Backgroun : The long-term survival after operation of patients with lung cancer invading the chest wall is known to be related to regional nodal involvement, completeness of resection and depth of chest wall involvement. In this study results of complete resection are reviewed to determine survival charateristics. Material and Method: Of 680 consecutive patients who were operated on for primary non-small cell carcinoma between 1988 and 1998, we retrospectively reviewed 55 patients(8.0%) who had complete resection for lung cancer invading the chest wall or parietal pleura. Result: Resection of the chest wall was on bloc in 29 patients(47.3%), and extrapleural in 26(52.7%). In the patients undergoing extrapleural resection, the depth of chest wall invasion was confined to the parietal pleura in all patients(100%). In the patients underging en bloc resection, the pathologic depth of invasion was into the parietal pleura alone in 9(31.0%) and into the chest wall in 20(69.0%). The follow-up rate of these patients was 100%. Hospital mortality was 5.4%(n=3). The actuarial 5-year survival rate was 26% for all hospital survivors(n=52). The actuarial 5-year survival rate of patients with T3N0M0 disease(29%) was better than that of T3N2M0 disease(18%), however, there was no significant(p=0.30) difference. The depth of chest wall invasion had no statistically significant effect on survival in our series, neither for patients with involved lymphatic metastasis nor for those without(p=0.99). Conclusion: These observations indicate that the good five year survival in patients with T3 NSCLC invading the chest wall resulted from complete resection. Survival of patients with lung cancer invading the chest wall after complete resection is dependent on the extent of nodal involvement and much less so on the depth of chest wall invasion.
Under the quickly changing health care environment in our society competitions among hospitals are getting harder and accordingly the hospital authorities do their best efforts to renovate their hospital management and let directors of food and nutrition services in hospital be seeking the drastic changes in their clinic-support operations. To attain this end it is essential to build an information system in food and nutrition services in hospital for practicing those operational changes efficiently. By building an information system we can totally manage a number of information about hospital food and nutrition services. This kind of information system can not only relieve dieticians and food-service workers from their repetitively routine jobs, but also connect with hospital management information systems organically. Resultantly productivity in this service area can be improved and the efficiency of hospital management will be increased. And accordingly the competitive advantage of the hospital can be greater than ever and that brings patients' and hospital employees' satisfaction. I would like to name this kind of information system for hospital food and nutrition services "TASTY", abbreviated from "Time-based Advanced Service Technology for Yong-Dong Severance Hospital, Nutrition Department" There are one basic information management area and five business management areas in TASTY. Five specific business areas are divided by menu, procurement, clinical nutrition service, production(including distribution and meal service), and financial management.inancial management.
Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.
This study examined the musculoskeletal symptom experience rate of some dental clinic workers and the factors influencing musculoskeletal symptoms according to their working environment and health habit. To that end, between March 9 and March 28, 2009, 200 workers at dental clinics in Chungcheong-do were surveyed using the self-administered questionnaire method. The data were analyzed using the SPSS WIN 12.0 program. The following conclusion was reached. 1. One-year musculoskeletal symptom experience rates of the subjects were categorized according to pans of the body: shoulders - 60.5%, lower limbs (legs, knees, and feet) - 57.0%, the lumbar region (back and waist) - 56.0%, the neck - 51.0% and the upper limbs (arms, wrists, and fingers) - 32.0%. 2. In general characteristics, a statistically significant difference was found according to gender, age, education, position, and oral health state. In working environments, a statistically significant difference was found according to work experience, the average daily number of patients handled, the average daily working hours, the posture for diagnosis, and satisfaction over work. In health habit, a statistically significant difference was found according to regular exercise, regular examination, and regular eating habit. 3. Factors influencing musculoskeletal symptoms were examined. As a result, influencing the musculoskeletal symptom experience were satisfaction over work among working environment characteristics, and regular exercise among health habit characteristics.
Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.
Objectives: This study aimed to investigate the satisfaction and features of patient groups treated with KMST. Methods: From December 4th 2013 to May 8th 2014, 94 outpatients and 37 inpatients were treated with KMST, and we analyzed their medical records and satisfaction level questionnaires. Results: Mean age of total inpatients and OB&GY inpatients, total outpatients and OB&GY outpatients treated with KMST was $50.84{\pm}9.72$ years, $46.86{\pm}8.43$ years, $44.39{\pm}12.16$ years and $44.01{\pm}11.20$ years respectively. Mean value of treatment numbers per person of each group was 14.70 times, 14.58 times, 3.29 times and 3.41 times respectively. Mean interval between treatments per person of each group was 1.32 days, 1.23 days, 10.90 days and 11.62 days each. Chief complaints of OB&GY inpatients in the order of frequency were lower abdominal pain, dyspepsia and vaginal discharge. As for OB&GY outpatients, they were cold hypersensitivity, vaginal discharge, dyspepsia and infertility. The satisfaction level questionnaires for KMST showed a mean value of $7.98{\pm}1.82$ out of 10-point scale in 6 multiple-choice questions. Conclusions: Most of the patients treated with KMST were female. Pain, dyspepsia and cold hypersensitivity, vaginal discharge were frequent chief complaints in OB&GY inpatients and outpatients group each. It was found that overall satisfaction level of patients treated with KMST was high and there was no reported side effect.
