• Title/Summary/Keyword: Local Medical Center

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Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.194-203
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    • 1999
  • Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

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Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

Packing effects on the intracavitary radiation therapy of the utaine lervix cancer ($^{192}Ir$source를 이용할 자궁경부암 강내치료시 사용하는 packing의 효과에 대한 고찰)

  • Cho, Jung-Kun;Lee, Du-Hyun;Si, Chang-Kun;Choi, Yoon-Kyung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.73-77
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    • 2004
  • Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.

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The Heterogeneity of T2NO Glottic Carcinoma Treated by Irradiation (T2NO 병기 성문암의 방사선치료-예후인자 분석)

  • Lee Hyung Sik;Moon Sun Rock;Ahn Ki Jung;Chung Eun Ji;Suh Chang Ok;Kim Gwi Eon;Loh John J K
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.199-205
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    • 1990
  • During a ten-year period from 1978 through 1987, 44 patients with T2NOMO glottic cancer were treated with radical radiation therapy at the Yonsei University Medical Center. Forty-two patients had a minimum follow-up of 3 years, and $81\%$ had at least five years of follow-up. Patients were staged according to the AJCC system. Forty-two patients have been analyzed in detail with respect to two variables: the status of vocal cord mobility and the degree of local extension of the disease. Five-year local recurrence free survival rates were as follows: All 42 patients, $53.3\%$ patients with normal vocal cord mobility (n =18), $69.1\%$ versus patients with impaired vocal cord mobility (n=24), $43.4\%$(p<0.05); patients with subglottic extension (n=15), $36.7$ versus patients without subglottic extension (n=29), $61.9\%$ (p<0.05). The most favorable Prognostic group included the patients with normal mobility without subglottic extension (n=14), $83.1\%$. On the basis of this analysis, we confirmed the presence of heterogeneity in T2NOMO glottic cancer This study indicates that further randomized controlled trials are warranted to evaluate.

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Disagreement of ICD-10 Codes Between a Local Hospital Information System and a Cancer Registry

  • Sriplung, Hutcha;Kantipundee, Tirada;Tassanapitak, Cheamjit
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.259-263
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    • 2015
  • Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

A study on the proposed amendment bill of Bioethics and Safety Law (2010): focusing on the meaning of significant contents related to the clinical research ("생명윤리 및 안전에 관한 법률" 전부개정안의 내용과 의의: 임상연구와의 관계를 중심으로)

  • Kim, Eun-Ae
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.99-131
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    • 2011
  • To strengthen the protection of human research subjects and human materials, the Korean Ministry of Health and welfare proposed the amendment bill of Bioethics and Safety Law(2010) to the Congress. It includes so many meaningful clauses. According to the bill, the scope that this act shall apply will be expended to the research involving human subjects and human materials. In the bill, there are the principles of this act; the protection of the life, health, and dignity of the human subjects, the obtaining of the adequate informed consent, the protection of the human subject's information confidentiality and the human subject's privacy, the assessment and minimizing of the risks involved and the guarantee of the safety for the human subjects, the preparation of the special protection program for the vulnerable human subjects, and so on. According to the bill, Institutional Bioethics Review Board(the same as Institutional Review Board) will be responsible for the auditing and monitoring on the research that was approved by IBRB, conducting the education program for the researchers, IBRB members and administrative staffs, preparing of the special protection program for the vulnerable human subjects, and forming the guidelines for the researchers as well as the review of the research protocols. And the State and local governments shall take necessary measures to support the expending of the social infrastructure. In addition to, IBRB will have to be assessed and to be gained the accreditation by the Korean Ministry of Health and welfare. So, if Bioethics and Safety Law is amended, it will contribute enormously to enhance the level of the human research subjects protection. Also, if this Law is amended, IBRB will play a major role for the conduct of the ethically, scientifically, and legally proper research. But now, as a matter of fact, the capability of IBRB members and IBRB office members is not enough to charge of this role because some people and some organizations does not know the importance of IBRB exactly. In spite of, IBRB shall be able to this role to protect the human subjects and to develop the level of the research On the international level. Therefore, the State, local governments and the Organization shall back up the administrative and financial terms of the IRB and IRB Office.

