Background: Funnel chest is one of the most common anomaly of chest wall, which is manifested by depression of sternum and costal cartilage. Popular operative methods were Ravitch operation and Wada operation. Material and Method: From 1983 to 1996, 21 cases of funnel chest were corrected surgically in the department of thoracic surgery, National Medical Center. Investigated age and sex distribution, combined anomaly,clinical symptom, degree of correction and complication, postoperative satisfaction. We used 2 different surgical methods, one was Wada & its variants(17 cases), the other was Ravitch and it variants(4 cases). Most of operative indications were cosmetic problems. Result: The pre-operative Welch index was 4.188, but this index decreased to 3.46 after the operations.(p=0.046) The degree of correction was higher in Wada & it variant operation than the modified Ravitch operation.(p=0.54) Their results were satisfactory in 20 patients, while unsatisfactory in 1 patient because of a k-wire fracture. There was no recurrence of chest wall depression or postoperative death during the OPD follow up period. Conclusion: We recommend Wada operation in symmetric and small degree of depressive chest wall deformity in preand post school age.
In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.
Rattanasing, Wannaporn;Kaewpitoon, Soraya J;Loyd, Ryan A;Rujirakul, Ratana;Yodkaw, Eakachai;Kaewpitoon, Natthawut
Asian Pacific Journal of Cancer Prevention
/
v.16
no.14
/
pp.5903-5906
/
2015
Background: Cholangiocarcinoma (CCA) is a serious public health problem in the Northeast of Thailand. CCA is considered to be an incurable and rapidly lethal disease. Knowledge of the distribution of CCA patients is necessary for management strategies. Objectives: This study aimed to utilize the Geographic Information System and Google $Earth^{TM}$ for distribution mapping of cholangiocarcinoma in Satuek District, Buriram, Thailand, during a 5-year period (2008-2012). Materials and Methods: In this retrospective study data were collected and reviewed from the OPD cards, definitive cases of CCA were patients who were treated in Satuek hospital and were diagnosed with CCA or ICD-10 code C22.1. CCA cases were used to analyze and calculate with ArcGIS 9.2, all of data were imported into Google Earth using the online web page www.earthpoint.us. Data were displayed at village points. Results: A total of 53 cases were diagnosed and identified as CCA. The incidence was 53.57 per 100,000 population (65.5 for males and 30.8 for females) and the majority of CCA cases were in stages IV and IIA. The average age was 67 years old. The highest attack rate was observed in Thung Wang sub-district (161.4 per 100,000 population). The map display at village points for CCA patients based on Google Earth gave a clear visual deistribution. Conclusions: CCA is still a major problem in Satuek district, Buriram province of Thailand. The Google Earth production process is very simple and easy to learn. It is suitable for the use in further development of CCA management strategies.
Background: Skin biopsy is the method to assist clinicians to make definite dermatological diagnosis which further helps in holistic management. Skin cancers are relatively rare clinical diagnosis in developing countries like Nepal, but the prevalence is on rise. Objectives: To investigate the profile of skin biopsies and frequencies and pattern of skin cancers in a tertiary care centre of Western Nepal. Materials and Methods: The materials consisted of 434 biopsies (1.37%) out of 31,450 OPD visits performed in the Department of Dermatology, Manipal Teaching Hospital, Pokhara, Nepal, during the period of Dec 2011-Nov 2014. Data were collected and analyzed using SPSS-16 with reference to incidence, age, sex, race and clinical and histopathological features. Results: The commonest disorders observed in biopsies were papulosquamous lesions, skin tuberculosis of different types, benign skin tumors, leprosy, collagen and fungal diseases. Viral diseases were rarely seen, probably due to straight forward clinical diagnosis. Dermatological malignancies accounted for 55/434 (12.67%) of biopsies. Skin disorders in general were commoner in females 280/434 (64%), including malignancies 32/55(58.2%). Mean age of patients with skin cancer was 54.5 years. Facilities for proper laboratory investigation of dermatological disorders will improve the quality of life. Conclusions: The most prevalent lesion in skin biopsies was papulosquamous disorders followed by skin tuberculosis of different types. Dermatological malignancy constituted 55/434 (12.67%) cases. The prevalence of skin malignancy is on rise in Nepalese society probably due to increase in life expectancy and better diagnostic services.
Background: A retrospective analysis of all cancer patients attending the radiotherapy outpatient department (OPD) of a single unit during the period of January 2005 till December 2006 was conducted to know the geographical distribution and incidence of the most common cancers, their stage of presentation, treatment compliance among the patients and follow-up. Materials and Methods: A total of 4,484 patients were registered in the Institute of Medical Sciences, Banaras Hindu University during the period of January 2005-December 2006; of which 1,975 registered in an individual unit were included for the retrospective analysis. Results: Most of the patients hailed from the various districts of UP and Bihar. Females outnumbered males with a ratio of 1.33:1. Females mostly belonged to the age group of 40-59 years; whilst males were a decade older. Major cancer sites in females were cervix and breast followed by head and neck. Leading cancer sites in males were head and neck, brain, bone, soft tissue and lung. Most of the cases presented in advanced stage of disease (74%). Squamous cell carcinoma was the most common histopathology (56%). A significant proportion of patients defaulted after undergoing preliminary investigations (16%). Only 53.9% of females and 58.5% of males took treatment out of which 68% and 63% completed the prescribed treatment. Compliance with follow-up was poor. Conclusions: The outcome of this study will significantly help us to define region specific strategies needed for cancer management in eastern Uttar Pradesh.
