• Title/Summary/Keyword: Regional Medical Center

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Cardiovascular Manifestations and Clinical Course after Acute Carbon Monoxide Poisoning (급성 일산화탄소 중독에 의한 심혈관계 독성의 임상 양상 및 경과)

  • Lee, In Soo;Jung, Yoon Seok;Min, Young Gi;Kim, Gi Woon;Choi, Sang Cheon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.103-110
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    • 2012
  • Purpose: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. Methods: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. Results: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echo cardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patients were discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were $2.53{\pm}2.29$ and $2.19{\pm}2.12$, respectively (p=0.860). Conclusion: Cardiovascular manifestations occur after acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant in itself in the clinical course, and the short-term prognosis of cardiac toxicity is unlikely to be unfavorable in acute CO poisoning.

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Radiotherapy and Concurrent Chemo-Radiotherapy in Locally Advanced Hypopharyngeal Cancers - A Hospital Registry Based Analysis

  • Sharma, Jagannath Dev;Krishnatreya, Manigreeva;Das, Ashok Kumar;Bhattacharyya, Mouchumee;Hazarika, Munlima;Kataki, Amal Chandra;Baishya, Nizara;Nandy, Pintu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4723-4726
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    • 2015
  • Background: The survival of patients with hypopharyngeal cancer is low amongst head and neck cancer cases. The incidence rates of hypopharyngeal cancers in our population are amongst the highest in the world and there are limited data available on the literature on varied responses to first course of treatment with radiotherapy (RT) and concurrent chemo-radiotherapy (CRT) in our population. Materials and Methods: Clinical characteristics and initial responses to treatment in patients who had received radiotherapy and chemo-radiotherapy in a regional cancer center from January 2010 to December 2013 were evaluated. The data were obtained from the hospital cancer registry, and analysis was carried using descriptive statistics. Pearson's chi-square was used to test for differences in the variables and p<0.05 was considered statistically significant. Results: A total of 554 patients were included in the analysis, 411 (74.2%) receiving RT and 143 (25.8%) being given CRT. There was significantly lower number of patients above 70 years with a higher proportion of patients below 50 years who had received CRT (p<0.05). Some 79.3% and 84.6% of patients in the RT and CRT groups respectively presented with a favorable performance status, and in the RT group 240 (58.4%) showed complete response (CR), and in the CRT group 103 (72.0%) showed CR at the first follow-up (p<0.05). Conclusions: Concurrent chemo-radiotherapy gives better short term response to treatment in locally advanced hypopharyngeal cancers.

Characteristics and Nursing Activities of Severe Trauma Patients Regarding the Main Damaged Body Parts (중증외상환자의 주 손상 부위별 특성과 간호활동)

  • Kim, Myung Hee;Kim, Myung Hee;Park, Jung Ha
    • Journal of Korean Biological Nursing Science
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    • v.15 no.4
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    • pp.210-218
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    • 2013
  • Purpose: The purpose of this study was to identify the characteristics and nursing activities of severe trauma patients regarding damaged body parts in Busan Regional Emergency Medical Center. Methods: A survey using a 'trauma patient information questionnaire and a list of nurse activities' was conducted with 133 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. The collected data were analyzed by the SPSS/WIN 12.0 program. Results: Almost all of the subjects were men, and the mean age was 48.8. The amount of road traffic accidents was 60.4%, and the mean RTS and ISS were 6.08, and 23.14 points. Nursing activities in common were airway management, assessment of LOC & GCS, and EKG monitoring. Most of head and neck trauma patients were cared for manasing using intracranial pressure: each patience had the following assessed: pupil size and light reflex, they were checked the leak of CSF, kept $30^{\circ}$ head elevation, and administered medications. Some of chest trauma patients were treated for chest tube and central venous catheter insertion. Partial abdominal trauma patients were administered analgesic and cared for using arterial pressure measurement. Part of the limbs and pelvis trauma patients were given a blood transfusion. Conclusion: Based on the results, the characteristics and nursing activities were specific according to the specific damaged body parts.

Usefulness of Endoscopic Imaging to Visualize Regional Alterations in Acid Secretion of Noncancerous Gastric Mucosa after Helicobacter pylori Eradication

  • Uno, Kaname;Iijima, Katsunori;Abe, Yasuhiko;Koike, Tomoyuki;Takahashi, Yasushi;Ara, Nobuyuki;Shimosegawa, Tooru
    • Journal of Gastric Cancer
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    • v.16 no.3
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    • pp.152-160
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    • 2016
  • Purpose: Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC. We aimed to determine whether AFI might be an alternative to CRE for identification of high-risk areas of gastric carcinogenesis after eradication. Materials and Methods: We included 27 sequential patients with metachronous GC detected during endoscopic surveillance for a mean of 82.8 months after curative endoscopic resection for primary GC and eradication. After their H. pylori infection status was evaluated by clinical interviews and $^{13}C$-urea breath tests, the consistency in the extension of corpus atrophy (e.g., open-type or closed-type atrophy) between AFI and CRE was investigated as a primary endpoint. Results: Inconsistencies in atrophic extension between AFI and CRE were observed in 6 of 27 patients, although CRE revealed all GC cases in the ANA. Interobserver and intraobserver agreements in the evaluation of atrophic extension by AFI were significantly less than those for CRE. Conclusions: We demonstrated that AFI findings might be less reliable for the evaluation of gastric mucosa with malignant potential after eradication than CRE findings. Therefore, special attention should be paid when we clinically evaluate AFI findings of background gastric mucosa after eradication (University Hospital Medical Information Network Center registration number: UMIN000020849).