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Analysis of Characteristics and Symptoms in Home-Based Hospice-Palliative Care Patients Registered at Local Public Health Centers (일 지역 보건소 등록 호스피스 완화돌봄 대상자의 특성 및 증상 분석)

  • Choi, Soon-Ock;Kim, Sook-Nam
    • Journal of Hospice and Palliative Care
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    • v.18 no.4
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    • pp.329-334
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    • 2015
  • Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

Luminescence Properties of Europium-doped NaSr(PO3)3 Phosphor (Europium이 첨가된 NaSr(PO3)3형광체의 형광특성)

  • Yoon, Changyong;Park, Cheolwoo
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.645-652
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    • 2019
  • Phosphor with phosphorus doped with rare earth ions was investigated by searching Sr and Eu phosphors suitable for substitution of Eu ions with similar ionic radius to polyphosphate host. The $NaSr(PO_3)_3$ phosphor was synthesized by the solid state method and the $NaSr(PO_3)_3:Eu^{2+}$ phosphor was prepared by the carbon thermal reduction method. Both of the phosphors were identified by X - ray diffraction. The excitation and emission spectra of $NaSr(PO_3)_3:Eu^{3+}$ increased fluorescence intensity and intensity quenching with increasing $Eu^{3+}$ concentration. The higher the $Eu^{3+}$ concentration in the emission spectrum, the higher the local symmetry of $Eu^{3+}$ environment. The mechanism of concentration quenching, in which fluorescence decreases due to the energy transfer between $Eu^{2+}$ ions with the closest critical distance between $Eu^{2+}$ ions with increasing $Eu^{2+}$ ion concentration, was confirmed in the emission spectrum of $NaSr(PO_3)_3:Eu^{2+}$ concentration. It is possible to change the fluorescent region through the post-processing of single rare earth ion added phosphors, and it is possible to change the fluorescence by applying the energy transfer and concentration quenching mechanism according to the local symmetry of $Eu^{3+}$ will be used for high phosphor development.

Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Factors related to COVID-19 Incidence and Mortality rate in Gyeongsangbuk-do, Korea (경상북도 지역의 코로나19 발생률 및 사망률 관련요인)

  • Kim, Dong-Hwi;Park, Sung-Jun;Kang, Hyun-Jun;Yeom, Eun-Jung;Yoo, Na-Eun;Lee, Jeong-Min;Nam, Eun-Ha;Park, Ji-Hyuk;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.45 no.4
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    • pp.235-244
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    • 2020
  • Objectives: Gyeongsangbuk-do has entered a super-aged society with 20.7% of the population aged 65 and older. As of April 30, 2020, the death rate of COVID-19(3.8 people) in Gyeongsangbuk-do is higher than the national mortality rate (2.3 people), and the fatality rate of COVID-19 by age accounts for more than half of the total of 58.6%, so it is time to propose to prevent infectious diseases in the event of additional infectious disease disasters COVID-19. Methods: We collected daily data on the number of confirmed cases and deaths due to COVID-19 from 19 February to 30 April 2020. The data collected was evaluated using the SPSS 21.0 statistical package. Results: As a result of comparing the incidence and death-related factors of confirmed patients in Gyeongsangbuk-do, there were significant differences in age group (p<0.001), underlying disease (p<0.001), and residence type (p<0.033). Conclusion: Factors affecting the mortality rate of confirmed patients in Gyeongsangbuk-do have been combined with individual level factors(age, gender, underlying disease), which means individual characteristics that have existed since before the disease, and regional level factors(Type of Residence), which are external factors that enable the use of medical resources. Therefore, each local government is required to establish preventive measures considering individual and regional level factors.