• Title/Summary/Keyword: experience report

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Beginner Surgeon's Initial Experience with Distal Subtotal Gastrectomy for Gastric Cancer Using a Minimally Invasive Approach

  • You, Yung Hun;Kim, Yoo Min;Ahn, Dae Ho
    • Journal of Gastric Cancer
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    • v.15 no.4
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    • pp.270-277
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    • 2015
  • Purpose: Minimally invasive gastrectomy (MIG), including laparoscopic distal subtotal gastrectomy (LDG) and robotic distal subtotal gastrectomy (RDG), is performed for gastric cancer, and requires a learning period. However, there are few reports regarding MIG by a beginner surgeon trained in MIG for gastric cancer during surgical residency and fellowship. The aim of this study was to report our initial experience with MIG, LDG, and RDG by a trained beginner surgeon. Materials and Methods: Between January 2014 and February 2015, a total of 36 patients (20 LDGs and 16 RDGs) underwent MIG by a beginner surgeon during the learning period, and 13 underwent open distal subtotal gastrectomy (ODG) by an experienced surgeon in Bundang CHA Medical Center. Demographic characteristics, operative findings, and short-term outcomes were evaluated for the groups. Results: MIG was safely performed without open conversion in all patients and there was no mortality in either group. There was no significant difference between the groups in demographic factors except for body mass index. There were significant differences in extent of lymph node dissection (LND) (D2 LND: ODG 8.3% vs. MIG 55.6%, P=0.004) and mean operative time (ODG 178.8 minutes vs. MIG 254.7 minutes, P<0.001). The serial changes in postoperative hemoglobin level (P=0.464) and white blood cell count (P=0.644) did not show significant differences between the groups. There were no significant differences in morbidity. Conclusions: This study showed that the operative and short-term outcomes of MIG for gastric cancer by a trained beginner surgeon were comparable with those of ODG performed by an experienced surgeon.

The Early Experience of Laparoscopy-assisted Gastrectomy for Gastric Cancer at a Low-volume Center

  • Yang, Shi-Jun;Ahn, Eun-Jung;Park, Sei-Hyeog;Kim, Jong-Heung;Park, Jong-Min
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.241-246
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    • 2010
  • Purpose: Laparoscopy-assisted gastrectomy (LAG) has become a technically feasible and safe procedure for early gastric cancer treatment. LAG is being increasingly performed in many centers; however, there have been few reports regarding LAG at low-volume centers. The aim of this study was to report our early experience with LAG in patients with gastric cancer at a low-volume center. Materials and Methods: The clinicopathologic data and surgical outcomes of 39 patients who underwent LAG for gastric cancer between April 2007 and March 2010 were retrospectively reviewed. Results: The mean age was 68.3 years. Thirty-one patients had medical co-morbidities. The mean patient ASA score was 2.0. Among the 39 patients, 4 patients underwent total gastrectomy and 35 patients underwent distal gastrectomy. The mean blood loss was 145.4 ml and the mean operative time was 259.4 minutes. The mean time-to-first flatus, first oral intake, and the postoperative hospital stay was 2.8, 3.1, and 9.3 days, respectively. The 30-day mortality rate was 0%. Postoperative complications developed in 9 patients, as follows: anastomotic leakage, 1; wound infection, 1; gastric stasis, 2; postoperative ileus, 1; pneumonia, 1; cerebral infarction, 1; chronic renal failure, 1; and postoperative psychosis, 1. Conclusions: LAG is technically feasible and can be performed safely at a low-volume center, but an experienced surgical team and careful patient selection are necessary. Furthermore, for early mastery of the learning curve for LAG, surgeons need education and training in addition to an accumulation of cases.

Relationship between Knowledge, Attitude and Practice of Breast-Self Examination among Middle and High School Girls (여중, 여고생의 유방자가검진에 대한 지식, 태도 및 실천의 관계)

  • Kim, Shin Jeong;Lee, Jung Min;Min, Hae Young;Min, Hye Young
    • Child Health Nursing Research
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    • v.23 no.2
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    • pp.147-157
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    • 2017
  • Purpose: This study was done to investigate the relationship between knowledge, attitude, and practice toward breast self-examination (BSE) among middle and high school girls. Methods: A cross-sectional descriptive study was conducted using self-report questionnaires. Participants were 412 students, 137 middle and 275 high school girls. Data were collected from December 7 to 23, 2016 and analyzed using t-test and Spearman correlation coefficient. Results: The percentage of correct answers for knowledge about breast self-examination among middle and high school girls was 29.2%. The mean score for practice ($5.89{\pm}0.10$) among middle and high school girls was low. For knowledge, there were significant differences according to grade (t=5.93, p<.001), having heard about BSE (t=4.02, p<.001), experience of BSE (t=2.51, p=.012), and need for education (t=3.37, p=.001). In practice, there were significant differences according to having heard about BSE (t=3.64, p<.001), experience of BSE (t=2.64, p=.017). Knowledge level of BSE positively correlated with practice of BSE (r=.21, p<.001). Conclusion: Research results suggest that education on BSE for middle and high school girls is needed to increase the possibility of early detection of breast cancer.

