• Title/Summary/Keyword: Hospital choice

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Sperm chromatin structure assay versus sperm chromatin dispersion kits: Technical repeatability and choice of assisted reproductive technology procedure

  • Laxme B, Vidya;Stephen, Silviya;Devaraj, Ramyashree;Mithraprabhu, Sridurga;Bertolla, Ricardo P.;Mahendran, Tara
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.277-283
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    • 2020
  • Objective: The sperm DNA fragmentation index (DFI) guides the clinician's choice of an appropriate assisted reproductive technology (ART) procedure. The DFI can be determined using commercially available methodologies, including sperm chromatin dispersion (SCD) kits and sperm chromatin structure assay (SCSA). Currently, when DFI is evaluated using SCD kits, the result is analyzed in reference to the SCSA-derived threshold for the choice of an ART procedure. In this study, we compared DFI values obtained using SCSA with those obtained using SCD and determined whether the difference affects the choice of ART procedure. Methods: We compared SCSA to two SCD kits, CANfrag (n=36) and Halosperm (n=31), to assess the DFI values obtained, the correlations between tests, the technical repeatability, and the impact of DFI on the choice of ART. Results: We obtained higher median DFI values using SCD kits than when using SCSA, and this difference was significant for the CANfrag kit (p<0.001). The SCD kits had significantly higher coefficients of variation than SCSA (p<0.001). In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) would be chosen for a significantly higher proportion of patients if a decision were made based on DFI derived from SCD rather than DFI determined using SCSA (p=0.003). Conclusion: Our results indicate that SCD kit-specific thresholds should be established in order to avoid the unnecessary use of IVF/ICSI based on sperm DNA damage for the management of infertility. Appropriate measures should be taken to mitigate the increased variability inherent to the methods used in these tests.

Effects of Korean Medicine Treatment on a Patient with Functional Scoliosis with an Abnormal Gait Pattern After Hip Injury: A Case Report

  • Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hoo-In;Choi, Jong-Ho;Park, Eun-Young;Lee, Soo-Kyung;Lee, June-Haeng;Kim, Min-Kyu;Lee, KeunJae;Yu, Ok-Cheol
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.282-285
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    • 2019
  • Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than $10^{\circ}$. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body's imbalance. Based on X-ray images, the Cobb angle had decreased from $14.73^{\circ}$ (pretreatment) to $1.90^{\circ}$ (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis

  • Kim, Min Gyun;Lee, Seung Tae;Park, Joo Yong;Choi, Sung Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.7.1-7.7
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    • 2015
  • Background: Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis. Methods: We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics. Results: A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement. Conclusions: We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.

Development of Critical Thinking Skill Evaluation Scale for Nursing Students (간호대학생의 비판적 사고력 평가도구 개발)

  • You, So Young;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.2
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    • pp.129-138
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    • 2014
  • Purpose: To develop a Critical Thinking Skill Test for Nursing Students. Methods: The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed. Results: Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001). Conclusion: The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.

How to Get into a Good Fellowship?

  • Ser Yee Lee;Shu Ming, Chai;Chung Yip Chan
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.16-22
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    • 2017
  • A specialist in the medical field is probably one of the most time-consuming professions to train for before one is considered an expert. Inclusive of medical school, it can take as long as 20 or more years of structured training before one graduates as a new specialist in a particular surgical subspecialty or medical field. A fellowship is often the last official phase in this professional marathon, typically defined as a 1 to 2-year full-on clinical subspecialty experience. One would expect this important "finishing school" to be well researched and written about, however, as compared to other professionals and fields, there is scanty literature on how one can get into a good fellowship program. This is a perspective piece on the intricacies of securing a position in a good fellowship program, drawn from the collective experience of the authors, their colleagues and friends. There are several ways to achieve this and many processes one will encounter. A variety of factors one will need to consider, decide and works towards in this effort of optimizing of their chances of success in getting into their fellowship program of choice. The thought processes, suggestions and solutions at each phase may be helpful. In conclusion, obtaining a choice fellowship position is as much an art as a science, and maybe some luck. Many factors, some more obvious and objective, some softer and more subtle, can all influence the outcome in one way or another.

