• Title/Summary/Keyword: Standard of Care

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Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System (한국 중독환자의 경향: 국가응급진료 정보망을 이용한 후향적 연구)

  • Kim, Woongki;Kim, Kyung Hwan;Shin, Dong Wun;Park, Junseok;Kim, Hoon;Jeon, Woochan;Park, Joon Min;Kim, Jung Eon;Kim, Hyunjong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.108-117
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    • 2019
  • Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

Surgical Outcomes of Cervical Esophageal Cancer: A Single-Center Experience

  • Yoonseo Lee;Jeonghee Yun;Yeong Jeong Jeon;Junghee Lee;Seong Yong Park;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Young Mog Shim
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.62-69
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    • 2024
  • Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.

Dose Planning Study of Target Volume Coverage with Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

  • Vincent Phua, Chee Ee;Tan, Boon Seang;Tan, Ai Lian;Eng, Kae Yann;Ng, Bong Seng;Ung, Ngie Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2243-2248
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    • 2013
  • Background: To compare the dosimetric coverage of target volumes and organs at risk in the radical treatment of nasopharyngeal carcinoma (NPC) between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: Data from 10 consecutive patients treated with IMRT from June-October 2011 in Penang General Hospital were collected retrospectively for analysis. For each patient, dose volume histograms were generated for both the IMRT and 3DCRT plans using a total dose of 70Gy. Comparison of the plans was accomplished by comparing the target volume coverage (5 measures) and sparing of organs at risk (17 organs) for each patient using both IMRT and 3DCRT. The means of each comparison target volume coverage measures and organs at risk measures were obtained and tested for statistical significance using the paired Student t-test. Results: All 5 measures for target volume coverage showed marked dosimetric superiority of IMRT over 3DCRT. V70 and V66.5 for PTV70 showed an absolute improvement of 39.3% and 24.1% respectively. V59.4 and V56.4 for PTV59.4 showed advantages of 18.4% and 16.4%. Moreover, the mean PTV70 dose revealed a 5.1 Gy higher dose with IMRT. Only 4 out of 17 organs at risk showed statistically significant difference in their means which were clinically meaningful between the IMRT and 3DCRT techniques. IMRT was superior in sparing the spinal cord (less 5.8Gy), V30 of right parotid (less 14.3%) and V30 of the left parotid (less 13.1%). The V55 of the left cochlea was lower with 3DCRT (less 44.3%). Conclusions: IMRT is superior to 3DCRT due to its dosimetric advantage in target volume coverage while delivering acceptable doses to organs at risk. A total dose of 70Gy with IMRT should be considered as a standard of care for radical treatment of NPC.

The Related Factors on the Health Promotion Behavior of Primary School Students (초등학생의 건강증진행위 실천에 영향을 미치는 요인 - 초등학교 6학년을 중심으로 -)

  • Han, Chang-Hyun;Kim, Gui-Young;Kim, Dong-Sik
    • Korean Journal of Health Education and Promotion
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    • v.22 no.2
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    • pp.155-171
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    • 2005
  • Objectives: The purpose of this study is to find out how well the primary school students are practicing the health promotion behaviors and the factors relating their health promotion behavior. Methods: This study was carried out by using questionnaires with 1,215 students attending at a 6th grade, 16 primary schools which arranged the school health teachers in Kyoungpook, Chilkok Gun from the 21th through 22th of December 2004. Among them, 1,189 were included in final analysis. The collected data was analyzed through frequency, percentage mean and standard deviation, multiple regression. Results: According to the data from multiple regression of analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes high in proportion to their parents' interest in health, to their perceived self efficacy, and in case of the barriers of the health promotion behavior practice. As to the female students, their health behavior practice becomes high in proportion to their parents' interest in health. It also becomes high in proportion to the perceived health status, the understanding of the importance of the health, internal health locus of control in personality, the perceived self efficacy and the perceived benefit of the health promotion behavior. But in case of the barriers of the health promotion behavior, it was the same as the male students' case. Conclusions: As the results of study, it showed that the knowledge to importance of health, the self efficacy, the knowledge of benefit of health promotion behaviors and the health concern to the children of the parents were related to health promotion behaviors of the primary school students. So, through the systematic development of health education program, we induced to desirable direction for the changeable factors of actions to health promotion for the health, and through the connective guidelines between the School and the Home, we have to adapt to effective health promotion program for the health management of the young boys and girls.

