• Title/Summary/Keyword: standard hospital

Search Result 2,939, Processing Time 0.027 seconds

The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery (위 점막하 종양에 대한 개복 및 복강경 위 절제술의 비교)

  • Lim, Chai-Sun;Lee, Sang-Lim;Park, Jong-Min;Jin, Sung-Ho;Jung, In-Ho;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
    • /
    • v.8 no.4
    • /
    • pp.225-231
    • /
    • 2008
  • Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

  • PDF

A Study on Exposure to radiation of the patient who visited an emergency room at a University Hospital (한 대학병원 응급실에 방문한 환자의 방사선 피폭에 관한 연구)

  • Ahn, Buyung-Ju;Lee, Sang-Bock;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
    • /
    • v.1 no.3
    • /
    • pp.23-34
    • /
    • 2007
  • To find how much radiation was exposed the patients who visit emergency room, a measurement study was made for radiation amount toward 200 patients selected randomly among visitors to an emergency room in a university hospital from March 16 to 31st, 2006. The results are as follows ; 1. Among the subjects 50 person(25.0%) were transferred from other hospitals, 24 persons(8.3) come after traffic accident, 50 persons for other accident and 76 persons for general medical care. 2. The average frequency of X-ray taking was calculated as 6.4 time per person among transferred patients, 14.5 times per person among patients with traffic accident and 2.6 times per person among general medical care. 3. The radiation exposure amount by kind of X-ray showed 28.9mGyfor general X-ray diagnosis, 84.2mGy for CT scanning and 1.02mGy for other special radiation study. 4. Average radiation exposure amount was calculated as 24.6mGy by transferred patients, 55.2mGy by patients with traffic accident, 17.1mGy by patients with other accidents and 17.0mGy by general patients. 5. Through the comparison of radiation exposure amount among to subject with maximum allowance threshold by International Commission on X-ray Radium Protection, transferred patients exceeded 6 times than allowance in whole body except extremities and joints, blood forming organ, reproductive system, vitreous body of eye, bone, thyroid gland, skin and etc, Patient suffered from traffic accidents were exposed 10 times more than allowance. In conclusion, the radiation exposure amount during X-rat diagnosis re too much and exceeded allowance standard by International Commission on X-ray Radium Protection. So further study and preventive measure to decrease radiation exposure by patients who visit emergency room.

  • PDF

Predictors of breast-feeding discontinuation in some followed-up hospital-delivered mothers (추적조사된 대구시내 일부 병원분만 산모에서 모유수유중단 예측변수)

  • Lee, Choong-Won;Lee, Moo-Sik;Park, Jong-Won;Lee, Mi-Young;Kang, Mi-Joung;Shin, Dong-Hoon;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
    • /
    • v.28 no.4 s.51
    • /
    • pp.845-862
    • /
    • 1995
  • We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

  • PDF

Effect of Enzyme Replacement Therapy on Growth in Korean Patients with Mucopolysaccharidosis Type I (I형 뮤코다당증 환자들에서 효소 보충 요법이 성장에 미치는 영향)

  • Huh, Rimm;Cho, Sung Yoon;Chang, Mi Sun;Lee, Jieun;Kwun, Younghee;Kim, Su Jin;Sohn, Young Bae;Park, Sung Won;Maeng, Se Hyun;Kwon, Eun-Kyung;Han, Sun Ju;Jung, Jooyoun;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.13 no.2
    • /
    • pp.111-119
    • /
    • 2013
  • Purpose: Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder caused by deficiency of the enzyme ${\alpha}$-L-iduronidase, which leads to a broad spectrum of multisystemic manifestations. Short stature and decreased growth velocity are prominent features of MPS I. The aim of the present study was to evaluate the effect of enzyme replacement therapy (ERT) on growth of Korean MPS I patients from a single center. Methods: Height data were obtained by retrospective chart review of 10 Korean patients with MPS I who had received ERT for a minimum of 3 years. Height was expressed as standard deviation scores (SDS) based on normative data. Annual growth rates were calculated before and during ERT. A piecewise regression model was used to analyze height z-scores before and after treatment. Individual analysis was performed for impact of phenotype [(severe (Hurler) versus attenuated (Hurler-Scheie, Scheie)] on growth. Results: Annual growth was 3.3 cm (z-score= -0.21) in the year before ERT and 6.2 cm (z-score= 0.17), 5.8 cm (z-score= 0.07), and 3.8 cm (z-score= -0.4) in the first, second, and third years of ERT, respectively. Regression analysis showed improvement in the slope after ERT (difference= 0.04; P=0.022). Estimated slope differences between severe and attenuated phenotypes were statistically significant before (P=0.001) and after treatment (P<0.0001), although no significant difference was noted when stratified by phenotype. Conclusion: ERT with aldurazyme appears to have a positive impact on linear growth in patients with MPS I.