Son, Dong Woo;Kang, Ji Hun;Kim, Yang Weon;Park, Chul Ho;Yoon, Yoo Sang;Ji, Jae Gu
Journal of The Korean Society of Clinical Toxicology
/
v.19
no.2
/
pp.110-126
/
2021
Purpose: The purpose of this study is to find out the current status of toxicology laboratory operated by six locations nationwide and to investigate the satisfaction of emergency medical professionals who working at local and regional emergency medical centers. Methods: This survey was conducted prospective. It was conducted on 665 emergency medical professionals working at regional and regional emergency medical centers across the South Korea. Among them, the analysis was conducted with data that 510 emergency medical professionals who respond to this survey. The questionnaire was conducted on an online basis for a month. To ensure statistical significance, consider a dropout rate of 10% based on a minimum response recovery rate of 70%. 506 people were selected for the survey. Results: According to a survey on the status of addiction analysis room usage, the average monthly usage of addiction test rooms among respondents were 406 cases.71.0 cases (17.4%) of toxicology laboratory in Seoul and 71 cases (17.4%) in Gwangju. 32 cases (7.8%), 118 cases (29.0%) requested by toxicology laboratory in Busan, and the toxicology laboratory in Daegu. Eighty two cases (20.1%), Daejeon area 25 cases (6.1%), Wonju area toxicology laboratory was 78 (19.6%). According to a survey on the satisfaction of the addiction analysis room,Seoul (4.9±2.71) and Gwangju (4.8±2.52) showed high satisfaction. Conclusion: Due to the limited operation time of the four addiction analysis rooms currently in operation, the satisfaction level of addiction analysis by emergency medical professionals in the area is low due to the delay until the result is notified.
The nuclear medicine department of a domestic medical institution uses $^{99m}TcI$, a radionuclide, from $^{99}Mo/^{99m}TcI$ Generator, to inject radioactive drugs into patients. Among the expired generators, imported from foreign countries, the medical institution implements its own disposal. Each medical institution shall satisfy the permitted in-house disposal concentration of radioactive wastes. The guidelines for self-disposal presented in Korea suggested that self-disposal can be performed 80 days after the generator is used. The purpose of these guidelines is to analyze them by comparing them with the data measured directly with the generator and to study if they are feasible. As a result, the generator with a capacity of 1,000 mCi has the longest half-life, and when tested with a high-radiation Mo(molybdenum) column, the number of days that are below the permitted concentration of body disposal with radioactive waste was 72 days and 71 days that were derived from direct column measurement. The results of the direct study confirmed that the guidelines for in-house disposal in Korea were reasonable, as there were 8 to 9 days of storage compared to the number of in-house disposal days provided in the guidelines.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.11
/
pp.411-420
/
2018
This study was conducted to identify the effects of interpersonal communication between health care providers after receiving supplementary education. The participants of this study were 433 health care providers who work at 29 general hospitals in Gwangju Metropolitan City and Jeollanamdo Province. Data were collected from June 8 to June 25, 2018 and evaluated by t-tests, dispersion analysis, correlation analysis and stepwise regression. The results were produced by investigating interpersonal communications according to socio-demographic and health-related characteristics including age, education level, bed size of the hospital at which the participant worked, job satisfaction, hospital location, personal health status, experience with health care management and experience with depression. There were significant differences in communication observed according to supplemental education awareness regarding age, bed size of hospital, occupation, wage, type of medical institution of employment, job satisfaction, work location, health status, health care education experience and chronic disease. There were positive correlations between supplemental education awareness in health workers and their interpersonal communication. The factors that had positive effects on interpersonal communication were level of education and health-related education experience, while age, hospital bed size and job dissatisfaction had negative effects. Finally, support environment, learning transfer and results were identified as sub-factors of supplemental education. Based on the results above, it was proposed that educational training to enhance results, provide a supportive environment and foster learning transfer be developed to increase communication between health workers and provide a safe health service for patients.
This study analyzed the movement of tumors using 4DCT. Appropriate uniform IM were identified using TC, II and CI depending on ITV margins. DVH and NTCP were also compared in each case. Dose analysis on tumors with uniform IM showed that the optimal treatment plan for satisfying all TC, CI, II was evaluated as 2 mm in phase 20 and 3 mm in 40%. That was compared to the dose from the normal tissues of $PTV_{20}$, $PTV_{40}$. In the 20% radiation field, V5, V10, and V20 for the lungs increased 1.49, 1.26, and 0.65%, while 40% increased by 1.9, 2.41 and 1.23%. NTCP had a dose increase of 0.57 to 0.029% from 20% and 40%. There was a dose increase in the spinal cord and heart at uniform IM, but there was no significant difference. These data suggest that the ITV setting of 20%, phase for Respiratory Gated Radiotherapy using Novalis ExacTrac system can be applied with a uniform IM 2 mm and 40% with 3 mm for optimal treatment plan.
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