• Title/Summary/Keyword: Primary Medical Center

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The Case Study of Lactobacillus mixture culture fluid on Atopic dermatitis (아토피피부염에 대한 Lactobacillus 혼합배양액의 임상 증례)

  • Jo, Eul-Hwa;Kim, Tae-Keun;Hong, Su-Jung;Jung, Do-Yean;Hwang, Seng-Yean;Ahn, Seong-Hun
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.135-143
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    • 2015
  • Objectives: Recently lactic acid formulation was known as the adjuvant therapy on atopic dermatitis(AD) symptoms because of little side effects. In this study, it was studied that Lactobacillus mixed culture appliment was effective on not on AD symptoms. Methods: The case-photos 30-40 times of AD symptoms from case were observed with literatures. The case-photos were acquired with environmental AD dermatitis experience program which is conducted in SUNCHANG RESERCH INSTITUTE OF HEALTH AND LONGEVITY from 2014.01 to 2014.08. Experience applicants were limited the oral administration and chemical external administration. Results: Lactobacillus mixed culture appliment was effective because of the mitigation or disappearance of AD primary symptoms like pruritus, erythema, edema, effusion, dry skin, scaly, scab etc. AD symptom degree was dependent on lactobacillus mixed culture appliment times, and classified as Reaction Period (RAP), Reduction Period (RDP), Efection Period (EP), Reproduction Period (RPP) on a single mixed culture appliment time. And AD symptoms which were appeared in RPP were classified as Rebound Period (RBP), Effection Period (EP), Subclinical Period (SCP). Conclusions: Lactobacillus mixed culture appliment is considered to be useful for AD symptoms and is estimated to be effective by different mechanism with oral administration or steroid ointment application. Lactobacillus mixed culture appliment is expected to induce a synergistic effects on AD symptom reliefs with the other oral administration.

Epidemiological Multi-center Study of Blast Injury in Military Centers (군내 폭발손상환자 현황에 대한 다기관연구)

  • Kim, Won Young;Choi, Wook Jin;Lee, Jong Ho;Park, Ha Young;Kim, Dong Ook
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.78-84
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    • 2008
  • Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.

Phase II Study of Preoperative Intra-Arterial Epirubicin, Etoposide, and Oxaliplatin Combined with Oral S-1 Chemotherapy for the Treatment of Borrmann Type 4 Gastric Cancer

  • Xiang, Xiao-song;Su, Yu;Li, Guo-li;Ma, Long;Zhou, Chang-sheng;Ma, Ru-feng
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.395-407
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    • 2020
  • Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.

Development of a public health care linkage model within the community care system in Daejeon City (대전광역시 지역사회 통합돌봄 체계내에서 공공보건의료 연계 모델 개발)

  • Lim, Ji-Yeon;Ahn, Na-Na;Lee, Seok-Goo;Ahn, Soon-Ki
    • Journal of agricultural medicine and community health
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    • v.47 no.1
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    • pp.1-13
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    • 2022
  • Objectives: This study aimed to establish a linkage model involving regional responsible medical institutions after analyzing the existing conditions and deriving problems through qualitative analysis within the community care system. Methods: A total of 14 participants of this study were selected through the snowball sampling method, including 7 community care service providers and 7 service users. As for the research data, primary data were collected through interviews, and as a result of analyzing according to Aday&Anderson' model, a total of 5 catergories, 8 topics, and 22 sub theme were derived. Results: The problem derived from the interview is that division services are provided for each institution due to the absence of a key central institution of community care system, and users' commercial institutions is unclear. The second is the inconsistency between the needs and supply for community care, resulting in a possibility of delay in returning to the community after discharge. Based on these problems, it is necessary to unify it as an community care window of the Dong-community center. In addition, there is a need for public health centers to play an active role, and to establish a public-private joint system with the Health and Living Support Center to establish a model that can play a certain role. Conclusions: Therefore, based on the results of this study, it can be used as basic data when constructing community care model and applying it as an expanded model in the future.

Comparing Seroma Formation at the Deep Inferior Epigastric Perforator, Transverse Musculocutaneous Gracilis, and Superior Gluteal Artery Perforator Flap Donor Sites after Microsurgical Breast Reconstruction

