• 제목/요약/키워드: Regional Medical Center

검색결과 548건 처리시간 0.029초

일개 외상외과에서의 중증외상환자 1년 치료 경험 분석 (Experience with the Treatment of Patients with Major Trauma at the Department of Trauma Surgery in One Regional Emergency Medical Center for One Year)

  • 김태연;정경원;권준식;김지영;백숙자;송서영;강찬숙;이국종
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.37-44
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    • 2011
  • Purpose: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient's demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. Methods: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. Results: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. Conclusion: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed.

산업장 화학 사고로 응급실에 내원한 환자의 임상적 고찰: 일개병원의 후향적 연구 (A Clinical Analysis of Patients Who Visited Emergency Department due to Chemical Incident Occurred at Industrial Place: A Retrospective Study)

  • 신희준;오세광;유병대;전덕호;이동하;우극현;윤성용;최성용
    • 대한임상독성학회지
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    • 제13권2호
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    • pp.78-86
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    • 2015
  • Purpose: The purpose of this study is to understand what kinds of chemical substances have been used annually and to investigate incidents that occurred due to chemical hazard release and to analyze statistically clinically chemical injury patients who visited one regional emergency medical center in Gumi city with documented references review. Methods: Annual chemical waste emission quantity (Kg/Year) (Cwep) was reproduced using national web site data governed by the Ministry of Environment and 5 years (from 1 .Jan. 2010 to 31. Dec. 2014) of medical records of chemical injury patients who visited our emergency department were reviewed retrospectively. By applying exclusion criteria, 446 patients of 460 patients were selected. Results: Dichloromethane, Toluene, Trichloroethylene, and Xylene were always included within Top 5 of Cweq. Six cases of chemical incidents were reported and in 3 of 6 cases involving Hydrogen fluoride were included during the study period. Male gender and twenties were the most prevalent group. Injury evoking chemicals were Hydrogen fluoride, unknown, complex chemicals (over 2 substances) in sequence. The most frequent site of wounds and injuries was the respiratory tract. Gas among status, intoxication among diagnosis, and discharge among disposition was most numerous in each group. Conclusion: There have been no uniform clinical protocols for chemical wounds and injuries due to various kinds of chemicophysical properties and ignorance of antidotes. Therefore conduct of a multicenter cohort study and experiments for ruling out chemicals according to chemicophysical priority as well as development of antidotes and clinical protocols for chemical injury patients is needed.

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Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

  • Kim, Hyun Ju;Rhee, Woo Joong;Choi, Seo Hee;Nam, Eun Ji;Kim, Sang Wun;Kim, Sunghoon;Kim, Young Tae;Kim, Gwi Eon;Kim, Yong Bae
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.126-133
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    • 2015
  • Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

노인 관상동맥질환자의 스트레스 측정도구 개발 (Development of a Stress Scale for Elderly Patients with Coronary Artery Disease)

  • 최연옥;김정선
    • 대한간호학회지
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    • 제44권6호
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    • pp.630-638
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    • 2014
  • Purpose: The purpose of this study was to develop a scale to evaluate stress in elderly patients with coronary artery diseases (CAD) and to examine validity and reliability of the scale. Methods: The development process for the preliminary scale included construction of a conceptual framework and initial items, verification of content analysis, sentence correction, and pilot study. This study was conducted using a questionnaire survey with one-to-one interviews during January and February, 2012. Participants were 240 elderly patients with CAD. Data were analyzed using item analysis, factor analysis, criterion related validity, and internal consistency. Results: The developed scale consisted of 32 items and 6 factors - aging and disease (7 items), family relations (5 items), anxiety and withdrawal (9 items), management of daily living (3 items), compliance of medical regimen (4 items), poverty and finance (4 items), and explained 68.5% of total variance. The scale had significantly positive correlation with the Korean Perceived Stress Scale (KPSS). Cronbach's alpha was .96, and Guttman split half coefficient was .91. Conclusion: Results indicate that the Stress Scale for Elderly Patients with CAD has validity and reliability, and is a suitable scale in health care settings to assess stress in elderly patients with CAD.

Lung Cancer in Malabar Cancer Center in Kerala - A Descriptive Analysis

  • Bhaskarapillai, Binukumar;Kumar, Saina Sunil;Balasubramanian, Satheesan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4639-4643
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    • 2012
  • The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.

Multidisciplinary Approach to an Extended Pressure Sore at the Lumbosacral Area

  • Yoon, Sehoon;Jeong, Euicheol;Lazaro, Hudson Alex
    • Archives of Plastic Surgery
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    • 제43권6호
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    • pp.586-589
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    • 2016
  • A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible. The large soft tissue defect with significant depth was reconstructed with a free latissimus dorsi musculocutaneous flap, which was expected to act as a local barrier from vertical infection and provide tensionless skin coverage upon hip flexion. The extensive sacral sore was treated effectively without complication, and the deep tissue infection completely resolved. There was no evidence of donor site morbidity, and wheelchair ambulation was possible by a month after surgery.

