• 제목/요약/키워드: Small Hospital

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거짓 장막힘과 감각신경세포병증으로 발현된 소세포폐암 1예 (Gastrointestinal Pseudoobstruction and Sensory Neuronopathy in Small Cell Lung Cancer)

  • 이현정;최영철;윤동주;고영채;장상현;윤수진;오건세;이수주
    • Annals of Clinical Neurophysiology
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    • 제13권2호
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    • pp.106-110
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    • 2011
  • Subacute sensory neuronopathy and gastrointestinal pseudoobstruction are considered classical paraneoplastic neurological syndromes. We report a 56-year-old male who presented with typical symptoms of subacute sensory neuronopathy and autonomic neuropathy with gastrointestinal pseudoobstruction. The biopsy of the palpable supraclavicular lymph node revealed a small cell lung cancer. To our knowledge, intestinal pseudoobstruction and sensory neuronopathy in a small cell lung cancer have not been reported in Korea.

Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

  • Tangkittikasem, Natthakan;Boonyaarunnate, Thiraphon;Aswakul, Pitulak;Kachintorn, Udom;Prachayakul, Varayu
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8613-8618
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    • 2016
  • Background: The symptoms of small bowel malignancies are mild and frequently nonspecific, thus patients are often not diagnosed until the disease is at an advanced stage. Moreover, the lack of sufficient studies and available data on small bowel cancer makes diagnosis difficult, further delaying proper treatment for these patients. In fact, only a small number of published studies exist, and there are no studies specific to Thailand. Radiologic and endoscopic studies and findings may allow physicians to better understand the disease, leading to earlier diagnosis and improved patient outcomes. Objective: To retrospectively analyze the clinical, radiologic, and endoscopic characteristics of small bowel cancer patients in Thailand's Siriraj Hospital. Materials and Methods: This retrospective analysis included 185 adult patients (97 men, 88 women; mean age = $57.6{\pm}14.9$) with pathologically confirmed small bowel cancer diagnosed between January 2006 and December 2013. Clinical, radiologic, and endoscopic findings were collected and compared between each subtype of small bowel cancer. Results: Of the 185 patients analyzed, gastrointestinal stromal tumor (GIST) was the most common diagnosis (39.5%, n=73). Adenocarcinoma was the second most common (25.9%, n = 48), while lymphoma and all other types were identified in 24.3% (n = 45) and 10.3% (n = 19) of cases, respectively. The most common symptoms were weight loss (43.2%), abdominal pain (38.4%), and upper gastrointestinal bleeding (23.8%). Conclusions: Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

Etoposide-Cisplatin Alternating with Vinorelbine-Cisplatin Versus Etoposide-Cisplatin Alone in Patients with Extensive Disease Combined with Small Cell Lung Cancer

  • Zhang, Jie;Qi, Hui-Wei;Zheng, Hui;Chen, Mo;Zhu, Jun;Xie, Hui-Kang;Ni, Jian;Xu, Jian-Fang;Zhou, Cai-Cun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4159-4163
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    • 2014
  • Background: The aim of this study was to evaluate the efficacy of alternating etoposide-cisplatin and vinorelbine-cisplatin (EP-NP) compared with an etoposide-cisplatin (EP) regimen for advanced combined small cell carcinomas. Materials and Methods: Histologically confirmed combined small cell carcinoma patients who met the inclusion criteria were randomly assigned (1:1) into either the EP-NP setting (group A) or the EP setting (group B). The primary endpoint was progression-free survival in patients who received at least one dose of treatment. Results: Eighty-two patients entered into this trial, 42 in group A and 40 in group B. The objective response rates in group A and group B were 42.9% and 32.5%, respectively (p=0.334). Survival analysis showed that median progression-free survival was 6.1 months in group A, which was significantly longer than the 4.1 months in group B (p=0.041). However, as to overall survival, no significant difference was found between the two groups (11.0 vs 10.1 months in groups A and B, respectively, p=0.545). No unexpected side effects were observed in either group. Conclusions: The EP-NP regimen for combined small cell carcinomas prolonged progressio-nfree survival compared with the EP regimen. Further clinical investigations are warranted.