  • PDF

The Effectiveness of Visual Field C10-2 in the Early Detection of Glaucoma with Parafoveal Scotoma (중심부 시야결손을 보이는 초기 녹내장 환자의 진단에서 자동시야계 C10-2의 유용성)

  • Hwang, Bo Een;Park, Hae-Young Lopilly;Park, Chan Kee
    • Journal of The Korean Ophthalmological Society
    • /
    • v.58 no.3
    • /
    • pp.321-326
    • /
    • 2017
  • Purpose To identify the correspondence between the central sensitivity of several visual field (VF) tests and ganglion cell inner plexiform layer (GC-IPL) thickness in early glaucoma patients with parafoveal scotoma. Methods Fifty-seven eyes from 57 patients with glaucomatous optic neuropathy and parafoveal scotoma were analyzed using the standard automated perimetry (SAP) C10-2 test, the SAP C24-2 test, and the frequency doubling technology perimetry (FDT) C24-2 test. The correlation between the VF central sensitivity and the GC-IPL thickness from macular scans via optical coherence tomography was analyzed. Results The central sensitivity was $27.51{\pm}5.43dB$, $27.39{\pm}5.05dB$, and $22.09{\pm}5.08dB$ for SAP C24-2, SAP C10-2, and FDT C24-2, respectively. Mean GC-IPL thickness was $70.2{\pm}8.5{\mu}m$. Using regression analysis, the value of log $R^2$ between the logarithmic central sensitivity and GC-IPL thickness was 0.498, and the linear $R^2$ between the antilogarithmic central sensitivity and GC-IPL thickness in SAP C10-2 was 0.486, and both were statistically significant (p < 0.05). This relationship was stronger in early glaucoma patients compared to late glaucoma patients using SAP C10-2. Conclusions The structure-function relationship between GC-IPL thickness and central sensitivity was better with SAP C10-2, especially in early glaucoma patients, compared to other VF modalities.

Comparison Analysis of The results of IRMA Test among Different Equipment According to Algorithm change. (IRMA 검사법 중 알고리즘 변경에 따른 장비 간 결과값 비교분석)

  • Kim, Jung In;Kwon, Won Hyun;Lee, Kyung Jae
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.23 no.2
    • /
    • pp.43-50
    • /
    • 2019
  • Purpose The principle of nuclear medicine test is divided into two main categories: competition(radioimmunoassay, RIA) and noncompetitive reaction(Immunoradiometric assay, IRMA). It is known that the curve fitting method, which is commonly used in inspection field, uses Spline interpolation in RIA method and Linear interpolation method in IRMA method. Among them, the insulin test using the IRMA test showed a significant difference, especially at low concentrations, despite the same algorithm of linear interpolation between fully automated radio immunoassay analyzers. In this study, we aim to obtain results from applying two different of algorithm using fully automated radio immunoassay analyzers including Gamma pro, Gamma 10, Cobra, and SR300. Materials and Methods A total of 30 test samples were selected for the test of TSH, ferritin, C-peptide, and insulin serum levels. Test was performed by IRMA method. We compared the difference in the results of applying the linear interpolation method and the spline interpolation method to Gamma Pro, Gamma 10, Cobra, and SR300 equipment. Results Two-way ANOVA was used for statistical analysis. The significance level was applied as P <0.05. The results of TSH, ferritin, C-peptide, and insulin tests were compared between the fully automated radio immunoassay analyzers. There was a significant difference between ferritin, C-peptide, and insulin serum levels(P<0.001). TSH didn't show any significant different between the devices(P=0.29). In the difference between linear and spline interpolation, there was no significant difference between insulin test(P=0.08), TSH test(P=0.81), and Ferritin test(P=0.06). However, C-peptide test showed a significant difference(P=0.03). Especially, the insulin test showed significant difference in lower ranges. As a result of comparing and analyzing the difference between the two interpolation methods, the devices in the low concentration group showed significant difference(P<0.001). Conclusion In case of new equipment in the laboratory it is necessary to recognize that there is a difference in the curve fitting method for each automated radio immunoassay analyzers in the low concentration area when the principle of inspection is IRMA method.