우상부의 공동성 폐 병변 (A Case with Single Cavitary Nodule in Right Upper Lung)

  • 최진원;박익수;최완영;신동호;박성수;이정희;전석철;박문향;이중달
    • Tuberculosis and Respiratory Diseases
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    • 제39권2호
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    • pp.199-204
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    • 1992
  • A 46 years old male showed radiologically a single cavitary nodular lesion in right upper lung, which extended to the regional chest wall. This finding has to be made into differential diagnosis of numerous pulmonary diseases including infections such as mycobacterial, fungal or bacterial, granulomatous diseases, and neoplasms. For the definite diagnosis, fine needle aspiration biopsy guided by biplane fluoroscopy was performed. The aspirates contained several sulfur granules, in the center of which many gram positive, filamentous organisms were compactly intermingled. Such a findings was compatible with pulmonary actinomycosis. Now the lesions is cleared out by medical treatment with amoxicillin for 3 months.

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Aggressiveness of Three Snow Mold Fungi on Creeping Bentgrass Cultivars under Controlled Environment Conditions

  • Chang, Seog-Won;Jung, Geun-Hwa
    • The Plant Pathology Journal
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    • 제25권1호
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    • pp.6-12
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    • 2009
  • Snow molds are the most important winter diseases of turfgrass in the United States and Canada. Eight isolates of three snow mold fungal species (three isolates of Typhula ishikariensis, three of T. incarnata, and two of Microdochium nivale) were collected from infected turfgrasses on golf courses. The isolates were evaluated for their relative aggressiveness on three cultivars (L-93, Penncross, and Providence) of creeping bentgrass (Agrostis palustris) under the same controlled conditions. Four plant ages (15, 19, 23 and 27 week-old plants from germination to inoculation) were evaluated for their susceptibility to the three pathogens and for the recovery of the plants. Regardless of age or cultivar of the host plant, M. nivale was found to be more aggressive and faster to infect and colonize than Typhula species. After three weeks recovery, M. nivale-inoculated plants showed higher disease severity than plants inoculated with the two Typhula species. Plants infected by Typhula species displayed no significant difference in disease severity. As creeping bentgrass plants get older, the severity of disease caused by three snow molds gradually decreases. This effect was observed in all cultivars tested, suggesting expression of age-related resistance as the bentgrass plants matured.

경로당 시설개선을 위한 공간 재구성 연구 - 대전광역시 소재 경로당 리모델링을 통하여 - (A Study on a Space Reprogramming for the Gyung Ro Dang Facility's Improvement - Through the remodeling of Gyung Ro Dang in Daejeon city -)

  • 이해욱
    • 한국실내디자인학회논문집
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    • 제19권6호
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    • pp.241-248
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    • 2010
  • The population of the elderly is rapidly increased because maturation of the social welfare system and development of medical technology. However, welfare environments for the elderly are poor either in its quality or its quantity. The aims of this study is to confirm the space improvement possibility to change the Gyung Ro Dang to the senior life support center as a community welfare service network. This study is done by the comparative analysis between existing Gyung Ro Dang in korea and former cases in Japan based on the elderly's facility preference. The facility's space reprogramming alternative from that analysis is applied to change the Gyung Ro Dang to a network facility for the regional senior life support. Afterward, it is proposed that first, facilities should be expanded scale by the new education and health improvement facilities functional room that the modern elderly need. second, Facility space will be reconstitution because the Gyung Ro Dang have to be extended it's role as a community welfare network.

농업혁신도시의 표준 프레임워크 도출에 관한 연구 (A Study on the Planning of Agropolis Framework)

  • 최수명;김영주
    • 농촌계획
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    • 제11권4호
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    • pp.17-24
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    • 2005
  • The sustainable development of local communities is faced with limitation due to poor infrastructure and lack of cooperation among stake-holders. To overcome such circumstances and thus to ensure balanced development of the local communities, the central government is driving construction of innovative cities mainly through transfer of public institutions to local cities. In this study, to contribute to the development of plans for the future agropolis' associated with the transfer of public institutions, efficient organization mechanisms of the agropolis such as basic structure and spatial allocation was examined through analyses of advanced cases(Sophia Antipolis, St. Hyacinthe Science Part Food Valley, Stoneleigh Park) of foreign countries. The analyses showed that the organization of agropolis were consisted of three main components; 1) agricultural and food industry complex conducting R&D, 2) service facilities(information, trade, consulting and advertisement) supporting agricultural and food industries and rural enterprise center in charge of a variety of events including exhibition, rural experience, education, and contest, 3) silver facilities such as hospital and town providing medical service and residence. Based on the results, inventories of facilities which are necessary in 'the future agropolis' and their spatial allocation were suggested.