• 제목/요약/키워드: Regional Medical Center

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Evaluating the Performance of the Emergency Medical Services Index

  • Eun, Sang Jun;Lee, Jin-Seok;Kim, Yoon;Jung, Koo Young;Park, Sue Kyung;Lee, Jin Yong
    • 보건행정학회지
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    • 제23권2호
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    • pp.176-187
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    • 2013
  • Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

Cardiac Lipoma Extirpation with Chronic Lung Abscess Excision: A Case Report of Simultaneous Video-Assisted Thoracoscopic Surgery Procedures

  • Kryvetskyi, Volodymyr Fedorovych;Lysak, Pavlo Serhiiovych;Kaminska, Svitlana Hryhorivna;Mitiuk, Bohdan Oleksiiovych
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.532-534
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    • 2021
  • This study examined a rarely seen benign heart tumor that was found incidentally on a chest X-ray. Radiological images were taken of a 42-year-old patient with no symptoms of a heart condition, showing a thick-walled left lung cavity that appeared after prior inflammation and concomitant enlargement of the cardiac shadow. A large subepicardial lipoma in combination with a chronic abscess on the left lung was revealed on chest computed tomography. The treatment consisted of simultaneous surgical removal of both the lung and heart lesions using video-assisted thoracoscopic surgery.

Cohort Profile: Gachon Regional Occupational Cohort Study (GROCS)

  • Lee, Wanhyung;Lee, Yongho;Lee, Junhyeong;Kim, Uijin;Han, Eunsun;Ham, Seunghon;Choi, Won-Jun;Kang, Seong-Kyu
    • Safety and Health at Work
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    • 제13권1호
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    • pp.112-116
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    • 2022
  • Background/Aims: The Gachon Regional Occupational Cohort Study (GROCS) is a large-scale longitudinal study of occupational safety and health data (covering Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service) conducted by the Gachon University Gil Medical Center (GUGMC) in Incheon, Republic of Korea. We conducted GROCS to identify the health effects of workers' occupational risks, behavior, socioeconomic status, and life style. Methods: The GROCS includes data from Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service. The baseline year for all data collection was 2018. Work Environment Monitoring was conducted in 240 companies located in Incheon. General Health Examination and Special Health Examination were performed on 32,725 and 9,504 workers, respectively. Occupational Health Services were provided to 16,883 workers in 171 companies. These data have been collected and operated at an external data management institution and were provided as a retrospective cohort after removing personal identification information. Results: In 2018, the total number of companies was 2,854, among which which 488 special Health Examination, 171 Work Environment Monitoring, and 240 Occupational Health Service. The proportion of companies undergoing Special Health Examination was 17.1%, the proportion of companies undergoing Work Environment Monitoring was 8.4%, and the proportion of Companies undergoing Occupational Health Service was 6.0%. Conclusion: GROCS expects researchers to utilize its useful and reliable resource for occupational health and surveillance with for academic or political purposes to lead to improved workers' health and working environment.

정상적인 노화 과정에서 국소뇌포도당대사의 변화: FDG PET 연구 (Changes of Regional Cerebral Glucose Metabolism in Normal Aging Process : A Study With EDG PET)

  • 윤준기;김상은;이경한;최용;최연성;김병태
    • 대한핵의학회지
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    • 제35권4호
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    • pp.231-240
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    • 2001
  • Purpose: Normal aging results in detectable changes in the brain structure and function. We evaluated the changes of regional cerebral glucose metabolism in the normal aging process with FDG PET. Materials and Methods: Brain PET images were obtained in 44 healthy volunteers (age range 20-69 'y'; M:F = 29:15) who had no history of neuropsychiatric disorders. On 6 representative transaxial images, ROIs were drawn in the cortical and subcortical areas. Regional FDG uptake was normalized using whole brain uptake to adjust for the injection dose and correct for nonspecific declines of glucose metabolism affecting all brain areas equally. Results: In the prefrontal, temporoparietal and primary sensorimotor cortex, the normalized FDG uptake (NFU) reached a peak in subjects in their 30s. The NFU in the prefrontal and primary sensorimotor cortex declined with age after 30s at a rate of 3.15%/decade and 1.93%/decade, respectively. However, the NFU in the temporoparietal cortex did not change significantly with age after 30s. The anterior (prefrontal) posterior (temporoparietal) gradient peaked in subjects in their 30s and declined with age thereafter at a rate of 2.35%/decade. The NFU in the caudate nucleus was decreased with age after 20s at a rate of 2.39%/decade. On the primary visual cortex, putamen, and thalamus, the NFU values did not change significantly throughout the ages covered. These patterns were not significantly different between right and left cerebral hemispheres. Of interest was that the NFU in the left cerebellar cortex was increased with age after 20s at a rate of 2.86%/decade. Conclusion: These data demonstrate regional variation of the age-related changes in the cerebral glucose metabolism, with the most prominent age-related decline of metabolism in the prefrontal cortex. The increase in the cerebellar metabolism with age might reflect a process of neuronal plasticity associated with aging.

