• 제목/요약/키워드: non-hospital

검색결과 6,038건 처리시간 0.03초

Paraneoplastic demyelination in the brain presenting as a clinically occult non-Hodgkin's lymphoma

  • Son, Hyoshin;Choi, Jongsuk;Kim, Sung Un;Park, Kyung Seok
    • Annals of Clinical Neurophysiology
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    • 제21권2호
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    • pp.108-112
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    • 2019
  • Non-Hodgkin's lymphoma (NHL) may initially present with atypical neurological manifestations, including paraneoplastic neurological syndromes. Herein, we report the case showing an initial manifestation of systemic NHL with paraneoplastic demyelination in the brain that initially mimicked the symptoms of stroke, seizure, and brain tumor. A high index of suspicion and timely diagnostic workup is required to prevent diagnostic delay and commence proper management of the condition. In this situation, a whole-body FDG PET/CT could be useful to screen for occult malignancy.

Recent Advances in Adjuvant Therapy for Non-Small-Cell Lung Cancer

  • Mi-Hyun Kim;Soo Han Kim;Min Ki Lee;Jung Seop Eom
    • Tuberculosis and Respiratory Diseases
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    • 제87권1호
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    • pp.31-39
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    • 2024
  • After the successful development of targeted therapy and immunotherapy for the treatment of advanced-stage non-small cell lung cancer (NSCLC), these innovative treatment options are rapidly being applied in the adjuvant setting for early-stage NSCLC. Some adjuvants that have recently been approved include osimertinib for epidermal growth factor receptor-mutated tumors and atezolizumab and pembrolizumab for selected patients with resectable NSCLC. Numerous studies on various targeted therapies and immunotherapy with or without chemotherapy are currently ongoing in the adjuvant setting. However, several questions regarding optimal strategies for adjuvant treatment remain unanswered. The present review summarizes the available literature, focusing on recent advances and ongoing trials with targeted therapy and immunotherapy in the adjuvant treatment of early-stage NSCLC.

중족부에 발생한 Mycobacterium abscessus 골수염 (Mycobacterium abscessus Osteomyelitis in the Mid Foot)

  • 천경아;곽이경;서진수
    • 대한족부족관절학회지
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    • 제15권1호
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    • pp.39-43
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    • 2011
  • Non-tuberculous mycobacterium has a wide-spread occurrence in nature, and skin, soft tissue, bone, lung and disseminated infection can be involved. Non-tuberculous mycobacterium infection occurs both in immunocompetent patients without underlying diseases and in immunocompromised hosts. Non-tuberculous mycobactrial osteomyelitis is a rare cause of granulomatous osteomyelitis, and has been previously reported in the sternum, spine, humerus, femur, tibia or metatarsal. Mycobacterium abscessus osteomyelitis is a very rare infection in the foot and only 1 case has been reported. Authors report a case of Mycobacterium abscessus osteomyelitis involving the tarsal and metatarsal bones in a non-immunocompromized middle aged women.

비수술적 부분비만 치료 효과에 관한 근거 중심적 연구 (The Review on the Evidence : Effects on Non-surgical Localized Fat Treatments)

  • 송미영;이명종;김호준
    • 한방비만학회지
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    • 제6권1호
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    • pp.1-10
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    • 2006
  • Localized fat and cellulate have not only esthetic but health problem, they are treated by surgical or non-surgical method. There are elecro-acupuncture, ultrasound, radio frequency, endermologie, mesotherapy, and carbon dioxide therapy in prevalent non-surgical treatments. We reviewed the studies on them to analyze their seicntific evidence. The studies are not many. They reported good results of circumference loss or appearance improvement of histologic change but most of them have poor study design. Before marketing or using these modalities, it is ontcal to evaluate to their effectiveness through strict and scientific clinical trials.

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Troponin-Positive Non-Obstructive Coronary Arteries and Myocardial Infarction with Non-Obstructive Coronary Arteries: Definition, Etiologies, and Role of CT and MR Imaging

  • Seung Min Yoo;Sowon Jang;Jeong A Kim;Eun Ju Chun
    • Korean Journal of Radiology
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    • 제21권12호
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    • pp.1305-1316
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    • 2020
  • In approximately 10% of patients with acute myocardial infarction (MI), angiography does not reveal an obstructive coronary stenosis. This is known as myocardial infarction with non-obstructive coronary arteries (MINOCA), which has complex and multifactorial causes. However, this term can be confusing and open to dual interpretation, because MINOCA is also used to describe patients with acute myocardial injury caused by ischemia-related myocardial necrosis. Therefore, with regards to this specific context of MINOCA, the generic term for MINOCA should be replaced with troponin-positive with non-obstructive coronary arteries (TpNOCA). The causes of TpNOCA can be subcategorized into epicardial coronary (causes of MINOCA), myocardial, and extracardiac disorders. Cardiac magnetic resonance imaging can confirm MI and differentiate various myocardial causes, while cardiac computed tomography is useful to diagnose the extracardiac causes.

