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A Clinical Study of the Pediatric Patients Who Visited in Emergency Room of Oriental Medical Hospital (모 한방병원 응급실에 내원한 소아 환자에 대한 임상적 연구)

  • Yun, Hye-Jin;Baek, Jung-Han;Seo, Jung-Min
    • The Journal of Pediatrics of Korean Medicine
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    • v.21 no.2
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    • pp.35-50
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    • 2007
  • Objectives The purpose of this study was to revitalize pediatric emergency care in oriental medical hospital. Methods The study was composed of 281 pediatric patients who visited emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital, from March 2006 to February 2007. Results The age distribution showed that 1 to 3 year's patients(40.6%) are the most New pediatric patients(59.1%) were more than who received medical treatment in this place. The seasonal distribution of between month's section and the 24 solar terms's section made no differences and pediatric patients who visited in emergency room was most in spring, least in autumn. Moreover the changes of season's patients were more than others. Pediatric patients who visited during the weekends and holidays(50.9%) were more than during the weekdays(49.1%). Systemic division of the major problems were the digestive symptoms(44.5%) and nervous symptoms(30.6%), respiratory symptoms(12.5%), musculoskeletal symptoms(5.3%), dermatological symptoms(1.8%), cardiovascular symptoms(0.7%) and others(4.6%) followed. The time interval between arrival and onset : within 6 hours were the most(54.5%). Pediatric patients who had digestive, nervous, musculoskeletal diseases within 6 hours were the most, but in the case of patients who had respiratory diseases, most of them were visited within 48 hours. Acting and herb-med treatment(77.9%) were the most in medical treatments. Pediatric patients(69.0%) who didn't revisit in this hospital after treatment in emergency room were more than who revisited(29.9%). Conclusions Pediatric patients who visited in emergency room of oriental medical hospital were most not acute form of a serious diseases, patients most visited in disease prefer to oriental medicine; such as dyspepsia, convulsions, crying, ankle sprain. Further studies will be needed for the actual circumstance's reflecion from this hospital and other oriental hospitals nearby or other western emergency rooms for the accurate studies.

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Lack of Prognostic Value of Mean Corpuscular Volume with Capecitabine Therapy in Metastatic Breast Cancer

  • Bozkurt, Oktay;Berk, Veli;Kaplan, Muhammed Ali;Cetin, Bulent;Ozaslan, Ersin;Karaca, Halit;Inanc, Mevlude;Duran, Ayse Ocak;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2501-2504
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    • 2014
  • Background: Capecitabine is an oral fluoropyrimidine derivative which is frequently used alone or in combination regimens for the treatment of metastatic breast cancer. Although overall and progression free survivals have increased in recent years with the use of new generation drugs, predictive factors that would further improve the outcomes are needed. Previous studies have demonstrated the relation between post-treatment increase in mean corpuscular volume (MCV) and predicting therapy response as well as survival. The present study investigated the clinical impact of MCV elevation in metastatic breast cancer patients treated with capecitabine. Materials and Methods: The data of a total of 82 patients from three centers followed between June 2005 and June 2013 were retrospectively analyzed. The demographic data and hormone receptor status of the patients, as well as initial examination before and after treatment and data concerning progression were recorded. MCV ${\geq}100$ fl was considered as macrocytosis. Capecitabine was given at a dose of $2500mg/m^2$ daily for 14 days every three weeks. Pre-treatment and post-treatment MCV and other parameters of complete blood count were recorded. Post-treatment initial evaluation was performed after 2 cycles of therapy. Results: The median age of the patients was 46.5 years (range 26-72 years) and 54% were premenopausal. Performance status was ECOG 0 and 1 in 81 (99%) patients. The median number of cycles for capecitabine therapy was 5 (min-max: 2-18). The median ${\Delta}MCV$ level (post-treatment values at sixth week - baseline) was 6.4. Whilst ${\Delta}MCV$ was ${\geq}6.4$ in 42 patients, it was <6.4 in 40 patients. Clinical benefit (complete response+partial response+stable disease) was observed in 37 (88%) of 42 patients with a median ${\Delta}MCV$ ${\geq}6.4$ and in 30 (75%) of 40 patients with ${\Delta}MCV$ <6.4 with no statistically significant difference (p=0.158). No significant difference was determined between the group with ${\Delta}MCV$ ${\geq}6.4$ and the group with ${\Delta}MCV$ <6.4 in terms of progression-free survival (11 vs 12 months) (p=0.55) and overall survival (20 months vs. 24 months) (p=0.11). Conclusions: The identification of new predictive markers in metastatic breast cancer is very important. In some recent studies, increase in MCV has been suggested as a marker in tumor response. In the present study, however, no significant difference was determined between tumor response and increase in MCV. Further studies including higher numbers of patients are needed to determine whether increase in MCV is a predictive marker or not.

