• 제목/요약/키워드: Regional Medical Center

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Current Status of Complementary Therapies Provided by Hospice Palliative Care in South Korea

  • Kwon, Sinyoung;Bak, Jihye;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • 제24권2호
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    • pp.85-96
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    • 2021
  • Purpose: The aim of this study was to investigatecomplementary therapiesprovided at hospice palliative care facilities in South Koreaas designated by the Ministry of Health and Welfare. Methods: The survey was conducted via e-mail from September 2 to September 23, 2020, with responsesfrom 109 therapists and 59 managers from 55 different hospice care facilities. Results: Hospices provided an average of 3.67 different types of therapies, ranging from 1 to 7 different types. The most common types of therapies were horticultural therapy (81.4%), music therapy (79.7%), art therapy (76.3%), and aromatherapy (57.6%). The average frequency of sessions was once a week, the median duration was 60 minutes. Most therapists (96.3%) had qualifications, but the certification-issuing organizations and training intensiveness varied greatly. None of the therapists were employed on a full-time basis, and their average monthly income was KRW 270,000. Therapists and managers gave average scores of 8.90 and 8.38 out of 10, respectively, regarding the positive impact of complementary therapies on patients. Conclusion: In order for patients and their families to benefit from complementary therapiesat hospice care facilities, in addition tobetter terms of employment for therapists, evidence-based guidelines for different types of therapies are needed so that therapy sessions can be conducted according to the theoretical underpinnings and characteristics of the type of therapy. It is expected that the results of this study will be used for policy-making in support of therapy as an essential hospice service.

Retrospective evaluation of toceranib phosphate (Palladia) for treatment of different tumor types in 31 dogs

  • Choi, Seo-In;Nam, Ye-Lim;Kim, Jin-Kyoung;Park, Hyung-Jin;Song, Kun-Ho;Seo, Kyoung Won
    • 대한수의학회지
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    • 제61권1호
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    • pp.10.1-10.11
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    • 2021
  • The purpose of this retrospective study was to provide additional data on the use of toceranib in a wide variety of tumor types in small breed dogs, especially < 8 kg (except 5 dogs). This was a retrospective study of 31 dogs with malignant tumors treated with a 2.5 mg/kg median dose of toceranib (Palladia; Zoetis, USA) on a Monday-Wednesday-Friday schedule. Clinical benefit was observed in 13 of 15 dogs (86.7%, 3 with complete response, 4 with partial response, 6 with stable disease) with gross disease. Distant metastasis, response to treatment, and treatment setting were significantly associated with survival time. Negative prognostic factors were multiple chemotherapy and distant metastasis (affecting progression-free survival [PFS]), surgery, regional enlarged lymph nodes, underlying disease, and toxicity (affecting median survival time [MST]). Positive prognostic factors were epithelial and round cell tumor (affecting PFS), epithelial tumor, microscopic disease, no evidence of disease response, and stable disease (MST). In conclusion, a clinical benefit from toceranib treatment was noted in most of the dogs with gross disease in our study. This study suggested that the toceranib is probably selective treatment to various tumor types in small breed dogs.

Epidemiological application of the cycle threshold value of RT-PCR for estimating infection period in cases of SARS-CoV-2

