The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.
The pilomatricoma (calcifying epithelioma of Malherbe) is rare benign hard, spherical and freely movable cutaneous tumor, which was differentiated from hair cells, particulary hair cortex cells. It is usually occured as a single, asymptomatic, 0.5 cm to 3.0 cm sized, deep seated, firm nodule, covered by normal or pink skin. It arises chiefly in young people, including children, and most often in the head, neck and upper extrimites. The authers experienced a case of pilomatricoma which occured in preauricular region. This case was summarized as follows. 1. 10 years old female has suffered from hard subepidermal mass on preauricular area and she visited our out patient clinic. So we performed surgical extirpation and the excised specimen was pathologically examined. 2. Grossly the tumor measures 2.0 cm in diameter and firm, bosselated, spherical shaped which covered by a thin layer of fibrous tissue. On cut section, it shows spicular gritty surfaces, well encapsulation, interwoven and keratotic lamellae. 3. Histopathologically, the epithelial masses of the tumor are composed of two type of cells, basophilic cells and shodow cells. The basophilic cells resemble hair matrix cells which posses round or elogated, deeply basophilic nuclei and scanty cytoplasm. The shadow cells show a central, unstained shadow at the site of the lost nucleus. Gradual development of basophilic cells into shadow cells can be observed. Foci of calcification are present within the lobule of shadow cells. The stroma of the tumor shows a considerable foreign body giant cell reaction adjacent to the shadow cells. 4. No recurrence was observed until post-operative 40 months.
In the situation of bringing out of social problem about the medical accident and medical dispute, from 1988 the enactment activity for a legislative bill on conciliation of dispute has promoted, a legislative bill on prevention and relief of medical accident was again proposed in December, 2005. This bill has been faced rough going in review process of National Assembly. Because the purpose of this legislative bill is the conciliation of interest of between medical service consumer and medical service supplier, an item of issues of law is no-fault compensation scheme. However, as no-fault compensation scheme runs counter to the principle liability with fault in our civil law, as expected, whether the inducement is valid or, if induced, the problem is not must be totally reviewed. First of all, the general of principle liability without fault and especially the medical system in foreign countries are reviewed, by reviewing an issue and the pros and cons of the inducement of no-fault compensation scheme, this article draws the conclusion. After all, considering that the necessity adapting Gefahrdungschftung in medical accident as much as other industrial fields exists, the many provisions of the principle liability without fault exists in civil law and special law of our law system, and no-fault compensation scheme let legislative purpose be, to what extent, achieved by conciliating patient and doctor, the inducement of principle liability without fault in medical field is reasonable in the aspect of politic and legal system.
Background Buried non-incisional double-eyelid blepharoplasty is a popular aesthetic procedure. Although various modified continuous suture techniques have been used to create a more natural appearance and to reduce downtime, complications such as loosening of the double fold, asymmetry, and foreign body reactions have been observed. Methods This study included 250 patients who underwent double-eyelid blepharoplasty between March 1997 and November 2012 using a modified single-knot continuous buried non-incisional technique. With 4 stab incisions in the upper eyelids, one of two needles loaded with double-armed 7-0 nylon was passed in one direction alternately through the dermis and the conjunctiva, while the other needle was passed subconjunctivally in the opposite direction. Both ends of the sutures were knotted within a lateral stab incision of the upper eyelids and were buried in the orbicularis oculi muscle. Results Most patients displayed satisfactory aesthetic results, and no significant complications occurred. There was no obvious regression of the double fold; however, 3 patients required reoperation to correct loosening of the fold on one side during the follow-up period. One patient presented with the suture knot subcutaneously, and the knot was removed in the clinic. Conclusions The modified single-knot continuous buried non-incisional technique is a simple and less time-consuming method for a durable double fold and provides satisfactory aesthetic results.
Background: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. Methods: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. Results: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. Conclusion: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.
A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제40권1호
/
pp.43-47
/
2014
Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.