A STUDY ON THE CHANGES IN PATIENT DISTRIBUTION AND PRACTICE PATTERN FOR LAST 8 YEARS IN THE DEPARTMENT OF PEDIATRIC DENTISTRY OF CHONNAM NATIONAL UNIVERSITY DENTAL HOSPITAL (최근 8년간 전남대학교 치과병원 소아치과에 내원한 초진환자의 분포 및 진료현황에 관한 실태조사(2003-2010))

  • Son, Jeong-Min;Kim, Seon-Mi;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.4
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    • pp.373-382
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    • 2012
  • The purpose of this study was to understand the change of demands in young patients and to suggest a directional shift for the pediatric dental practitioners who are facing these changes. This study collected data on new patients who had visited Chonnam National University Dental Hospital, Department of Pediatric Dentistry from 2003 to 2010 and the researchers were able to find out the following information. Total number of dental visits has been increasing since 2009 and 2010, which includes an increase of male patients in the 13~15 years age group showed significant increase and that in the 3~4 years age group showed a significant decrease. December showed the largest number of total dental visits, of which 69.6% of newly visit patients were living in Gwang-ju. Patients who had systemic diseases were 10.7% of total newly visit patients and 19.1% of patients received sedative treatment. Considering the chief complaints of new patients, 36% of patients visited because of dental caries. Regarding the dental treatment of patients, 38.4% had restoration treatment in 2003 and 30.4% had restoration treatment in 2010.

Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas

  • Dong-Yeon Kim;Hee-Jae Suh
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.729-738
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    • 1998
  • In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritionally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group of heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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Triple Negative Breast Cancer

  • Cetin, Idil;Topcul, Mehmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2427-2431
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    • 2014
  • Triple-negative breast cancers (TNBC), characterized by absence of the estrogen receptor (ER) and progesterone receptor (PR) and lack of overexpression of human epidermal growth factor receptor 2 (HER2), have a poor prognosis. To overcome therapy limitations of TNBC, various new approaches are needed. This mini-review focuses on discovery of new targets and drugs which might offer new hope for TNBC patients.

Wall-Suction Assisted Vacuum Sealing for Treatment of Infected Diabetic Foot Ulcer (벽매립형 중앙 흡인장치를 이용한 감염성 당뇨병성 족부 궤양의 밀봉 치료)

  • Bae, Su-Young;Lee, Chang-Wook;Seo, In-Seock
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.26-30
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    • 2004
  • Purpose: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. Materials and Methods: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. Results: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. Conclusion: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.

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Studies on a New Alimentotherapy for Diabetic Patients (당뇨환자를 위한 새로운 식이요법제에 관한 연구)