A "GAP-Model" based Framework for Online VVoIP QoE Measurement

  • Calyam, Prasad;Ekici, Eylem;Lee, Chang-Gun;Haffner, Mark;Howes, Nathan
    • Journal of Communications and Networks
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    • v.9 no.4
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    • pp.446-456
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    • 2007
  • Increased access to broadband networks has led to a fast-growing demand for voice and video over IP(VVoIP) applications such as Internet telephony(VoIP), videoconferencing, and IP television(IPTV). For pro-active troubleshooting of VVoIP performance bottlenecks that manifest to end-users as performance impairments such as video frame freezing and voice dropouts, network operators cannot rely on actual end-users to report their subjective quality of experience(QoE). Hence, automated and objective techniques that provide real-time or online VVoIP QoE estimates are vital. Objective techniques developed to-date estimate VVoIP QoE by performing frame-to-frame peak-signal-to-noise ratio(PSNR) comparisons of the original video sequence and the reconstructed video sequence obtained from the sender-side and receiver-side, respectively. Since processing such video sequences is time consuming and computationally intensive, existing objective techniques cannot provide online VVoIP QoE. In this paper, we present a novel framework that can provide online estimates of VVoIP QoE on network paths without end-user involvement and without requiring any video sequences. The framework features the "GAP-model", which is an offline model of QoE expressed as a function of measurable network factors such as bandwidth, delay, jitter, and loss. Using the GAP-model, our online framework can produce VVoIP QoE estimates in terms of "Good", "Acceptable", or "Poor"(GAP) grades of perceptual quality solely from the online measured network conditions.

Work Reentry After Childbirth: Predictors of Self-Rated Health in Month One Among a Sample of University Faculty and Staff

  • Falletta, Lynn;Abbruzzese, Stephanie;Fischbein, Rebecca;Shura, Robin;Eng, Abbey;Alemagno, Sonia
    • Safety and Health at Work
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    • v.11 no.1
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    • pp.19-25
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    • 2020
  • Background: Childbirth represents a significant transition for women, with physical and psychological sequelae. Reentry to the workplace during the postpartum period is understudied, with implications for maternal well-being and job-related outcomes. This study's aim was to examine selected pregnancy, childbirth, and return-to-work correlates of overall self-rated health within the first month of work reentry after maternity leave. Methods: Between December 2016 and January 2017, we surveyed women employed at a large, public Midwestern university who had given birth in the past five years (N = 249) to examine self-rated overall health in the first month of work reentry. Using ordinal logistic regression, we examined whether physical or psychological health problems during pregnancy, childbirth complications, length of maternity leave, and depression and anxiety at work reentry were related to overall health. Results: Women who experienced depression (odds ratio [OR] = 0.096 [95% confidence interval {CI} = 0.019 to 0.483, p = 0.004]) and anxiety (OR = 0.164, [95% CI = 0.042 to 0.635, p = 0.009]) nearly every day reported worse health at work reentry than those with no symptoms. Controlling for demographics and mental health, women who experienced medical problems during pregnancy (OR = 0.540 [95% CI = 0.311 to .935, p = 0.028]) were more likely to report poor health, while taking a longer maternity leave (OR = 14.552 [95% CI = 4.934 to 42.918, p < 0.001]) was associated with reporting better health at work reentry. Conclusion: Women who experience medical complications during pregnancy, return to the workplace too soon after birth, and experience mental health symptoms are vulnerable physically as they return to work.

Affecting factors of the Drinking Behavior of Liver Cirrhosis Patients The Aspects of Convergence of Drinking Behavior and Disease-related of factors (간경변증 환자 음주행위 관련변인 -음주행위와 질병관련 변인의 융복합 측면-)

  • Seo, Young-Sook;Do, Eun-Su
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.249-258
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    • 2015
  • This study was conducted to determine the affecting factors among patients with drinking behavior of liver cirrhosis. Data were collected by questionnaire from 157 patients who were diagnosed with liver cirrhosis at a tertiary hospital located in D-city. Measurements included patients' demographic characteristics, clinical characteristics, disease-related of symptom experience, emotional-factors of anxiety-depression and social-factor of social support. Data were analyzed using t-test, and logistic regression analyses. The incidence rate of drinking behavior was 31.8%. Multivariate analysis revealed that smoking(yes), men, symptom experience, social support and anxiety were more likely to report high level of drinking behavior. Future research should consider managing drinking behavior as an essential component of comprehensive care for patients with liver cirrhosis.