  • Soonjong Bae;Jong-Myon Bae
    • Journal of Medicine and Life Science
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    • 제20권3호
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    • pp.107-114
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    • 2023
  • Epidemiological control of coronavirus disease 2019 (COVID-19) is needed to estimate the infection period of confirmed cases and identify potential cases. The present study, targeting confirmed cases for which the time of COVID-19 symptom onset was disclosed, aimed to investigate the relationship between intervals (day) from symptom onset to testing the cycle threshold (CT) values of real-time reverse transcription-polymerase chain reaction. Of the COVID-19 confirmed cases, those for which the date of suspected symptom onset in the epidemiological investigation was specifically disclosed were included in this study. Interval was defined as the number of days from symptom onset (as disclosed by the patient) to specimen collection for testing. A locally weighted regression smoothing (LOWESS) curve was applied, with intervals as explanatory variables and CT values (CTR for RdRp gene and CTE for E gene) as outcome variables. After finding its non-linear relationship, a polynomial regression model was applied to estimate the 95% confidence interval values of CTR and CTE by interval. The application of LOWESS in 331 patients identified a U-shaped curve relationship between the CTR and CTE values according to the number of interval days, and both CTR and CTE satisfied the quadratic model for interval days. Active application of these results to epidemiological investigations would minimize the chance of failing to identify individuals who are in contact with COVID-19 confirmed cases, thereby reducing the potential transmission of the virus to local communities.

Bowel Obstruction Due to Less-Digestible Pet Food with No Shadowing on Ultrasonography in a Small-Breed Puppy

  • Junyoung Kim;Jihye Choi;Junghee Yoon
    • 한국임상수의학회지
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    • 제41권2호
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    • pp.127-132
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    • 2024
  • A 6-month-old intact female Bichon Frise dog weighing 0.9 kg presented with vomiting, anorexia, and lethargy persisting for 3 days. No remarkable abnormalities were detected on the history or physical examination. Laboratory findings were mostly normal, except for elevated levels of alkaline phosphatase (ALP) and blood urea nitrogen (BUN). Abdominal radiography revealed a fluid-dilated stomach and gas-dilated intestinal loops in the regional areas. Abdominal ultrasonography was performed to investigate the cause of gastrointestinal dilation, which revealed a rectangular, homogeneous, echogenic foreign material with no shadowing in the small intestine, causing mechanical obstruction. Upon further inquiry involving detailed re-take of history with the owner, a history of ingesting dog gum 4 days prior was identified. On surgical enterotomy, the hard pet food was identified and removed from the distal duodenum. Postoperatively, the patient's clinical signs showed complete improvement, with a return to normal appetite. The present case demonstrates that less-digestible, hard pet food, despite showing no shadowing on ultrasonography, can act as a foreign material, causing mechanical intestinal obstruction in a small-breed puppy. Furthermore, surgical removal of these materials is necessary in cases of intestinal obstruction.

Association of daily carbohydrate intake with intermuscular adipose tissue in Korean individuals with obesity: a cross-sectional study

  • Ha-Neul Choi;Young-Seol Kim;Jung-Eun Yim
    • Nutrition Research and Practice
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    • 제18권1호
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    • pp.78-87
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    • 2024
  • BACKGROUND/OBJECTIVES: The prevalence of obesity, a worldwide pandemic, has been increasing steadily in Korea. Reports have shown that increased intermuscular adipose tissue (IMAT) is associated with an increased risk of cardiovascular disease, independent of body mass index. However, the relationship between dietary intake and IMAT accumulation in the Korean population remains undetermined. The objective of this study was to evaluate regional fat compartments using advanced magnetic resonance imaging (MRI) techniques. We also aimed to investigate the association between IMAT amounts and dietary intake, including carbohydrate intake, among Korean individuals with obesity. SUBJECTS/METHODS: This cross-sectional study, performed at a medical center in South Korea, recruited 35 individuals with obesity (15 men and 20 women) and classified them into 2 groups according to sex. Anthropometry was performed, and body fat distribution was measured using MRI. Blood parameters, including glucose and lipid profiles, were analyzed using commercial kits. Linear regression analysis was used to test whether the IMAT was associated with daily carbohydrate intake. RESULTS: Carbohydrate intake was positively associated with IMAT in all individuals, with adjustments for age, sex, height, and weight. No significant differences in blood indicators were found between the sexes. CONCLUSIONS: Regardless of sex and age, higher carbohydrate intake was strongly correlated with greater IMAT accumulation. This suggests the need to better understand sex differences and high carbohydrate diet patterns in relation to the association between obesity and metabolic risk, which may help reduce obesity prevalence.

