• Asian Pacific Journal of Cancer Prevention
• /
• 제13권12호
• /
• pp.6333-6336
• /
• 2012

The burden of cancer is growing globally and is one of the top leading causes of death. Information on cancer patterns are essential for effective planning of cancer control interventions. There is limited published information available on pattern of cancer for the state of Odisha, India. The present study was an attempt to explore the pattern and trend of cancer in Odisha. To fulfill the objectives retrospective data available from 2001-2011 at Acharya Harihar Regional Cancer Center (AHRCC), Cuttack, Odisha, were analyzed. Medical records of cancer patients were reviewed and relevant information on diagnosis, primary site and demographic data were retrieved. Data were entered and analyzed using SPSS 16.0 (SPSS Inc.). A total of 74,861 cancer inpatients were registered at AHRCC for the years 2001-2011. The proportion of females outnumbered males with female:male ratio 1.1:1. The number of female cases increased four folds and that of males three fold over the period studied. Malignancies such as oral cancer (16.93%), acute lymphocytic leukemia/non Hodgkins lymphoma (14.09%) and cancer of gastrointestinal tract (21.07%) are leading cancers among males and carcinomas of breast (28.94%), cervix (23.66%) and ovary (16.11%) were leading among females. Findings from this study indicate an overall increase in cancer reporting which could be regarded as proxy measure for overall cancer situation in Odisha. There is scope and need for integrating other government hospitals, existing private health service providers and research institutions across the state for better planning of cancer control program.

• Journal of Korean Neurosurgical Society
• /
• 제65권1호
• /
• pp.22-29
• /
• 2022

Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

• Journal of Genetic Medicine
• /
• 제18권2호
• /
• pp.110-116
• /
• 2021

Microdeletions of chromosome 22q11.2 are one of the most common microdeletions occurring in humans, and is known to be associated with a wide range of highly variable features. These deletions occur within a cluster of low copy repeats (LCRs) in 22q11.2, referred to as LCR22 A-H. DiGeorge (DGS)/velocardiofacial syndrome is the most prevalent form of a 22q11.2 deletions, caused by mainly proximal deletions between LCR22 A and D. As deletions of distal portion to the DGS deleted regions has been extensively studied, the recurrent distal 22q11.2 microdeletions distinct from DGS has been suggested as several clinical entities according to the various in size and position of the deletions on LCRs. We report a case of long-term follow-up of a female diagnosed with a 22q11.2 distal deletion syndrome, identified a deletion of 1.9 Mb at 22q11.21q11.23 (chr22: 21,798,906-23,653,963) using single nucleotide polymorphism array. This region was categorized as distal deletion type of 22q11.2, involving LCR22 D-F. She was born as a preterm, low birth weight to healthy non-consanguineous Korean parents. She showed developmental delay, growth retardation, dysmorphic facial features, and mild skeletal deformities. The patient underwent a growth hormone administration due to growth impairment without catch-up growth. While a height gain was noted, she had become overweight and was subsequently diagnosed with pre-diabetes. Our case could help broaden the genetic and clinical spectrum of 22q11.2 distal deletions.

• 대한통합의학회지
• /
• 제10권1호
• /
• pp.39-48
• /
• 2022

Purpose : This study aimed to determine the experiences of the disaster response team 9 participants who participated in the disaster after the fire incident occurred in Jecheon Sports Center and their meaning and essence. Methods : Nine disaster response teams were the subjects of the study, and Individual in-depth interviews were conducted. Data were collected online between January 6 and April 30, 2021, from the software Zoom^TM. This study was conducted as a qualitative study by applying Giorgi's phenomenological experiential research method, which has an advantage in revealing the essential structure and meaning of experience. Results : Three major themes were derived from the study results: the stimulus through unfamiliar experiences, the grievances due to work environment and regional characteristics, and dullness resulting from hiding and enduring. The following 17 sub-themes were identified: learning through unfamiliar experiences, frustration due to unexpected circumstances, shock from unfamiliar experiences, doing my best in the present, confidence due to increased experience, disunified system, intervention of various interests, the atmosphere that puts responsibility on others, inactive help, unforgettable regional characteristics, working without time to settle, tolerating it in my own way, memories left in the unconsciousness, sudden suffering from memories that come to mind, movement in anxiety and tension, dullness, work with colleagues in the same situation. Conclusion : This study is meaningful in that it attempted to provide basic data in preparing a long-term strategy for effective policy direction and institutional protection based on the systematic mental health management of the disaster response team. Additionally, this study's results can be used as primary data for future research among Disaster Response Team.