Children's accident is a largely preventable public health problem. Little is known. however, about population-based incident and outcome of pediatric accident. From 1997.9 through 1998,8. admission data from emergency center in I city were collected. 1418 patient from 0 through 13 years of age were selected. All children with unintensional accidental problems were identified through coded sheet which categorizes epidemiologic characteristics. The specific purposes of this study are analysis about the characteristics of pediatric accidents. And it aims to produce the basic data necessary for accident prevention policy development. The results of this study were as follows; 1. The number of male children$(62.6\%)$ were higher than female children$(37.4\%)$ 2. The age group from 1 to 3 years represents the highest proportion$(45.4\%)$ of every accidents except on traffic accident. 3. The highest proportion of accident were as follows occured during the June-August$(34\%)$, Sunday$(22.6\%)$, and 17-21 p.m. $(37.2\%)$ 4. The main causes of accident include general trauma$(70.9\%)$, environmental accident$(l6.8\%)$. and traffic accident$(l2.1\%)$, 5. Preschool age group represents more than half$(65.4\%)$ of traffic accident. 6. environmental injury includes burns $(46.6\%)$, foreign body$(43.6\%)$, exposure to poisonous materials$(6.3\%)$. and bite(3.3) This results could be used to develope prevention programs and assist in accident prevention system development. And also these data substantiate that accident prevention program decrease safety-related injury rate in preschool age group must be concentrated on enhancing access to a system to have a significant effect. Furthermore, it is necessary for accident prevention. So several suggestions are described here: 1. Development of parent's educational program for accident prevention and safety education should be done actively. 2. Home safety surveillance system should be initiated. 3. The initiation of children's accident report system could be contribute the analysis and the reduction of accident.
During laparoscopic cholecystectomy, a surgical clip is used to control the cystic duct and cystic artery. In the past, metallic clips were usually used, but over recent years, interest in the use of Hem-o-lok clips has increased. Surgical clip migration into the common bile duct (CBD) after laparoscopic cholecystectomy has rarely been reported and the majority of reported cases involved metallic clips. In this report, we describe the case of a 53-year-old woman who presented with abdominal pain caused by migration of a Hem-o-lok clip into the CBD. The patient had undergone laparoscopic cholecystectomy 10 months previously. Abdominal CT revealed an indistinct, minute, radiation-impermeable object in the distal CBD. The object was successfully removed by sphincterotomy via ERCP using a stone basket and was identified as a Hem-o-lok clip.
This study was carried out to understand the general conditions about management of hypertension and the differences in opinions between the Eastern-Western Nursing Sciences. In this context, this study was aimed to find out a possible integration of the Eastern-Western Nursing Sciences for the management of hypertension and to suggest a distinct frame of Korean nursing intervention method which is unique for the hypertensive patients by combining two hypertensive management systems originated from the Western type, "mainly classified by stage", and the Eastern type, "typically classified by form" as they are identified in the literature. From the research literature including both domestic and foreign, this study identified that exuberance of Yang of the Liver form mainly appeared to the patient who is at a border hypertension or the first stage of hypertension, Deficiency of Yin of the Liver and Kidneys form mostly appeared to the first stage and the second stage of Hypertension and Deficiency of the both of Yin and Yang form appeared to the third stage of Hypertension. These unifications of the types of Hypertension classified by stages and forms suggest the possibility not only of integration of the Eastern-western Medicine but also of establishment for the intervention of specific nursing management which is the united Eastern-western Nursing Science for the Hypertension. Hence, the new frame for the nursing management of Hypertensive patient is suggested as follows : 1) In case of the exuberance of Yang of the Liver form, as classified by form which is categorized to the border Hypertension or the first stage of Hypertension, nursing intervention should include general therapy, cooking meal and neutral care to restrain the condition of the exuberance of Yang of the liver. 2) In case of the deficiency of Yin of the liver and the Kidneys form, as classified by form which is categorized to the second stage of Hypertension, nursing intervention should include both the general and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of the deficiency of Yin of the Li ver and Kidneys. 3) In case of the deficiency of both of Yin and Yang form, as classified by form which is categorized to he third stage of Hypertension should include both the general therapy and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of deficiency of the both of Yin and Yang. In addition, using this basic frame of Hypertensive management, a specific way of nursing intervention, which is suitable for exuberance of Yang of the Liver form, deficiency of Yin of the Liver and Kidneys form, and deficiency of both of the Yin and Yang form and classified by Korean herbal medicine related to hypertension, should be pursued continuously in the future.
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