Quantitative Electroencephalogram Markers for Predicting Cerebral Amyloid Pathology in Non-Demented Older Individuals With Depression: A Preliminary Study (비치매 노인 우울증 환자에서 대뇌 아밀로이드 병리 예측을 위한 정량화 뇌파 지표: 예비연구)

  • Park, Seon Young;Chae, Soohyun;Park, Jinsick;Lee, Dong Young;Park, Jee Eun
    • Sleep Medicine and Psychophysiology
    • /
    • v.28 no.2
    • /
    • pp.78-85
    • /
    • 2021
  • Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

CT Evaluation of Long-Term Changes in Common Bile Duct Diameter after Cholecystectomy (담낭 절제술 후 총담관 직경의 장기 변화에 대한 CT 평가)

  • Sung Hee Ahn;Chansik An;Seung-seob Kim;Sumi Park
    • Journal of the Korean Society of Radiology
    • /
    • v.85 no.3
    • /
    • pp.581-595
    • /
    • 2024
  • Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction.

Enhanced immunity effect of Korean Red Ginseng capsule: A randomized, double-blind and placebo-controlled clinical trial

  • Yi Yang;Jing Li;Shengyuan Zhou;Daoyan Ni;Cailing Yang;Xu Zhang;Jian Tan;Jingrui Yan;Na Wang
    • Journal of Ginseng Research
    • /
    • v.48 no.5
    • /
    • pp.504-510
    • /
    • 2024
  • Background: As a physiological function of body, immunity can maintain health by identifying itself and excluding others. With economic development and increasingly fierce social competition, the number of sub-healthy population is gradually increasing, and the most basic problem exposed is human hypoimmunity. Hypoimmunity can be manifested as often feeling tired, catching colds, mental depression, etc. In order to enhance immunity, eating healthy foods with the effect of enhancing immunity may become an effective choice. KRG has pharmacological effects of enhancing immunity. Because the screening and evaluation method of immune population are not unified, there are relatively few KRG immunity tests for sub-health population. It is of great significance to study the effect of KRG on people with hypoimmunity to improve sub-health status. Methods: This was a 180-day, randomized, double-blind, placebo-controlled clinical trial. According to the trial scheme design, 119 qualified subjects were included and randomly divided into the test group taking KRG and the placebo control group. Subjects need to check safety indicators (blood pressure and heart rate, blood routine, liver and kidney function, urine routine and stool routine) and efficacy indicators (main and secondary) inspection at baseline, efficacy indicators inspection during the mid-term of the test (90th days of administration), safety and efficacy indicators inspection after the test (180th days of administration). Results: After the test, the safety indicators of placebo control group and KRG test group were basically within the normal range, and there is no significant difference in fireness score between the two groups. Through follow-up interviews, it was found that the subjects in the test group and the control group had no adverse reactions and allergic reactions such as nausea, flatulence, diarrhea, and abdominal pain during the test period. Self-comparison of the test group, the results of the main efficacy indicators: (1) immune related health scores were significantly improved in the mid-term and after the test (P < 0.01), (2) CD3 and CD4/CD8 increased significantly after the test (P < 0.05), (3) IgG, IgA, IgM and WBC increased significantly in the mid-term and after the test (P < 0.01); the results of the secondary efficacy indicators: (1) TNF-α decreased significantly in the midterm (P < 0.05), IFN-γ decreased significantly in the mid-term (P < 0.01), (2) NK increased significantly in the mid-term and after the test (P < 0.05), (3) monocyte increased significantly in the mid-term and after the test (P < 0.01). Inter-group comparison of the test group and the control group, the results of the main efficacy indicators: (1) immune related health scores were higher than that of the control group in the mid-term and after the test (P < 0.01), (2) IgA of the test group was higher than that of the control group in the mid-term and after the test (P < 0.05); the results of the secondary efficacy indicators: (1) WBC of the test group was higher than that of the control group in the mid-term (P < 0.05); (2) monocytes of the test group were higher than that of the control group in the mid-term and after the test (P < 0.05), neutrophils of the test group were higher than that of the control group in the mid-term (P < 0.05). Conclusion: Taking KRG has no adverse effects on the health of the subjects. According to the standard of clinical trial scheme, the immune related health scores and IgA in the main efficacy indicators were positive, which shows that KRG is helpful in enhancing human immunity.