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Regional Amyloid Burden Differences Evaluated Using Quantitative Cardiac MRI in Patients with Cardiac Amyloidosis

  • Jin Young Kim;Yoo Jin Hong;Kyunghwa Han;Hye-Jeong Lee;Jin Hur;Young Jin Kim;Byoung Wook Choi
    • Korean Journal of Radiology
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    • 제22권6호
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    • pp.880-889
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    • 2021
  • Objective: This study aimed to investigate the regional amyloid burden and myocardial deformation using T1 mapping and strain values in patients with cardiac amyloidosis (CA) according to late gadolinium enhancement (LGE) patterns. Materials and Methods: Forty patients with CA were divided into 2 groups per LGE pattern, and 15 healthy subjects were enrolled. Global and regional native T1 and T2 mapping, extracellular volume (ECV), and cardiac magnetic resonance (CMR)-feature tracking strain values were compared in an intergroup and interregional manner. Results: Of the patients with CA, 32 had diffuse global LGE (group 2), and 8 had focal patchy or no LGE (group 1). Global native T1, T2, and ECV were significantly higher in groups 1 and 2 than in the control group (native T1: 1384.4 ms vs. 1466.8 ms vs. 1230.5 ms; T2: 53.8 ms vs. 54.2 ms vs. 48.9 ms; and ECV: 36.9% vs. 51.4% vs. 26.0%, respectively; all, p < 0.001). Basal ECV (53.7%) was significantly higher than the mid and apical ECVs (50.1% and 50.0%, respectively; p < 0.001) in group 2. Basal and mid peak radial strains (PRSs) and peak circumferential strains (PCSs) were significantly lower than the apical PRS and PCS, respectively (PRS, 15.6% vs. 16.7% vs. 26.9%; and PCS, -9.7% vs. -10.9% vs. -15.0%; all, p < 0.001). Basal ECV and basal strain (2-dimensional PRS) in group 2 showed a significant negative correlation (r = -0.623, p < 0.001). Group 1 showed no regional ECV differences (basal, 37.0%; mid, 35.9%; and apical, 38.3%; p = 0.184). Conclusion: Quantitative T1 mapping parameters such as native T1 and ECV may help diagnose early CA. ECV, in particular, can reflect regional differences in the amyloid deposition in patients with advanced CA, and increased basal ECV is related to decreased basal strain. Therefore, quantitative CMR parameters may help diagnose CA and determine its severity in patients with or without LGE.

Detection of Oyster-Associated Norovirus by Microchip Electrophoresis of an Amplified cDNA - Research Note -

  • Oh, Ho-Kyung;Sin, Yeong-Min;Kim, Ki-Hyun;Park, Kun-Sang;Kim, Dae-Byung;Ahn, Byung-Yoon;Kim, Ok-Hee
    • Preventive Nutrition and Food Science
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    • 제12권2호
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    • pp.126-130
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    • 2007
  • Noroviruses, members of the family Caliciviridae, are often found in shellfish grown in polluted water and are emerging as a leading cause of foodborne disease worldwide. As the presence of norovirus in food commodities becomes an important medical and social issue, there are increasing needs for designing improved detection methods for the virus. In this study, we tested the Agilent 2100 Bioanalyzer for the analysis of norovirus DNA amplified from oyster samples. Microchip electrophoresis provided us with more accurate information, compared to conventional agarose gel electrophoresis, in the resolution and quantification of amplified products. The development of an improved method for food-associated noroviruses would contribute to a rapid identification of contaminated food and improve our understanding of the modes of food contamination and norovirus transmission.

Microbiota of Breast Tissue and Its Potential Association with Regional Recurrence of Breast Cancer in Korean Women

  • Kim, Hyo-Eun;Kim, Jongjin;Maeng, Sejung;Oh, Bumjo;Hwang, Ki-Tae;Kim, Bong-Soo
    • Journal of Microbiology and Biotechnology
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    • 제31권12호
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    • pp.1643-1655
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    • 2021
  • Recent studies have reported dysbiosis of the microbiome in breast tissue collected from patients with breast cancer and the association between the microbiota and disease progression. However, the role of the microbiota in breast tissue remains unclear, possibly due to the complexity of breast cancer and various factors, including racial and geographical differences, influencing microbiota in breast tissue. Here, to determine the potential role of microbiota in breast tumor tissue, we analyzed 141 tissue samples based on three different tissue types (tumor, adjacent normal, and lymph node tissues) from the same patients with breast cancer in Korea. The microbiota was not simply distinguishable based on tissue types. However, the microbiota could be divided into two cluster types, even within the same tissue type, and the clinicopathologic factors were differently correlated in the two cluster types. Risk of regional recurrence was also significantly different between the microbiota cluster types (p = 0.014). In predicted function analysis, the pentose and glucuronate interconversions were significantly different between the cluster types (q < 0.001), and Enterococcus was the main genus contributing to these differences (q < 0.01). Results showed that the microbiota of breast tissue could interact with the host and influence the risk of regional recurrence. Although further studies would be recommended to validate our results, this study could expand our understanding on the breast tissue microbiota, and the results might be applied to develop novel prediction methods and treatments for patients with breast cancer.

The Busan Regional CardioCerebroVascular Center Project's Experience Over a Decade in the Treatment of ST-segment Elevation Myocardial Infarction

  • Lim, Kyunghee;Moon, Hyeyeon;Park, Jong Sung;Cho, Young-Rak;Park, Kyungil;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.351-359
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    • 2022
  • Objectives: The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI). Methods: Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort. Results: In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI. Conclusions: A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.