Background: In spite of the development of chemotherapy, prognosis of metastatic lung cancer was poor. On the other hand, surgical intervention has proven itself to bring out superior results, therefore more operations are being praticed based on this superiority against chemotherapy and other modalities on metastatic lung cancer. Material and Method : We analyzed the surgical cases performed from 1983 to 1997 on 17 cases and estimated 5 year survival rate using Kaplan-Meier method. Result: Average age was 42.8, ratio between male and female was 10:7. We had 8 single lobe resections,3 pneumonectomies,1 wedge resection,2 bilobectomy and 3 cases of lobar resection with wedge resection. 5 deaths have occured and among the 5, 3 patients were caused by recurrence of ca. The remaining 12 patients are being followed up in OPD basis among these, 3 recurrence were observed and 9 are still free of cancer. The average survival time was 40.5 months and 5 year survival rate obtained through the Kaplan-Meier method was 60.4%. Conclusion: Even though we are a bit short of cases, we recommend that a thoracic surgeon approach this disease through a surgical method as possibly as he could.
Stroke patients have increased with the overall aging of our population, 60 years and older. Recently the number of stroke patients has been on the increase even among younger people in their thirties. The family support is frequently mentioned as a major variable which plays an important role in helping the patients adapt themselves to their hemiplegic situations. The purpose of the study was to examine between family support and activities of daily living(ADLs)abilities for the hemiplegic patients, and to provide the basic data to help the patients carry out their ADLs on their own. The sample for the study included 106 hemiplegic patients and their family members. The data were collected using a focused, structured interviews. The major findings of the study were as follows: 1. The hemiplegic patients perceived that their family supports were very high(Mean, 49.00). 2. The degree of family support was significantly higher in female. high economic status, and non-use of brace patients than in male, poor economic status, use of brace patients. 3. The ADL abilities of the hemiplegic patients were significantly higher in ambulatory, younger, and longer-period-of-illness patients and patients who used a cane as a assistive device. 4. The family support for the hemiplegic patients showed a statistically significant Cor relationship with their performance of ADL(r=.30809. p=0.0013). 5. The performance of ADL for the ambulatory patients were mainly affected by the degree of family support, the period of the hemiplegic illness, the use of brace, informal care giving, and the age. These variables explained 50% of variance. 6. The length of illness was a statistically significant affecting variable for ADL performance in OPD and assistive device in IPD. In conclusion, the higher the hemiplegic patients perceived the degree of family support, the better they performed ADL. We should develop nursing methods which enhance the family support for the hemiplegic patients in order to increase their performance of ADL.
A 62-year-old male was admitted to our hospital complaining of coldness in both legs and discolorization in the right toes. On angiogram, obstruction of right external iliac artery and left common iliac artery was shown. The patient underwent extended extraanatomic arterial reconstruction due to poor general conditions. From right subclavian artery to right popliteal artery, artery bypass was done with 8 mm PTFE and 6 mm PTFE Suprapubic crossover bypass was done with another 8 mm PTFE from 8 mm PTFE in right inguinal area that was anastomosed with right subclavian artery and left common femoral artery The patient was discharged from hospital and OPD follow up was done. Right leg pain and discolorization of entire toes disappeared and were normalized. We report a case of extended extraanatomic arterial reconstruction: subclavian artery-popliteo-crossover-femoral-PEFE-bypass.
This study was conducted to confirm the degree of self care and problems in patients with ostomy. The subjects were 80 patients with ostomy who were visiting to OPD in K University Medical Center and were members in the Ostomy Association of Korea. Data were collected from August, 2004 to September. The research tools were a self care measure for ostomy patient developed by Park (1996) and a problem measure for ostomy patient developed by Lee (1996). Data were analyzed by t-test, ANOVA, and Pearson's correlation. The results were as following: 1. Male (65.8%) and female (34.2%) had the ostomy in the most. Age was the most 61 years old and over. 68.5% of the subjects had managed the ostomy by themselves. 2. The mean score of self care in ostomy was 3.57 score. Hygiene of skin care around ostomy in the behavior of self care was the highest as mean 4.47 score. 3. The problems were as following: 1) expense 2) a decline on Activity of Daily Living 3) discomfort in travel 4) worry about ostomy 5) trouble of workplace 4. In the relationship between self care and religion there was significant difference in religion(t= 2.727, P=.008). 5. The relationship between self care and problem with ostomy was found to have statistically significant negative correlation(r= -.237, P=.041).
Objective : In order to study effects of decreasement of blood pressure on hypertension patients by moxibustion a clinical study was performed. Methods : Moxibustion at Quchi(LI11), Guanyan(CV4) 10 times on 25 hyper tension patients who were treated via opd on Dong-Eui Oriental Medical Hospital. Results : 1. After 10 times moxibustion at Quchi(LI11), Guanyan(CV4),the systolic blood pressure were decreased 16.5% degree. 2. After 10 times moxibustion at Quchi(LI11), Guanyan(CV4),the diastolic blood pressure were decresed 26.6% degree. 3. Subjective symptoms(i.e. headache, dizziness, heat in the upper part of the body, dyspnea etc) were decresed after 10 times moxibustion at Quchi(LI11), Guanyan(CV4). Conclusion : Continous Moxibustion at Quchi(LI11), Guanyan(CV4) implies decreasement of blood pressure and improvement of subjective symptoms.
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