  • 라정찬;배진희;박형근;강경선
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.4
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    • pp.614-620
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    • 2003
  • Mulberry, Morifolium leaves and fruits, Lycii fructus, and Panax ginseng have been known to maintain normal blood sugar levels in folk medicine. Here we investigated the effects of coated rice (Sodangmi$^{TM}$) with these herb extracts to diabetes mellitus patients. Alloxan-induced diabetic mice (80 mg/kg bw, i.v.) separated into 4 groups. 2 groups received the mixed extracts of these plants (Sodans Extract$^{TM}$) orally everyday for 4 weeks. Positive control received Alloxan except Sodans Extract$^{TM}$. Negative control received neither Alloxan nor Sodang Extract$^{TM}$. Blood sugar levels, volume of water consumed, body weights of each group were measured and compared. Blood sugar levels in the Alloxan and Sodang Extract$^{TM}$-received groups got close to normal levels on 4th week after starting the experiments. Volume of water consumed also showed similar pattern. Blood sugar levels in positive control remained high through the experimental periods. Body weights in positive control remained low, but those in the extracts-received groups recovered to normal levels. The clinical trials for both of healthy volunteers and diabetes mellitus patients also showed Sodangmi$^{TM}$ could control blood sugar level. The blood sugar level decreased since 3rd week after starting to receive Sodangmi$^{TM}$, and the difference between the blood sugar level before and after the meal was decreased significantly by receiving Sodangmi$^{TM}$. From these results, we suggest that the functional rice with herb extracts could be used as a new alimentotherapy for diabetes mellitus patients.llitus patients.

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change

  • Lee, Tae-Jin;Cheong, Chelim
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.393-400
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    • 2017
  • Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results: The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions: The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

The Offer of Advanced Imaging Techniques Leads to Higher Acceptance Rates for Screening Colonoscopy - a Prospective Study

  • Albrecht, Heinz;Gallitz, Julia;Hable, Robert;Vieth, Michael;Tontini, Gian Eugenio;Neurath, Markus Friedrich;Riemann, Jurgen Ferdinand;Neumann, Helmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3871-3875
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    • 2016
  • Background: Colonoscopy plays a fundamental role in early diagnosis and management of colorectal cancer and requires public and professional acceptance to ensure the ongoing success of screening programs. The aim of the study was to prospectively assess whether patient acceptance rates to undergo screening colonoscopy could be improved by the offer of advanced imaging techniques. Materials and Methods: Overall, 372 randomly selected patients were prospectively included. A standardized questionnaire was developed that inquired of the patients their knowledge regarding advanced imaging techniques. Second, several media campaigns and information events were organized reporting about advanced imaging techniques, followed by repeated evaluation. After one year the evaluation ended. Results: At baseline, 64% of the patients declared that they had no knowledge about new endoscopic methods. After twelve months the overall grade of information increased significantly from 14% at baseline to 34%. The percentage of patients who decided to undergo colonoscopy because of the offer of new imaging methods also increased significantly from 12% at baseline to 42% after 12 months. Conclusions: Patients were highly interested in the offer of advanced imaging techniques. Knowledge about these techniques could relatively easy be provided using local media campaigns. The offer of advanced imaging techniques leads to higher acceptance rates for screening colonoscopies.

Season of Diagnosis and Survival of Advanced Lung Cancer Cases - Any Correlation?

  • Oguz, Arzu;Unal, Dilek;Kurtul, Neslihan;Aykas, Fatma;Mutlu, Hasan;Karagoz, Hatice;Cetinkaya, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4325-4328
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    • 2013
  • Introduction: The influence of season at diagnosis on cancer survival has been an intriguing issue for many years. Most studies have shown a possible correlation in between the seasonality and some cancer type survival. With short expected survival, lung cancer is an arena that still is in need of new prognostic factors and models. We aimed to investigate the effect of season of diagnosis on 3 months, 1 and 2 years survival rates and overall survival of non small cell lung cancer patients. Materials and Methods: The files of non small cell lung cancer patients that were stages IIIB and IV at diagnosis were reviewed retrospectively. According to diagnosis date, the patients were grouped into 4 season groups, autumn, winter, spring and summer. Results: A total of 279 advanced non small cell lung cancer patients' files were reviewed. Median overall survival was 15 months in the entire population. Overall 3 months, 1 and 2 years survival rates were 91.0%, 58.2% and 31.2% respectively. The season of diagnosis was significantly correlated with 3 months survival rates, being diagnosed in spring being associated with better survival. Also the season was significantly correlated with T stage of the disease. For 1 and 2 years survival rates and overall survival, the season of diagnosis was not significantly correlated. There was no correlation detected between season and overall survivals according to histological subtypes of non small cell lung cancer. Conclusion: As a new finding in advanced non small cell lung cancer patients, it can be concluded that being diagnosed in spring can be a favorable prognostic factor for short term survival.