Safety of Stress Cardiac Magnetic Resonance in Patients With Moderate to Severe Aortic Valve Stenosis

  • Janek Salatzki;Andreas Ochs;Nadja Kirchgassner;Jannick Heins;Sebastian Seitz;Hauke Hund;Derliz Mereles;Matthias G. Friedrich;Hugo A. Katus;Norbert Frey;Florian Andre;Marco M. Ochs
    • Journal of Cardiovascular Imaging
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    • 제31권1호
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    • pp.26-38
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    • 2023
  • BACKGROUND: Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS. METHODS: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS. RESULTS: A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms. CONCLUSIONS: Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.

상급종합병원 비급여 진료비 변이에 따른 항목 표준화에 관한 연구 (A Study of Category Standardization according to Non-benefit Medical Expense in Tertiary Hospitals)

  • 노옥희;안상윤;김용하;이종형;박아르마;김광환
    • 한국산학기술학회논문지
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    • 제21권5호
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    • pp.274-280
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    • 2020
  • 이 연구의 목적은 건강보험심사평가원에서 공개한 2015년 4월부터 2018년 4월까지 상급종합병원의 비급여 진료비 자료를 사용하여 비급여 진료비 항목별로 현황 및 평균 비용과 변이가 있는지 파악하는 것이다. 조사대상은 2015년, 2016년, 2017년, 2018년 4월 기준 상급종합병원 44개 기관 중 취소되거나 신규로 지정된 기관은 제외하고 최종 41개 상급종합병원의 비급여 진료비 현황이다. 연구방법은 건강보험심사평가원 정보공개창구에서 공개 자료를 요청한 후 승인을 받아 진행하였다. 분석방법은 일반적 특성과 연도별 비급여 항목 현황은 빈도분석, 연도별 변이 파악은 변동계수(C.V.)를 선정하여 분석하였다. 연구 결과, 비급여 진료비 세부항목의 현황을 비교 분석한 결과 비급여 항목의 개수가 2015년에는 총 51개였지만, 2016년 53개, 2017년, 98개로 점점 증가 추세를 보였으며 2018년에는 총 193개 항목으로 급격히 증가하였다. 상급종합병원 비급여 진료비 변이에 따른 항목 표준화를 위해서 정부는 비급여 진료비 표준화를 확대하고 의료기관은 표준화된 비급여 진료비 항목이나 명칭 등을 사용하도록 의무화하여야 한다.

유기인계 중독 환자에서 알코올이 사망률에 미치는 효과 (Effect of Alcohol on Death Rate in Organophosphate Poisoned Patients)

  • 민용훈;박승민;이귀자;오영택;안희철;손유동;안지윤;이영환;하상욱;김유정
    • 대한임상독성학회지
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    • 제13권1호
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    • pp.19-24
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    • 2015
  • Purpose: Many patients who are acutely poisoned with organophosphorus pesticides have co-ingested alcohol. The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between alcohol coingested patients and non-coingested patients, looking at vital signs, length of admission, cholinesterase activity, complications, and mortality. Methods: All patients visiting one Emergency Department (ED) with organophosphate intoxication between January 2000 and December 2012 were reviewed retrospectively. The patients were divided into two groups, alcohol coingested group and non-coingested group. Results: During the study period, 136 patients (alcohol coingested group, 95 patients; non-coingested group, 41 patients) presented to the ED with organophosphate intoxication. Seventy-one alcohol coingested patients (74.1%) vs. 16 non-coingested patients (39.0%) received endotracheal intubation, with results of the analysis showing a clear distinction between the two groups (p=0.001). Twenty-three alcohol coingested patients (24.2%) vs. 1 non-coingested patient (2.4%) required inotropics, indicating a significant gap (p=0.002). Twenty-eight alcohol coingested patients (29.5%) vs. 2 non-coingested patients (4.9%) died, with results of the analysis showing a clear distinction between the two groups (p=0.002). Conclusion: In cases of organophosphate intoxication, alcohol coingested patients tended to receive endotracheal intubation, went into shock, developed central nervous system complications, and more died.

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일개 대학병원의 환자군별 진료서비스 변이와 포괄수가제 적용에 따른 진료수익 변화 (Studies on the variations of hospital use and the changes in hospital revenues of 10 KDRGs under the PPS)

  • 전기홍;송미숙
    • 보건행정학회지
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    • 제7권1호
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    • pp.100-124
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    • 1997
  • In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

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In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture

  • Kim, Eugene;Park, Se-Jin;Lee, Ho-Seok;Park, Jai-Hyung;Park, Jong Kuen;Ha, Sang Hoon;Murase, Tsuyoshi;Sugamoto, Kazuomi
    • Clinics in Shoulder and Elbow
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    • 제21권3호
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    • pp.151-157
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    • 2018
  • Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.