Analysis of L-asparaginase Related Adverse Reaction (L-asparaginase 약물 유해 반응 보고 분석)

  • Ko, Kyung Mi;La, Hyen O
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.143-149
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    • 2017
  • Background: L-asparaginase (L-ASP) is a critical agent for the treatment of acute lymphoblastic leukemia and lymphoma, which is associated with serious toxicities including hypersensitivity, pancreatitis and thrombosis. Methods: To evaluate the toxicity of L-ASP in real clinical settings, we included the patients with L-ASP adverse drug reactions (ADRs) reported in a regional pharmacovigilance center of Seoul St. Mary's hospital from January 2014 to December 2015. Results: A total of 83 cases of L-ASP related ADRs were reported in 54 patients. Of these 83 cases, 65 cases (78.3%, 65/83) were spontaneously reported and 18 cases (21.7%, 18/83) were detected by further medical records review. Of the patients with ADRs, pediatric patients accounted for 83.3% of the cases (45/54) and median age was 9 years. The most common clinical manifestations of ADRs were hematology manifestations (31.3%, 26/83), followed by hepatobiliary manifestations (18.1%, 15/83). Thirty-four serious ADRs were reported in 19 patients. The sserious ADR group showed significantly longer hospitalization and higher rate of discontinuation of L-ASP than the non-serious ADR group (p = 0.005, 0.03). The most common clinical manifestations of serious ADRs were hepatobiliary manifestations (41.2%, 14/34). In total, 8 cases (9.6%, 8/83) of unlabeled ADRs were identified. They were serious ADRs. Conclusion: We identified unlabeled serious ADRs of L-ASP. Also, correlations were observed between serious ADRs and length of hospitalization, discontinuation rate respectively. Further investigations and developed spontaneous ADR reporting systems are needed to evaluate these correlations.

A Study of Comparison of Features of Poor Group and Non-Poor group In the Self-support Program Participants - A Comparison of Men and Women - (지역자활센터 자활사업 참여자의 빈곤집단과 비빈곤집단의 특성 비교 - 성별 차이를 중심으로 -)

  • Lee, Mi-Young
    • Korean Journal of Social Welfare
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    • v.63 no.4
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    • pp.253-275
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    • 2011
  • The aim of this study is to examine the difference of features between poor group and non-poor group. And, it is examined whether there are man and woman's differences. The investigation targeted the person who were using 'Regional self-support center'. They were classified into poor and non-poor group depending on the participation pattern of the self-support programs. Using logistic regression technique, I analyzed the effects of a series of independent variables on the dependent variable of whether or not person is in poor group and then compared the analysis results. The findings and policy implications are as follows. First, it was found that the health condition of women has a significant effect on the likelihood of poverty. Therefore, it is necessary to support appropriate medical service and improvement of health condition to them. Second, the business career of women was one of the factors affecting. Whether the business career is or not, it is necessary to do different support. Third, like what has been known until now, care giving was found to be a heavy burden for woman.

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Reduced Gray Matter Density in the Posterior Cerebellum of Patients with Panic Disorder : A Voxel-Based Morphometry Study

  • Lee, Junghyun H.;Jeon, Yujin;Bae, Sujin;Jeong, Jee Hyang;Namgung, Eun;Kim, Bori R.;Ban, Soonhyun;Jeon, Saerom;Kang, Ilhyang;Lim, Soo Mee
    • Korean Journal of Biological Psychiatry
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    • v.22 no.1
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    • pp.20-27
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    • 2015
  • Objectives It is increasingly thought that the human cerebellum plays an important role in emotion and cognition. Although recent evidence suggests that the cerebellum may also be implicated in fear learning, only a limited number of studies have investigated the cerebellar abnormalities in panic disorder. The aim of this study was to evaluate the cerebellar gray matter deficits and their clinical correlations among patients with panic disorder. Methods Using a voxel-based morphometry approach with a high-resolution spatially unbiased infratentorial template, regional cerebellar gray matter density was compared between 23 patients with panic disorder and 33 healthy individuals. Results The gray matter density in the right posterior-superior (lobule Crus I) and left posterior-inferior (lobules Crus II, VIIb, VIIIa) cerebellum was significantly reduced in the panic disorder group compared to healthy individuals (p < 0.05, false discovery rate corrected, extent threshold = 100 voxels). Additionally, the gray matter reduction in the left posterior-inferior cerebellum (lobule VIIIa) was significantly associated with greater panic symptom severity (r = -0.55, p = 0.007). Conclusions Our findings suggest that the gray matter deficits in the posterior cerebellum may be involved in the pathogenesis of panic disorder. Further studies are needed to provide a comprehensive understanding of the cerebro-cerebellar network in panic disorder.

