• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2329-2336
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• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3489-3494
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• 2016

Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.72-76
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• 2011

Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms with a propensity to arise from the minor salivary glands. The most frequent location of PLGA is the palate, even though other locations have been described. Previously used terms for PLGA include lobular carcinoma and terminal duct carcinoma. Although the frequency of the tumor is unknown, the recognition of PLGA as an individual tumor has increased with the establishment of specific histopathological criteria characterizing the PLGA. The first choice of treatment is a wide surgical excision including the subjacent bone if necessary. The prognosis is generally good and the recurrence rate ranges from 17% and 22%. Distant metastases is unusual (9%) but occur mainly in the regional lymph nodes. This is a case report of a 67 year old female patient with PLGA who was treated with a wide excision by layers (2 stage) of the lesion including the surrounding bone. We present this case with a review of the relevant literature.

• 대한한의학회지
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• 제31권5호
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• pp.179-187
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• 2010

임상에서 치료가 어려운 건선을 오래 앓아온 환자가 홍피성 건선이 발생하여 집중적인 입원치료 후 꾸준한 외래진료를 거쳐 호전된 경과를 볼 수 있었기에 보고하는 바이다. 상기 환자는 심장 질환을 동반하고 있었으며 그와 관련된 부종 등의 증상에도 한방치료로 긍정적인 효과를 얻었다. 앞으로 홍피성 건선의 한방치료에 대한 치료의 기준을 마련할 필요가 있을 것으로 생각된다.

• 한국임상수의학회지
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• 제33권6호
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• pp.392-394
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• 2016

A 2-year-old spayed female Persian cat presented to Kangwon National University Veterinary Medical Teaching Hospital with pruritus and erythema on the tips of both ears, around the eyes, and in the caudal abdomen. This patient had previously been prescribed prednisolone, but did not respond positively to the treatment. A skin screening test revealed that there were no fleas or fungi, and that only cocci were present. Blood testing revealed no remarkable findings. The patient was prescribed antibiotics (amoxicillin-clavulanic acid 25 mg/kg for 2 weeks) with no prednisolone. After 2 weeks, clinical signs were alleviated and the skin screening test showed no signs of cocci. However, clinical signs recurred even with the prescription of antibiotics. Four weeks after the steroid-free interval, Malassezia spp. hypersensitivity was detected upon a serum allergy test, and pathological analysis confirmed eosinophilic and mastocytic superficial dermatitis in the caudal abdomen. Based on these results, we suspected allergic dermatitis and prescribed 7 mg/kg cyclosporine A once a day. After 3 weeks, clinical signs were resolved. Seven weeks after the first trial with cyclosporine A, we reduced the cyclosporine A dose to 7 mg/kg every other day. The patient's symptoms have since been well controlled for 6 months. This study suggests that cyclosporine A can be a good choice for treating cats with suspected allergic dermatitis that has not responded positively to steroid treatment.

• 재활치료과학
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• 제2권1호
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• pp.5-12
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• 2013

본 연구는 조현병의 신경과학적 연구에 대한 흐름을 알아봄으로써 임상가들에게 조현병 환자 치료의 토대를 제공하고, 보다 효과적인 치료를 선정하는데 도움이 되고자 하였다. 현재까지 조현병 환자의 신경과학적 연구는 매우 활발히 이루어지고 있는데, 본 고찰에서는 조현병의 발생에 대한 연구와 조현병으로 인한 신경해부학적 기능 이상에 초점을 두고 살펴보았다. 조현병의 발생과 관련된 연구는 신경생화학적 이상, 신경발달적 모델, 뇌단백물질, 뇌유래신경영양인자에 대한 근거들을 다루었으며, 조현병의 신경해부학적 기능 이상에 대해서는 주로 신경영상학적 특징들에 근거하였다. 결론적으로, 조현병은 광범위한 기능적 손실을 가져오는 정신과적 질환으로 이제까지 원인과 치료에 대한 많은 연구들이 실행되고 있지만 아직 명백한 결과를 가져오지는 못하고 있다. 그러나 이제까지 밝혀진 많은 근거들은 임상가들이 조현병 환자를 치료하고 재활함에 있어서 충분한 도움이 될 것으로 생각된다. 앞으로도 조현병의 원인 규명과 치료에 대한 다양한 신경과학적 연구가 진행될 것으로 보인다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권1호
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• pp.80-84
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• 1999