Influence of teamwork skill and decision making competency on nursing work performance (간호사의 팀워크스킬과 의사결정역량이 간호업무성과에 미치는 영향)

  • Mun, Mi Yeong;Kim, Mi Yeon
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1361-1373
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    • 2016
  • This study was undertaken to investigate the influence of teamwork skill and decision making competency on nursing work performance. A total of 170 nurses more than one years working experience were recruited from two university hospitals. Data were collected during March, 16 to 25, 2016 using a structured self-report questionnaires. Data were analyzed using the IBM SPSS/WIN 21.0 program. Teamwork skill and decision making competency for nursing work performance showed significant positive correlation. The significant predictors of nursing work performance among nurses were total clinical experience (${\beta}=.23$, p<.001), teamwork skill (${\beta}=.61$, p<.001) and decision making competency (${\beta}=.13$, p=.015). These variables explained 66% of the variance in nursing work performance among nurses. The results indicate that nurses' teamwork skill and decision making competency are factors positively influencing on nursing work performance.

Botulinum Toxin Injection for the Treatment of Delayed Gastric Emptying Following Pylorus-Preserving Gastrectomy: an Initial Experience

  • Lee, Jung Hwan;Kim, Chan Gyoo;Kim, Young-Woo;Choi, Il Ju;Lee, Jong Yeul;Cho, Soo-Jeong;Kim, Young-Il;Eom, Bang Wool;Yoon, Hong Man;Ryu, Keun Won
    • Journal of Gastric Cancer
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    • v.17 no.2
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    • pp.173-179
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    • 2017
  • Purpose: To report our experience of endoscopic botulinum toxin injection in patients who experienced severe delayed gastric emptying after pylorus-preserving gastrectomy (PPG). Materials and Methods: We reviewed the medical records of 6 patients who received the botulinum toxin injection. They presented with severe delayed gastric emptying in the early postoperative period. Endoscopic botulinum toxin was administered as 4 injections of 25-50 IU into each of the 4 quadrants of the prepyloric area. Results: All botulinum toxin injections were successful without any complications, enabling 5 patients to tolerate soft solid diets and one to tolerate a soft fluid diet within 10 days. The endoscopic criteria of 4 patients improved. Symptom recurrence caused 2 patients to undergo repeat injections that were successful. The median follow-up period was 27 months, and all patients could ingest normal regular diets at the last follow-up. Conclusions: Endoscopic botulinum toxin injection is a feasible treatment option for early delayed gastric emptying after PPG.

compare the level of job stress, burn-out and job satisfaction between intensive care unit nurses and general unit nurses (중환자실간호사와 병동간호사의 직무스트레스, 소진 및 직무만족도 정도비교)

  • Oh, Eun-Wha;Yang, So-Myoung;Kim, So-Hyun;You, Ha-Na;Chin, Eun-Young;Kim, Yeo-Jin;Kim, Young-hee
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.22 no.1
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    • pp.27-36
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    • 2016
  • Purpose: The purpose of this study was to compare the level of job stress, burn-out and job satisfaction between intensive care unit nurses and general unit nurses. Methods: The subjects of this study were 100 intensive care unit nurses and 100 general unit nurses in university's hospitals. The data were collected using self-report questionnaires. The data were analyzed by descriptive statistics, -test, ANCOVA, t-test, ANOVA, and Pearson correlation coefficient by using the SPSS WIN 20.0 program. Results: There were significantly negative correlation in the score of job stress and job satisfaction in both groups of nurses. Job stress of intensive care unit nurses was significantly differences according to department satisfaction. Burn-out of intensive care unit nurses was significantly differences according to position, department satisfaction. Job satisfaction of intensive care nurses unit was significantly differences according to department satisfaction. Job stress of general unit nurses unit was significantly differences according to department satisfaction. Burn-out of general unit nurses was significantly differences according to clinical experience, position, department satisfaction. Job satisfaction of general unit nurses was significantly differences according to clinical experience, department satisfaction. Conclusions: The appropriate rewards for intensive care nurses and general unit nurses to decrease their job stress will be needed in hospital settings. In addition, a plan for systemic nurse training program is needed to provide high quality nursing education for each unit nurses effectively.

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Predictors of College Life Adjustment among Nursing Students (간호대학생의 대학생활 적응에 영향을 미치는 예측요인)

  • Oh, Yun-Jung
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.307-317
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    • 2017
  • This study was to identify the factors influencing college life adjustment and sub-scales of nursing students. Self- report questionnaire surveys were conducted toward 282 freshman nursing students to measure college life adjustment, psychological well-being, emotional intelligence, and self-efficacy. Data were collected from September 22 through October 7, 2016. This study was analyzed using SPSS Win 18.0. The average mean of college life adjustment was 3.36 and academic activity was the highest, followed by individual psychology, social experience, Interpersonal relationship, and career preparation. A correlation of psychological well-being, emotional intelligence, self-efficacy, college life adjustment and sub-scales showed positive correlation. The strongest predictor of college life adjustment was a self-efficacy. And sub-scales, the strongest predictor of academic activity was academic achievement, career preparation was self-efficacy, individual psychology and social experience was emotional intelligence, and Interpersonal relationship was psychological well-being. An intervention program which includes these significant variables of subjects is essential to improve of college life adjustment.