개에서 발생한 양측성 경골조면 부분 견열골절의 방사선학적 변화 (Radiographic Changes of Bilateral Partial Avulsion Fracture of Tibial Tuberosity in a Dog)

  • 계서연;최미현;이남순;장재영;이혜경;김현욱;윤정희
    • 한국임상수의학회지
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    • 제30권2호
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    • pp.134-137
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    • 2013
  • 4개월 된 수컷 진도 견에서 좌측 후지 파행이 발생하였다. 방사선 검사에서 양측 경골 견인 골단 아래 작은 골편이 관찰되었으나, 견인 골단의 변위는 없었다. 그 후 양측 경골 조면 부위의 골밀도는 방사선 투과성에서 비투과성으로 변화하였다. 좌측 경골은 수술 후 회복되었으나, 우측 경골은 보존적 처치로 자가 치료되었다. 본 환자는 경골조면의 부분 견열골절로 진단되었으며, 이는 개에서 'Osgood-Schlatter disease'로 불려져 왔던 질환이다. 이 증례는 환자의 경골조면 부분 견열골절의 순차적인 방사선학적 영상 변화에 대한 유용한 임상적 정보를 제공할 수 있을 것으로 생각한다.

일부 병원 실내에서의 공기중 미생물 오염에 관한 연구 (A Study on Airborne Microorganism in Hospital)

  • 정선회;백남원
    • 한국산업보건학회지
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    • 제8권2호
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    • pp.231-241
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    • 1998
  • To assess biological indoor air quality in hospital, concentrations of viable airborne microbes were determined at intensive care unit(ICU), patient room (PR), outpatient waiting room(OPWR) in hospitals of large(1000 beds), middle(500 beds), small(100 beds) hospitals, respectively. Gram positive bacteria, gram negative bacteria, fungi were sampled using suctional sampling method by RCS sampler (Reuter centrifugal air sampler) and RCS GK-A agar plate. In gram positive bacteria groups, CNS(Coagulase Negative Staphylococcus), Micrococcus, Lactobacillus, S. aureus, Enterococcus, St. viridans identified. In gram negative bacteria groups, A. baumannii, Kl. peumoniae and E. coli were identified, and Penicillium was identified in fugi groups. Results of the study were as follows. 1. The highest concentrations of airborne microbes was $971CFU/m^3$ at 5:00 PM in small hospital patient room, and average concentrations of airborne microbes in large, middle and small hospitals were $282CFU/m^3$, $289CFU/m^3$ and $625CFU/m^3$, respectively. Average concentrations of airborne microbes in office(control) was $90CFU/m^3$. Thus, the small hospital showed the worst condition. 2. Representatives of 8 different genera were identified in 150 samples. The most frequently isolated organisms were Staphylococcus (73.0%), Micrococcus (20.7%) and Lactobacillus (4.7%), respectively. Pathogenic microbes isolated were A. baumannii, E. coli, Enterococcus, Kl. peumoniae, S. aureus, St. viridans and Penicillium as fungi. In office, no pathogenic microbes were identified. Average concentrations of airborne pathogenic microbes in large, middle and small hospital were $5CFU/m^3$ (2%), $11CFU/m^3$ (4%) and $12CFU/m^3$ (2%), respectively. Thus, condition in a large hospital was better than those in a middle and a small hospital.

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Chronic Subdural Hematomas : A Comparative Study of Three Types of Operative Procedures

  • Lee, Joon-Kook;Choi, Jong-Hun;Kim, Chang-Hyun;Lee, Ho-Kook;Moon, Jae-Gon
    • Journal of Korean Neurosurgical Society
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    • 제46권3호
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    • pp.210-214
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    • 2009
  • Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

복부 둔상으로 인한 소장 천공의 임상 양상에 대한 고찰 (Clinical Characteristics of Small Bowel Perforation due to Blunt Abdominal Trauma)