Dieulafoy's disease, a vascular anomaly mainly in the upper stomach, is a rare but potentially life-threatening cause of upper gastrointestinal bleeding. Pathogenesis is still controversial, but the most accepted theory is that a persistent caliber vessel in the submucosa is exposed by a small mucosal erosion leading to massive bleeding. The bleeding site is usually within 6 cm of the esophagogastric junction in the cardia or fundus of the stomach. The treatment of choice is therapeutic endoscopy or surgery. The age of patients reported is mainly between 50 and 70 years, and patients of pediatric age are extremely rare. We are reporting a 5-year-old male patient who had Dieulafoy's disease which was diagnosed by emergency upper gastrointestinal endoscopy. Endoscopic finding was a nodular lesion with an adherent clot on the lessor curvature of the stomach 2 cm below the esophagogastric junction. Epinephrine and $Beriplast^{(R)}$ was injected in the lesion. On the second day after endoscopic sclerotherapy, the patient had recurred massive hematemesis and accompanying shock. So we performed gastrotomy and ligation. After the operation, he showed an improved general condition and was discharged at the 12th hospital day.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.407-412
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• 2008

Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

• 한국치위생학회지
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• 제8권4호
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• pp.43-53
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• 2008

Some female college students have to recognize and understand the actual conditions of the tooth bleaching, and effective consultation and training to provide basic data for the purpose of investigation. this study made a survey about recognize and understand the actual conditions of the tooth bleaching and oral health knowledge and generalization methods for 649 female college student in Daejeon and Jeonbuk areas during the period between March. 15 and April. 10,2008. The results were as follows: 1. Tooth Status was found low, self-discontent respondents Status 44.2% and average 31.1%, self-contentment were 14.8%. Tooth color was average respondents were 69.8%, yellow 29.0%, White 1.7% (p=0.001, p=0.030). 2. Tooth bleaching experience has not experienced the most the military was 86.4%, to the desired Tooth bleaching for the external beauty 44.2%, confidence of smile time 37.5%. self-discontent 10.7%(p=0.000, p=0.000). 3. Tooth health status satisfaction was dental hygiene students higher than non dental hygiene, and scaling knowledge of the Tooth bleaching effect was non dental hygiene higher than non dental hygiene(p=0.039, p=0.000). 4. General knowledge for Tooth bleaching was found high 96.1%, as for the recognition route, 55.6% were through broadcast medium(p=0.025, p=0.000). 5. Medical institution chosen for Tooth bleaching treatment method appears the most preferred by 79.9% to the dental hospital dental clinic. 6. Important to consider that the choice of Tooth bleaching was Tooth bleaching duration of 37.1% cost 33%, And when Tooth bleaching hoped to be long-lasting. In this research the high recognized of Tooth bleaching treatment, but very low Tooth bleaching experience female college students for the Tooth bleaching had the wrong information. Therefore, Tooth bleaching treatment and counseling that can be used to development and education were required to provide the correct information.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.75-81
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• 2007

Introduction: Microsurgical replantation of amputated digit have become common procedure in recent years. However replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. So, fingertip amputation was covered by volar V-Y flap, composite graft, cross finger flap and groin flap. But patients who have been treated by these methods experience shortening of digit, nail deformity, excessive tenderness and persistent pain. Replantation could solve most of these problems. Material & Methods: In our department, from March 2004 to August 2007, 36 digits in 32 patients with complete amputation at distal to nail base were replanted using a microsurgical technique. Results: The overall survival rate of the replanted finger was 75%. Venous anastomosis was possible in 8 cases and impossible in 28 cases. In latter cases external bleeding technique was applied with medical leech. Conclusion: After replantation, a few patient complained decreased sensibility, nail deformity and cold intolerance. But most of patients were satisfied with the functional and cosmetic appearance of the viable replanted digits. We believe the replantation should be the first choice in fingertip amputation.