Development of Standard Process for Private Information Protection of Medical Imaging Issuance (개인정보 보호를 위한 의료영상 발급 표준 업무절차 개발연구)

  • Park, Bum-Jin;Yoo, Beong-Gyu;Lee, Jong-Seok;Jeong, Jae-Ho;Son, Gi-Gyeong;Kang, Hee-Doo
    • Journal of radiological science and technology
    • /
    • v.32 no.3
    • /
    • pp.335-341
    • /
    • 2009
  • Purpose : The medical imaging issuance is changed from conventional film method to Digital Compact Disk solution because of development on IT technology. However other medical record department's are undergoing identification check through and through whereas medical imaging department cannot afford to do that. So, we examine present applicant's recognition of private intelligence safeguard, and medical imaging issuance condition by CD & DVD medium toward various medical facility and then perform comparative analysis associated with domestic and foreign law & recommendation, lastly suggest standard for medical imaging issuance and process relate with internal environment. Materials and methods : First, we surveyed issuance process & required documents when situation of medical image issuance in the metropolitan medical facility by wire telephone between 2008.6.1$\sim$2008.7.1. in accordance with the medical law Article 21$\sim$clause 2, suggested standard through applicant's required documents occasionally - (1) in the event of oneself $\rightarrow$ verifying identification, (2) in the event of family $\rightarrow$ verifying applicant identification & family relations document (health insurance card, attested copy, and so on), (3) third person or representative $\rightarrow$ verifying applicant identification & letter of attorney & certificate of one's seal impression. Second, also checked required documents of applicant in accordance with upper standard when situation of medical image issuance in Kyung-hee university medical center during 3 month 2008.5.1$\sim$2008.7.31. Third, developed a work process by triangular position of issuance procedure for situation when verifying required documents & management of unpreparedness. Result : Look all over the our manufactured output in the hospital - satisfy the all conditions $\rightarrow$ 4 place(12%), possibly request everyone $\rightarrow$ 4 place(12%), and apply in the clinic section $\rightarrow$ 9 place(27%) that does not medical imaging issuance office, so we don't know about required documents condition. and look into whether meet or not the applicant's required documents on upper 3month survey - satisfy the all conditions $\rightarrow$ 629 case(49%), prepare a one part $\rightarrow$ 416 case(33%), insufficiency of all document $\rightarrow$ 226case(18%). On the authority of upper research result, we are establishing the service model mapping for objective reception when image export situation through triangular position of issuance procedure and reduce of friction with patient and promote the patient convenience. Conclusion : The PACS is classified under medical machinery that mean indicates about higher importance of medical information therefore medical information administrator's who already received professional education & mind, are performer about issuance process only and also have to provide under ID checking process exhaustively.

  • PDF