A Study on the theory Substantial Compliance under UCP 600 (UCP 600상 상당일치론의 적용에 관한 연구)

  • Kang, Ho-Kyung;Lim, Mok-Sam
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.41
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    • pp.79-102
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    • 2009
  • L/C transaction, the most important issue for the seller and the buyer is the theory of documentary transaction and the theory of strict compliance which are the principles of L/C transactions. According to the leading cases in England and America where the practice of L/C transactions was created and developed, the descriptions of the commodities specified on all the documents which are submitted based on an L/C, should be identical to the descriptions of commodities specified in the L/C. And further, many leading cases of L/C continuously repeat to emphasize strict compliance. However, the recent leading cases in and out of the country show that the principle of strict compliance is being weakened. The leading cases in America show two trends of weakening the principle of strict compliance. That is, on the contrary to strict compliance, tends to apply substantial compliance (which puts more value on the substance of the documents). These leading cases reflect the attitudes of the judicial and the legislative authorization that don't want to approve formal approach to the commercial law. Recently, the Supreme Court of Korea is giving a decision on the principle of strict compliance, "The documents attached to an L/C should strictly comply with the conditions in the L/C, but it doesn't mean that they should be perfectly identical without any mistake in words. In case the bank can understand through reasonable care that a small mistake in words is too trivial to give different meaning or to give damage to the conditions of the L/C, the documents are regarded to comply with the conditions of the L/C. However, the judgment should be based on whether the difference between the documents and the L/C can be admitted by the international standard bank transaction practice or not." This decision tells that the principle of strict compliance is quite much modified so application of this modification can't be ignored. However, from the viewpoint of the party who requests to open an L/C, there is a criticism that a bank's arbitrary judgement can be involved. Therefore, reviewing the original purpose of L/C transactions (activating international transactions), the principle of strict compliance may be thought old-fashioned because it emphasizes a form, but in reality, for prompt transaction and payment, the principle of strict compliance should be observed in L/C transactions. And further, if a legislative device is prepared to systematically compensate for several side-effects, the principle of strict compliance will improve dynamic flow of prompt and low-costly L/C transactions. On the other hand, it will be able to protect the interested parties.

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Chest-wall Surface Dose During Post-mastectomy Radiation Therapy, with and without Nonmagnetic Bolus: A Phantom Study

  • Choi, Cheon Woong;Hong, Joo Wan;Park, Cheol Soo;Ahn, Jae Ouk
    • Journal of Magnetics
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    • v.21 no.2
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    • pp.293-297
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    • 2016
  • For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

The Effects of Rhythmic Exercise Program on Physiologic Variables, Life satisfaction, Calcium, Phosphorous, Osteocalcin, Deoxypyridinoline in the Elderly Women (율동적 운동 프로그램이 여성노인의 생리적 지수, 생활만족, Calcium, Phosphorous, Osteocalcin, Deoxypyridinoline에 미치는 영향)

  • Jung, Young-Ju
    • Journal of Korean Biological Nursing Science
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    • v.4 no.2
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    • pp.93-112
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    • 2002
  • Recently, the number of the elderly has increased according to the improvement of socioeconomic status and the efficient medical care system. In spite of the development of medicine, the elderly suffers from the various health problems caused by weakness of musculoskeletal system, cardiopulmonary function and immunologic dysfunction. Regular rhythmic exercise program is known to be one of the effective tools to enhance the health condition in the elderly. However, there has been few studies to evaluate the comprehensive effects of rhythmic movement program on the elderly. This study was focused to evaluate the indices of cardiopulmonary function, life satisfaction, calcium, phosphorous, osteocalcin and deoxypyridinoline which are the essential factors of health problems in the elderly women. Twenty six subjects, aged between 68 and 72, who can do the ordinary activities and do not have cardiovascular dysfunction and mental disorder, participated in this study. They were divided into two groups: 13 in the experimental group and 13 in the control group. The experimental group participated in the rhythmic movement program at the welfare center located in G-city. The program were consisted of three sessions a week during 10 weeks. Each session had three parts: warming up(10 minutes), main exercise(40 minutes), finishing(10 minutes). Heart rate, blood pressure and peripheral arterial oxygen saturation were measured for the evaluation of cardiopulmonary function. Serum calcium, phosphorous, osteocalcin and urine deoxypyridinoline were measured as the indices of bony metabolism. Data were analyzed with mean, standard deviation, $x^2$-test, t-test, paired t-test using SPSS PC+ program. The results of this study were as follows. 1) Heart rate of the experimental group showed significant decrease following the rhythmic movement program. Peripheral arterial oxygen saturation of the experimental group showed significant increase following the program. 2) The degree of life satisfaction of the experimental group showed significant increase following the program. 3) Calcium showed significant decrease following the program but remained within normal range. There was no significant difference of phosphorous between two groups. 4) Osteocalcin, the index of bone formation, showed no significant change following the program, but significant increase in the experimental group comparing with the control group. 5) Deoxypyridinoline, the index of bone resorption, in urine of the experimental group showed significant decrease following the program. In conclusion, the rhythmic exercise program in the elderly showed the improvement of physiologic function and favorable effects on life satisfaction and bony metabolism. According to the above results, the regular rhythmic movement program can be strongly recommended for the improvement of health in the elderly women.