급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측 (Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging)

  • 최준영;양유정;최승진;여정석;박성욱;송재관;문대혁
    • 대한핵의학회지
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    • 제37권4호
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    • pp.219-228
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    • 2003
  • 목적: 심근경색증 후 재관류술에 의해 구조된 심근의 범위는 중요한 예후 인자중의 하나이다. 급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상이 구조심근과 심근벽운동 호전을 예측할 수 있는지 알아보았다. 대상 및 방법: 흉통 발생 $5.2{\pm}2.8$시간에 급성심근경색증으로 일차적 관동맥성형술을 시행한 36명을 대상으로 관동맥성형술 후 $5.8{\pm}2.1$일에 디피리다몰 부하 -4 시간 재분포 Tl-201 SPECT 영상을 얻었다. Tl-201 재분포 영상은 좌심실을 16분절로 나누고, 각 분절의 섭취를 5등급으로 평가하였다. 심초음파는 내원 당시, 경색 후 7일, 30일, 7개월에 시행하였고, 구조심근 분절은 내원 당시 심초음파상 벽 운동 이상이 있으면서 30일 또는 7개월 심초음파에서 벽 운동이 호전된 분절로 정의하였다. 결과: 내원 당시 212분절에서 벽운동 이상을 보였다(저운동 41분절, 무운동 171분절). 이중 1개월에는 78분절(36.8%)에서, 7개월에는 97분절(45.8%)에서 벽 운동이 호전되어 구조심근으로 판정하였다. 구조심근을 찾는 Tl-201 재분포 영상의 수신자판 단특성곡선면적은 1개월에 대해서는 $0.79{\pm}0.03$, 7개월에 대해서는 $0.83{\pm}0.03$이었다. Tl-201 섭취 40%를 경계로 정할 때 재분포 영상의 구조심근을 찾는 예민도, 특이도는 1개월에서는 84.6%(66/68), 55.2%(74/134), 7개월에서는 87.6%(85/97), 64.3%(74/115)였다. 재분포영상에서 Tl-201의 섭취정도와 벽 운동의 호전될 확률은 서로 비례하는 경향을 나타내었다. 결론: 급성심근경색증의 일차적 관동맥성형술 후 10일 이내에 시행한 조기 Tl-201 재분포영상은 구조심근과 심근벽운동 호전 예측 판정에 높은 예민도로 유용하게 사용될 수 있는 검사이다.EX>$100{\mu}M$)는 각각 11.9배와 6.8배, K562(Adr) 세포에서($50{\mu}M$)는 각각 14.3배와 8배, K562(Vcr) 세포에서($10{\mu}M$)는 각각 7배와 5.7배 증가하였다. Cyclosporin A에 의한 MIBI와 tetrofosmin의 섭취율(30분)을 기저치(30분)와 비교해 본 결과 HCT15/CL02세포에서($50{\mu}M$)는 각각 10배와 2.4배, K562(Adr)세포에서($50{\mu}M$)는 각각 44배와 13배, K562(Vcr)세포에서($10{\mu}M$)는 각각 18.8배와 11.8배 증가하여, MIBI의 섭취율이 tetrofosmin보다 1.2배에서 4배정도 높게 나타났다. 결론: 이러한 결과로 보아 MIBI와 tetrofosmin은 다약제내성의 발현을 평가할 수 있는 방사성의약품으로 판단되며, 다약제내성 극복제의 효능평가에는 MIBI가 tetrofosmin보다 더 우수할 것으로 사료되나, 세포추에 따른 차이가 있을 수 있으므로 보다 많은 세포주에서의 추가적인 연구가 필요할 것이다.여 후 구한 MPD는 평균 $13.3{\pm}1.9GBq\;(9.7{\sim}16GBq)$ 이였고, 치료용량 방사성옥소 투여 후 구한 MPD는 평균 $13.8{\pm}2.1GBq(10.4{\sim}16.3GBq)$로 유의한 차이가 얻었으며 (p=0.20), 두 수치간에는 유의한 상관 관계가 있었다(r=0.8, p<0.0001). 7명의 환자에서 말초혈액림프구 중기염색체 분석법으로 MPD를 측정하였는데 혈액의 피폭선량은 $1.78{\pm}0.03Gy$였으며, 같은 환자에서 혈중 방사능소실곡선으로부터 구한 피폭선량은 $1.54{\pm}0.03Gy$로 유의하게 낮았으나 (p=0.01), 두

Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly

  • Nam, Kiryong;Park, Eunhye;Chung, Yuhjin;Kim, Chang-yup
    • Journal of Preventive Medicine and Public Health
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    • 제53권6호
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    • pp.455-464
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    • 2020
  • Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

Thoracic and Cardiovascular Surgeons' Perception of the Concentration of Cardiovascular Operations in Seoul Metropolitan Area's Hospitals

  • Jeong, Hyo Seon;Lee, Kun Sei;Chee, Hyun Keun;Ahn, Hye Mi;Sim, Sung Bo
    • Journal of Chest Surgery
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    • 제49권sup1호
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    • pp.53-59
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    • 2016
  • Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.

응급실에서의 폭력 환자 예측을 위한 한국어판 행동신호 사정도구의 유용성 검증 (Usefulness of Korean Version of Behavioral Cue Checklist for Predicting of Patient Violence in Emergency Departments)

  • 김장미;이은남
    • 대한간호학회지
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    • 제48권3호
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    • pp.289-297
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    • 2018
  • Purpose: This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments. Methods: This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed. Results: Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively. Conclusion: The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.

Development of the anti-cancer food scoring system 2.0: Validation and nutritional analyses of quantitative anti-cancer food scoring model

  • Hong, Yeo-Jin;Kim, Jeongseon;Lee, Hye Yoon;Rim, Chai Hong
    • Nutrition Research and Practice
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    • 제14권1호
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    • pp.32-44
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    • 2020
  • BACKGROUND/OBJECTIVE: We have previously designed the anti-cancer food scoring model (ACFS) 1.0, an evidence-based quantitative tool analyzing the anti-cancer or carcinogenic potential of diets. Analysis was performed using simple quantitative indexes divided into 6 categories (S, A, B, C, D, and E). In this study, we applied this scoring model to wider recipes and evaluated its nutritional relevance. MATERIALS/METHODS: National or known regional databases were searched for recipes from 6 categories: Korean out-dining, Korean home-dining, Western, Chinese, Mediterranean, and vegetarian. These recipes were scored using the ACFS formula and the nutrition profiles were analyzed. RESULTS: Eighty-eight international recipes were analyzed. All S-graded recipes were from vegetarian or Mediterranean categories. The median code values of each category were B (Korean home-dining), C (Korean out-dining), B (Chinese), A (Mediterranean), S (vegetarian), and D (Western). The following profiles were correlated (P < 0.05) with ACFS grades in the univariate trend analysis: total calories, total fat, animal fat, animal protein, total protein, vitamin D, riboflavin, niacin, vitamin B12, pantothenic acid, sodium, animal iron, zinc, selenium, and cholesterol (negative trends), and carbohydrate rate, fiber, water-soluble fiber, vitamin K, vitamin C, and plant calcium (positive trends). Multivariate analysis revealed that animal fat, animal iron, and niacin (negative trends) and animal protein, fiber, and vitamin C (positive trends) were statistically significant. Pantothenic acid and sodium showed non-significant negative trends (P < 0.1), and vitamin B12 showed a non-significant positive trend. CONCLUSION: This study provided a nutritional basis and extended the utility of ACFS, which is a bridgehead for future cancer-preventive clinical trials using ACFS.