  • 배정민
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.125-128
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    • 2011
  • Purpose: Blunt small bowel injury (SBI) is frequently combined other organ injury. So, clinical outcome and characteristics of SBI are influenced by other combined injuries. Thus, we analyzed isolated SBI patients and studied clinical outcome and characteristics. Methods: Between 2005 and 2010, 36 consecutive patients undergoing laparotomy due to isolated SBI were identified in a retrospectively collected. Database. Clinical outcome and characteristics were analyzed. Results: Laparotomy was performed in 36 patients. Primary repair was performed 17 patients. Segmental resection of small bowel was performed 19 patients. Median time gap from trauma to operation was 9 hours. In 24 hours from trauma, operation was performed 31 patients. Post operative death was 5 patients. Mean hospital stay was 18 days and median hospital stay was 12 days. There were significant differences between operation type and minor complication and hospital stay. And there were significant differences between time gap in 24 hours and minor complication. But, there were no significant between time gap and mortality. Conclusion: Although this study had many limitations, some valuable information was produced. When operation above 24 hours was delayed in SBI, minor complications were significantly increased. Segmental resection of small bowel in SBI were significantly increased minor complications and hospital stay. So, preventive measures for surgical site infection was important to reduce wound complication and hospital stay. Further continuous study and multi-center study were should be performed to improve clinical outcome in SBI.

중소규모 의료시설의 리모델링에 관한 연구 (A Study on the Remodeling of Small-to-Middle Size Hospital)

  • 이필순;박재승
    • 한국실내디자인학회논문집
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    • 제38호
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    • pp.241-249
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    • 2003
  • Recently, the demand of construction a new hospital is apt to decrease in the rate of increase. The demand changes quantitative expansion into seeking quality of more pleasant healing environment. Special conditions should be taken into consideration when we remodeling the hospital, because it has special and complicated equipment system. Also, newly invented medical instruments cause extension and reconstruction of a building, therefore construction of hospital continued growth and variation. Hospitals of small-to-middle size are changing to correspond on patients' request under these environment. Now we have little awareness and experience about remodeling yet, and systematic research is insufficient. Therefore, this study is aiming to purpose a data of future hospital construction plan and suitable hospital remodeling's plan direction through analysis of done medium and small scale hospitals.

Isolated Distal leg Weakness due to a Small Cerebral Infarction Masquerading as a Spinal Lesion

  • Han, In-Bo;Ahn, Jung-Yang;Chung, Young-Sun;Chung, Sang-Sup
    • Journal of Korean Neurosurgical Society
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    • 제41권3호
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    • pp.182-185
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    • 2007
  • Acute stroke with isolated monoparesis manifesting as distal weakness of a single lower extremity has rarely been described. We report two patients with small cortical infarction who had distal weakness of a single lower extremity. In both cases, diffusion-weighted image [DWI] was used to detect small lesions in the contralateral cortex. These cases illustrate that small cortical infarction can cause isolated monoparesis limited to distal part of the leg and it may be misdiagnosed as spinal lesions, especially when lower back pain and transient sensory symptoms are accompanied. In case of the abrupt onset of weakness limited to one lower limb, the possibility of stroke should be considered and careful attention to identify cortical lesions using magnetic resonance imaging, especially DWI is required.

Irinotecan as a Second-line Chemotherapy for Small Cell Lung Cancer: a Systemic Analysis

  • Zhang, Ming-Qian;Lin, Xin;Li, Yan;Lu, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권5호
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    • pp.1993-1995
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    • 2015
  • Purpose: This analysis was conducted to evaluate the efficacy and safety of irinotecan based regimens as second-line chemotherapy in treating patients with small cell lung cancer. Methods: Clinical studies evaluating the efficacy and safety of irinotecan based regimens as second-line chemotherapy for patients with small cell lung cancer were identified using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In irinotecan based regimens as second-line chemotherapy, 4 clinical studies which including 155 patients with small cell lung cancer were considered eligible for inclusion. In all chemotherapy consisted of irinotecan with or without nedaplatin. Pooled analysis suggested that, in all patients, the pooled RR was 27.1% (42/155) in irinotecan based regimens. Nausea, vomiting, diarrhea and myelosuppression were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment related death occurred with the irinotecan based treatments. Conclusion: This systemic analysis suggests that irinotecan based regimens as second-line chemotherapy are associated with mild response rate and acceptable toxicity for patients with small cell lung cancer.