Survey on Intestinal Helminthic Infection Status of Students in Two Counties, Hadong-gun and Goseong-gun, Korea

  • Bahk, Young Yil;Park, Yun-Kyu;Na, Byoung-Kuk;Sohn, Woon-Mok;Hong, Sung-Jong;Chai, Jong-Yil;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • v.56 no.4
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    • pp.335-339
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    • 2018
  • This study was conducted to investigate the prevalence of intestinal parasites among students from Goseonggun, Gangwon-do and Hadong-gun, Gyeongsangnam-do as typical low and high endemic counties. From May to July 2017, a total of 2,033 fecal samples were collected at 27 elementary, 10 junior high, and 8 high schools from 2 counties and examined by the Kato-Katz technique for egg-positive surveys (Collection rate: 37.02% [2,033/5,492]). Of the participants examined, 13 (0.64%) were found to harbor eggs of 3 parasitic species, Trichuris trichiura, Clonorchis sinensis and Metagonimus yokogawai. Based on the regional distribution, the egg-positive rate in Goseong-gun was 0% (0/550) and that in Hadong-gun was 0.88% (13/1,483). The positive rates for C. sinensis, M. yokogawai, and T. trichiura in Hadonggun were 0.20% (3/1,483), 0.61% (9/1,483), and 0.07% (1/1,483), respectively. The present survey showed that the prevalence of parasitic infection among students is currently very low even in remote, previously endemic areas, and the present status of parasitic diseases can be summarized as some transmission of fish/food-borne trematodes. Thus, it is necessary to carefully, continuously monitor the trematode infection status, particularly of C. sinensis and M. yokogawai.

Complete Sequences of HIV-1 in a Korean Long-term Nonprogressor with HIV-1 Infection (장기간 진행하지 않는 인면역결핍바이러스(Human Immunodeficiency Virus, HIV)-1 감염자로부터 분리한 HIV-1의 전체 염기서열 결정)

  • Cho, Young-Keol;Lee, Hee-Jung;Desrosiers, Ronald C.
    • The Journal of Korean Society of Virology
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    • v.29 no.2
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    • pp.107-118
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    • 1999
  • To characterize the molecular nature of human immunodeficiency virus (HIV)-1, we determined the full-length HIV-1 sequences from cultured peripheral blood mononuclear cells (PBMC) of a Korean long-term nonprogressor (LTNP). Without antiretroviral therapy, the individual has maintained CD4+ T counts over $500/{\mu}l$ from 1989 to 1999. Plasma viral RNA copy was 992 U/ml in 1998. Culture supernatant showed positive from culture days 9. A series of 9 overlapping PCR products were amplified from cultured PBMC and cloned About 9.2 kb from R of 5' LTR to R of 3' LTR was determined by automated sequencing. The G-to-A hypermutations were shown throughout the entire region. As a result of G to A hypermutations, premature stop codon was found in integrase coding region. Though there was no recombination between subtypes over all genomes, TATA box in both LTRs was TAAAA which is detected in subtype E instead of TATAA in subtype B. And, there were nucleotide GC insertion between $NF-{\kappa}B$ I and Sp1 III, and duplication of $TCF-1{\alpha}$ in LTR. We could not find any deletion of amino acid in Nef, Gag, Pol and Env gene. This study is the first report on molecular nature of full genomes of HIV-1 isolated in Korea.

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A Study on the Level of Health Promotion to Introduce the WHO's Health Promoting Hospitals in Regional Public Hospitals (WHO 건강증진병원 사업 도입을 위한 전국지방의료원의 건강증진병원 환경 평가)

  • Lee, Dong-Won;Song, Jin-Sung;Nam, Eun-Woo
    • Korea Journal of Hospital Management
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    • v.15 no.2
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    • pp.44-60
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    • 2010
  • This research, which is designed to introduce the concept of the WHO's health promoting hospital project to Korea, was conducted in a total of 34 local hospitals across the nation. To evaluate the level of health promotion at hospitals, an evaluation index for health promoting hospital environments was made using the Analytic Hierarchy Process Decision-Making Method, from which a total of 20 questions were developed in the five areas of no-smoking, moderation in drink, exercise, nutrition and rest in Korea. Through this analysis, it was found that local hospitals across the nation were on average excellent in terms of their no-smoking environments, but poor in their rest and moderation in drink environments. A comparison of local public hospital environments by region showed that Busan, Daegu, and South Gyeongsang Province were good, while South Chungcheng Province, Jeju Province and Gwangwon Province were poor. In terms of the number of beds, mid-size local hospitals (200-299 beds) came first. This research revealed that local hospitals across the nation had different health promotion environments according to area and size, and in particular, their environments for rest and moderation in drink turned out to be lacking, which vividly showed that these areas desperately needed to be supplemented in order to introduce the concept of health promotion at hospitals in Korea.

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