• Journal of Hospice and Palliative Care
• /
• 제25권2호
• /
• pp.85-97
• /
• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• 한국의료질향상학회지
• /
• 제21권2호
• /
• pp.40-56
• /
• 2015

Objectives: To outline overall duties of quality improvement (QI) performers within a health care organization, thus describing their key tasks, including task element-related frequency, importance and difficulty in enough detail. Methods: A DACUM (Developing A CurriculUM) workshop took place to outline overall job activities of QI performers. To examine the scope of their duty and task, we performed a questionnaire survey of 338 QI performers from 111 hospitals. Results: The results of our survey showed that for the task assigned to each QI performer, there were 10 duties, 31 tasks and 119 task elements. Respondents cited a project planning as the most frequent/important duty, and a research was the highest level of difficulty in their duty. They also said that the most frequent task was index management, the most important task was a business plan, and the highest level of difficulty was a practical application of QI research. QI performers added that the most frequent task element was receipt of patient safety reporting in patient safety system, the most important task element was an analysis for patient safety and its improvement, and the highest level of difficulty was a regional influence analysis related to the patient safety and its improvement. Conclusion: To ensure that QI performers play a pivotal role as a manager to better improve patient safety and the quality of health care services, proper training program for them should be developed by reflecting the results of our study.

• Journal of Radiation Protection and Research
• /
• 제47권2호
• /
• pp.67-76
• /
• 2022

Background: We conducted a cross-sectional study of residents within and outside Fukushima Prefecture to clarify their perceptions of the need for smartphone applications (apps) for explaining exposure doses. The results will lead to more effective methods for identifying target groups for future app development by researchers and municipalities, which will promote residents' understanding of radiological situations. Materials and Methods: In November 2019, 400 people in Fukushima Prefecture and 400 people outside were surveyed via a web-based questionnaire. In addition to basic characteristics, survey items included concerns about radiation levels and intention to use a smartphone app to keep track of exposure. The analysis was conducted by stratifying responses in each region and then cross-tabulating responses to concerns about radiation levels and intention to use an app by demographic variables. The intention to use an app was analyzed by binomial logistic regression analysis. Text-mining analyses were conducted in KH Coder software. Results and Discussion: Outside Fukushima Prefecture, concerns about the medical exposure of women to radiation exceeded 30%. Within the prefecture, the medical exposure of women, purchasing food products, and consumption of own-grown food were the main concerns. Within the prefecture, having children under the age of 18, the experience of measurement, and having experience of evacuation were significantly related to the intention to use an app. Conclusion: Regional and individual differences were evident. Since respondents differ, it is necessary to develop and promote app use in accordance with their needs and with phases of reconstruction. We expect that a suitable app will not only collect data but also connect local service providers and residents, while protecting personal information.

• Journal of Preventive Medicine and Public Health
• /
• 제37권1호
• /
• pp.88-98
• /
• 2004

Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health

• 보건의료산업학회지
• /
• 제3권1호
• /
• pp.14-24
• /
• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• 대한핵의학회지
• /
• 제38권3호
• /
• pp.218-224
• /
• 2004

목적: 이 연구에서는 좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 생존 가능한 심근을 평가하기 위하여 시행한 휴식기 N-13 ammonia PET과 TI-201 재분포 SPECT를 분절단위로 비교해 보고, PET/SPECT 불일치를 일으키는 기전을 알아 보았다. 대상 및 방법 : 심근경색 병력과 좌심실기능이상, 그리고 약물 부하-휴식 TI-201 SPECT 상 1분절 이상의 고정관류결손이 있는 18명(남 17, 여 1; 나이 $59.7{\pm}8.9$세)을 대상으로 N-13 ammonia/F-18 FDG 심근 PET을 시행하였다. 좌심실을 5분절로 나누어 분절별로 혈류와 대사를 육안 및 정량분석으로 평가하였다. 결과: 재분포 TI-201 SPECT와 N-13 ammonia PET은 전체 90분절 중 80분절에서 일치하는 섭취양상을 보여 88.9%의 높은 일치율과 정량분석상의 높은 상관관계 (R=0.81, p<0.001)를 보였다. 전체 환자 중 9명에서는 재분포 TI-201 SPECT와 N-13 ammonia PET이 모든 분절에서 일치하였으며(환자군 1), 나머지 9명의 10분절(하벽 9, 심첨부 1)에서는 TI-201 SPECT상 관류결손을 보이면서 N-13 ammonia PET상 섭취가 거의 정상을 보였다(환자군 2). 환자군 1과 2사이에 좌심실수혈율의 유의한 차이는 없었지만, 환자군 2에서 수축기 및 이완기 좌심실내경이 환자군 1보다 유의하게 커져있었다. 환자군2에서 감쇠보정이 안 된 N-13 ammonia PET 영상을 재구성해서 TI-201 재분포 SPECT 영상과 비교하였을 때, 두 영상 모두 하벽에 비슷한 양상의 관류결손이 발견되었다. 결론: 좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 생존 가능한 심근을 찾기 위한 혈류/대사 PET에서 TI-201 재분포 SPECT와 N-13 ammonia PET은 높은 판독 일치율과 높은 상관관계를 보인다. PET/SPECT 불일치 소견은 주로 좌심실 확장이 심한 환자에서의 거의 정상인 관류 PET을 보이면서 TI-201 SPECT 상 하벽의 고정 관류 결손이며, 이의 기전은 확장된 심실 내부의 혈액과 횡격막에 의한 감쇠로 생각된다.