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The relationship between the numbers of natural teeth and nutritional status of elderly in Korea -based on 2007~2009 national health and nutrition survey data- (한국 노인의 자연치아 수와 영양소 섭취상태와의 관련성 -2007~2009년 국민건강영양조사 자료에 근거하여-)

  • Shin, Bo-Mi;Bae, Su-Myoung;Ryu, Da-Young;Choi, Yong-Keum
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.3
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    • pp.521-531
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    • 2012
  • Objectives : The aim of this study was to evaluate the relation between the state of dental health(number of natural teeth) and nutritional status of Korean elderly using Korean Dietary Reference Intakes, which was an objective standard for nutritional intake based on database of Korea National Health and Nutrition Examination Survey, large scale of sample obtained by the government. Methods : Complex sampling procedure was used to analyze the fourth data(2007-2009) of Korea National Health and Nutrition Examination Survey. When preparing planning file, the estimator of variance as a stratification variance (variance name : kstrata), population of survey unit as a cluster variance(variance name : PSU), and previous exam and nutritional related weighted as a weighted were analyzed by considering reproduced survey and nutritional related total weighted. Complex samples chi-square test was used to estimate the relation between number of natural teeth and inadequate intake and relation factors included in the model were analyzed by complex samples logistic regression analysis. Results : The group of edentulous had a higher risk to intake less nutrient, except calcium, riboflavin and vitamin C than recommended level comparing to reference group which had natural teeth more than 20(phosphate : OR=1.763; 95% CI=1.273-2.443, thiamine : OR=1.748; 95% CI=1.276-2.395, protein : OR=1.610; 95% CI=1.213-2.138). Conclusions : The number of teeth in Korean elderly over 65 years old had a relation with nutritional status in this investigation. Especially, intake level of nutrients was different between the edentulous group and the reference group. Therefore, dental health care is needed from young and middle age to keep health dental condition for through whole life as well as old age. Although the dental condition of the aged is not good, it is evitable to educate them about the relation between dental health and nutritional ingestion to take balanced nutrition, we think.

The Utilization of Aromatherapy in Clinical Physical Therapy (임상물리치료에 있어서 아로마테라피의 활용)

  • Chang Chung-Hoon;Jeong Dong-Hyuk;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.82-95
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    • 2003
  • Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

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A research study on the necessity of school oral health education (학교구강보건교육의 필요성에 관한 조사 연구)

  • Kwag, Jung-Suk;Woo, Seung-Hee;Kim, Eun-Ju
    • Journal of Korean Dental Hygiene Science
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    • v.1 no.1
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    • pp.47-55
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    • 2018
  • The purpose of this study was to examine the influence of oral health education experience on needs for oral health education in children and adolescents in elementary and secondary schools. A self-administered survey was conducted on the students in elementary, middle and high schools located in the city of Mokpo, South Jeolla Province, from October 1 to 31, 2018. The data that were collected from 327 students were analyzed by SPSS 21.0. Statistical data on frequency, percentage, mean and standard deviation were obtained, and t-test, one-way ANOVA, correlation analysis and logistic regression analysis were carried out. The findings of the study were as follows: First, the subjects got 2.25 on a three-point scale in self-rated oral health status. This score was above average, which indicated that the students thought they were in good oral health. As for problems with oral health, dental caries was given the highest score of 2.48 on a five-point scale, followed by oral malodor with 2.35. Second, the students who experienced oral health education accounted for 69.1 percent, and the students who felt the need for this education represented 82.6 percent. As for educational content desired, the biggest group of 57.8 percent hoped to learn about how to prevent and manage dental caries, and the second largest group of 17 percent wanted to learn about how to take care of oral health during orthodontic treatment. Third, as a result of investigating the state of oral health education by the grade of school, the elementary school students had more oral health education experience than the middle and high school students, and the middle school students placed the most importance on the necessity of oral health education. The differences were statistically significant. Fourth, as a result of analyzing the correlation between oral health education experience and the necessity of oral health education, the students who had more oral health education experience asked more for this education, which implies that there was a statistically significant positive correlation. The findings of the study ascertained that oral health education should be provided for students in childhood and adolescence to boost the level of their oral health knowledge and change their oral health attitude in a positive manner. If oral health practice programs that connect schools, local communities and families with one another are developed to guide the oral health behaviors of teenagers in the right direction, it will make a contribution to the promotion of oral health.