teams are encouraged to pursue ongoing education and training in spiritual care. Although challenges exist in universally applying this guide across all hospice and palliative care organizations in Korea-due to varying resources and the specific environments of medical institutions-it is significant that the Korean Society for Hospice and Palliative Care has introduced a spiritual care guide poised to enhance the spiritual well-being and quality of care for hospice and palliative care patients.

Management of Diabetic Mellitus in Low-income Rural Patients (일개 농촌지역 저소득층 당뇨병환자의 관리 상태)

  • Kim, Hye-Yeon;Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Ahn, Hye-Ran;Choi, Seong-Woo;Lee, Young-Hoon;Cho, Dong-Hyeok;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.