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Career Choice and Employment Preparation Condition for EMT Students (응급구조(학)과 학생의 취업진로선택 및 취업준비 현황)

  • Park, So-Mi;Choi, Eun-Sook;Kim, Mi-Sook;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.65-78
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    • 2011
  • Purpose : We investigated the career choice and the employment preparation of emergency medical technology (EMT) students. The results of study will provide the base information about the consciousness for career choice and employment of the EMT students. Method : We conducted 1,586 surveys from 665 students at six four-year colleges and 921 students at seven three-year colleges, from Aug. 27th to Oct. 31st in 2010. The result was analyzed by SPSS 18.0 using description statistics, t-test, ANOVA, Scheffe and Pearson correlation coefficient. Result : The general characteristics showed male 50.2% and female 49.8%, and first grade 34.6%, second grade 27.4%, third grade 28.2%, and fourth grade 9.8%. The 53.9% of students had experienced the hospital training and the 44.8% did the fire station training. For the choice of job, there were the 61.8% student who hope to enter the employ in fire station or public service, while 25.7% students hope to be employed in hospitals. The reason for a wish job were 'majors-related job' in 18.2% students, 'employment stability' in 17.2% and 'hit on the aptitude and talent' in 16.7%, 'appropriate salaries' in 15.9%. In the questionnaire of the University what to assist you for job preparation, they chose the 'support for get major related license', 'support for officer exam preparation' and 'support of foreign language study' in 34.6%, 16.8% and 16.6%, respectively. For achieved licence, they had a driver's license in 53.9%, BLS (basic life support) provider in 20.3%, life guard in 16.2% and scuba in 8.8%. The statistically significant correlation was identified between the awareness of University that provides job information and one's career awareness (r= .203, p<.000), the awareness that University provide job information and one's confidence in employment (r= .236, p<.000), and one's career awareness and one's confidence in employment (r = .356, p = .000). Conclusion : The most of EMT Students are well conscious of the their future employment and has prepared career to be employed their preference job.

Possible Effects of Senior Hospital Selection Factors and Satisfaction on Revisit Intention (노인병원 선택요인과 만족도가 재이용의사에 미치는 영향 - 환자보호자 관점에서 -)

  • Choi, Young-Sun;Rue, Hwang-Gun;Bae, Sung-Kwon
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.33-46
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    • 2009
  • In order to analyze possible effects of senior hospital selection factors and service satisfaction on senior hospital patients' revisit of senior hospital, this study surveyed guardians of total 204 patients hospitalized in major 4 senior hospitals in Busan. As a result, this study came to the following conclusions: First, it was found that guardians considered appropriateness of medical treatment cost as the biggest factor of choice, which was followed by kindness of doctor and hospital employees, locational accessibility (traffic convenience), and doctor's medical capacity. Second, the factor analysis about patients' satisfaction showed that the influential factors consisted of satisfaction at medical staffs, satisfaction at nursing and care, and satisfaction at facilities. Third, there was not significant difference in the overall impression of hospital and the intention of revisit depending upon sociological variables. Fourth, satisfaction at nursing and care and satisfaction at facilities had significant effects on better satisfaction at overall impression of hospital, and it was noted that the shorter admission period and the less complaint led to the higher intention of revisit. Therefore, it is necessary to improve satisfaction at medical staffs, nursing and care, and facilities rather than patients' own sociological characteristics.

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Delayed Posttraumatic Spinal Epidural Hematoma: Importance of Early Surgical Treatment for Neurologic Deficits

  • Lee, Deok Heon;Oh, Tak-Hyuk;Lee, Jong-Chul;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.176-179
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    • 2016
  • Delayed posttraumatic spinal epidural hematoma is an extremely rare disease, and it remains a challenge for surgical teams of trauma centers. Magnetic resonance imaging is an essential tool for early diagnosis, and emergent evacuation of the hematoma is the best choice of treatment. We report the case of a 33-year old man with posttraumatic epidural hematoma in the thoracic spine (T10 and T11 levels), who developed an abrupt-onset paraplegia 5 days after the trauma.

Extracorporeal Membrane Oxygenation Treatment of Traumatic Lung Injury - 2 cases - (외상성 폐손상시 체외막형 산화기 치료 - 2 예 -)

  • Yang, Jin-Sung;Shin, Hwa-Kyun;Her, Keun;Won, Yong-Soon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.155-158
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    • 2011
  • Mechanical ventilation is usually the treatment of choice for severe respiratory failure associated with trauma. However, in case of severe hypoxia, mechanical ventilation may not be sufficient for gas exchange in lungs. Patients with Acute Respiratory Distress Syndrome (ARDS) undergo difficulties in oxygen and carbon dioxide exchange. Extracorporeal Membrane Oxygenation (ECMO) is the ideal therapeutic option for those patients with severe traumatic injuries. ECMO allows lungs to reserve their functions and decreases further lung injuries while increasing survival rate at the same time. We report two cases of patients with traumatic ARDS and Multiple Organ Failure including compromised heart function. The preservation of lung function was successful using ECMO therapy.

Diagnosis and resolution of pancreatic pseudocysts with percutaneous ultrasound-guided aspiration in two dogs (개 췌장 위낭종에서 초음파 유도 흡인 생검을 통한 진단 및 치료 2례)

  • Choi, Jihye;Kim, Hyunwook;Seo, Jeemin;Lee, Minjung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.341-347
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    • 2007
  • Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.