• 제목/요약/키워드: Regional Medical Center

검색결과 550건 처리시간 0.022초

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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    • 제30권4호
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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.

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

  • 박성빈;최병규;하근우;서준범
    • Tuberculosis and Respiratory Diseases
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    • 제59권4호
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    • pp.356-360
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    • 2005
  • 연구배경 : 징병검사에서 집단 흉부 간접 방사선 촬영의 폐결핵에 관련한 임상적 유용성을 평가하고자 하였다. 방 법 : 2003년 4월부터 11월까지 서울 지방병무청 제 2 징병검사장에서 징병검사를 시행한 25386명을 대상으로 하였다. 모두 흉부 간접 방사선 촬영을 시행하였고 이상소견자는 직접 방사선 촬영으로 확인하였다. 흉부 간접 방사선 촬영과 직접 방사선 촬영과의 양성 예측율을 알아보았다. 폐결핵을 중심으로 추적검사를 통해 활동성 폐결핵 유병율, 침윤정도와 임상경과를 알아보았다. 결 과 : 총 25386명중 328명에서 흉부 간접 방사선 촬영상 이상소견이 발견되어 직접 방사선 촬영으로 재검사하였다. 재검사 중 302명(1.19%)에서 이상소견이 확인되었다. 폐결핵을 포함한 폐실질병변이 109예였고, 종격동 병변이 6예, 심혈관계 이상이 45예, 흉막병변이 49예, 측만증을 포함한 골격계 이상이 90예 그리고 기타 7예였다. 흉부 간접 방사선 촬영상 폐결핵은 99예 였으며, 이중 활동성 폐결핵이 67예로 활동성 폐결핵의 유병율은 0.26%였다. 활동성 폐결핵 환자의 42예, 폐렴 1예, 종격동 종양 1예, 늑골골절 2예 그리고 기흉 4예가 최초 진단되었다. 활동성 폐결핵 환자의 폐침윤 정도는 경증이 52예 였으며, 60예에서 추적검사상 호전되었다. 결 론 : 징병검사에서 집단검사로서 흉부 간접 방사선 촬영은 한계와 문제점이 있으나, 특히 활동성 폐결핵을 포함한 병의 최초 조기발견에 있어 유용한 검사로 의미가 있을 것으로 사료된다.

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
    • 한국환경보건학회지
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    • 제46권5호
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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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    • 제16권12호
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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.

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

  • 김타열;진원형
    • 한국지역지리학회지
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    • 제14권4호
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    • pp.367-381
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    • 2008
  • 본 연구는 대구시 상업지역의 공간분포 및 계층구조 변화를 분석한 것이다. 분석기법으로 집중지수, 집중화계수 및 특화계수를 이용하였으며, 1985년$\sim$2003년의 기간을 고찰했다. 도시인구의 성장과 함께 도시적 토지이용이 증가되었다. 인구 성장 118%에 비해 상업입지량 증가율은 330%에 달하였다. 주요 상업적 토지이용은 판매업이 가장 높고 그 다음이 업무, 식품 순이다. 업종별 공간 분포의 분석에서 숙박, 의료, 운수창고 및 위락 등이 집중도가 높으며, 도시 외곽으로 갈수록 특수상업지구를 형성하였다. 판매업의 분산화가 가장 높게 나타나고 있으며, 식품, 업무도 분산 성향이 높았다. 한편 분석기간 동안, 도심부의 상업 집중 성향이 나타나고 있다. 도심핵의 공간적 확장과 함께 도심 주변지역의 상업 집중 또한 증가하는 추세이다. 도시상업의 공간구조는 단핵도시의 성격이 강화되고 있다. 그러나 내부시가지의 결절에 2계층의 중심지들이 생성되면서 다핵화의 과정에 있고, 특히 동대구역 역세권 지역은 부도심으로 성장할 잠재력을 나타내고 있다.

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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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    • 제3권1호
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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

  • 김재승
    • Nuclear Medicine and Molecular Imaging
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    • 제41권2호
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    • pp.141-151
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    • 2007
  • 파킨슨병은 노년층에 가장 흔한 퇴행성 뇌질환 중의 하나로 진행성핵상마비, 다중계 위축, 루이체 치매 등과 같은 비전형 파킨슨병과 임상적으로 감별이 어려울 수 있다. 파킨슨병과 비전형 파킨슨병의 감별은 치료방침 결정과 예후평가뿐만 아니라 파킨슨병의 원인과 병태생리를 연구하고 새로운 치료법 개발에 있어서도 매우 중요하다. 파킨슨병과 비전형 파킨슨병과 같이 파킨슨 증후군을 유발하는 질환은 선조체내 도파민 신경의 퇴행성 변화를 흔히 동반하지만 병태생리학적으로 서로 다른 뇌피질 및 피질하 구조물에서의 신경세포 소실을 동반하고 있다. 따라서 국소 시냅스 활성도와 신경 및 시냅스의 손상, 그리고 원발병변과 기능적으로 연결된 원격부위의 기능이상 등을 대변하는 뇌포도당 대사를 F-18FDG PET으로 평가하는 것은 파킨슨 병의 감별진단과 병태생리를 평가하는데 유용하다.

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

  • 김시진;임유라;배현주
    • 한국환경보건학회지
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    • 제47권2호
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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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    • 제44권5호
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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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    • 제16권13호
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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.