  • Merchant, Alisha;Speck, Nicole E.;Michalak, Michal;Schaefer, Dirk J.;Farhadi, Jian
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.494-500
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    • 2022
  • Background Seroma formation is the most common donor site complication following autologous breast reconstruction, along with hematoma. Seroma may lead to patient discomfort and may prolong hospital stay or delay adjuvant treatment. The aim of this study was to compare seroma rates between the deep inferior epigastric perforator (DIEP), transverse musculocutaneous gracilis (TMG), and superior gluteal artery perforator (SGAP) donor sites. Methods The authors conducted a retrospective single-center cohort study consisting of chart review of all patients who underwent microsurgical breast reconstruction from April 2018 to June 2020. The primary outcome studied was frequency of seroma formation at the different donor sites. The secondary outcome evaluated potential prognostic properties associated with seroma formation. Third, the number of donor site seroma evacuations was compared between the three donor sites. Results Overall, 242 breast reconstructions were performed in 189 patients. Demographic data were found statistically comparable between the three flap cohorts, except for body mass index (BMI). Frequency of seroma formation was highest at the SGAP donor site (75.0%), followed by the TMG (65.0%), and DIEP (28.6%) donor sites. No association was found between seroma formation and BMI, age at surgery, smoking status, diabetes mellitus, neoadjuvant chemotherapy, or DIEP laterality. The mean number of seroma evacuations was significantly higher in the SGAP and the TMG group compared with the DIEP group. Conclusion This study provides a single center's experience regarding seroma formation at the donor site after microsurgical breast reconstruction. The observed rate of donor site seroma formation was comparably high, especially in the TMG and SGAP group, necessitating an adaption of the surgical protocol.

Delphi Study on the Reduction of Cross-contamination and Improvement of Management System on Firefighting Protection Suit (소방 방화복 교차오염 저감 및 관리체계 개선을 위한 델파이 연구)

  • Kim, Soo Jin;Ham, Seunghon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.2
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    • pp.182-194
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    • 2022
  • Objectives: This study evaluates and recommends the priority of policy implementation to improve the fire protection clothing management system used by firefighters and the reduction of cross-contamination from contaminated clothing at the scene of a fire. Methods: It consisted of 7 experts and conducted three interviews and two modified Delphi surveys. Through the results of previous research and interviews with experts, a plan to reduce cross-contamination of fire suits and improve the management system was first derived. An improvement plan was presented in the four areas including resources, management, fire protection related work, and laws and regulations, and the priority of policy implementation was derived by analyzing the importance and practicality of the policy at the same time. Results: As a result of the analysis, the first priority was education on the health effects of pollutants at the disaster scene for firefighters, and the second priority was the addition of SOP for the primary decontamination of on-scene personal protective equipment in preparation for the health effects of the disaster scene, and education for fire suppression and rescue workers. The next step was to improve the management system of personal protective equipment such as fire suits and develop a training course for systematic operation. Conclusions: This findings could be used in the implementation of mid- to long-term firefighting policies for the systematic operation and establishment of a systematic management system for personal protective equipment such as fire protective suits.

Endovascular Treatment of Congenital Portosystemic Shunt: A Single-Center Prospective Study

  • Ponce-Dorrego, Maria-Dolores;Hernandez-Cabrero, Teresa;Garzon-Moll, Gonzalo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.147-162
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    • 2022
  • Purpose: To design a prospective study on endovascular closure of congenital portosystemic shunts. The primary endpoint was to assess the safety of endovascular closure. The secondary endpoint was to evaluate the clinical, analytical and imaging outcomes of treatment. Methods: Fifteen patients (age range: 2 days to 21 years; 10 male) were referred to our center due to congenital portosystemic shunts. The following data were collected prior to treatment: age, sex, medical history, clinical and analytical data, urine trimethylaminuria, abdominal-US, and body-CT. The following data were collected at the time of intervention: anatomical and hemodynamic characteristics of the shunts, device used, and closure success. The following data were collected at various post-intervention time points: during hospital stay (to confirm shunt closure and detect complications) and at one year after (for clinical, analytical, and imaging purposes). Results: The treatment was successful in 12 participants, migration of the device was observed in two, while acute splanchnic thrombosis was observed in one. Off-label devices were used in attempting to close the side-to-side shunts, and success was achieved using Amplatzer™ Ductus-Occluder and Amplatzer™ Muscular-Vascular-Septal-Defect-Occluder. The main changes were: increased prothrombin activity (p=0.043); decreased AST, ALT, GGT, and bilirubin (p=0.007, p=0.056, p=0.036, p=0.013); thrombocytopenia resolution (p=0.131); expansion of portal veins (p=0.005); normalization of Doppler portal flow (100%); regression of liver nodules (p=0.001); ammonia normalization (p=0.003); and disappearance of trimethylaminuria (p=0.285). Conclusion: Endovascular closure is effective. Our results support the indication of endovascular closure for side-to-side shunts and for cases of congenital absence of portal vein.

Experience of Disaster Response Team in Jecheon Sports Center Fire

  • Ha, Jeongmin;Kim, Hyun-Jung;Kim, Jin-Hwa;Park, Dahye
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.39-48
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    • 2022
  • Purpose : This study aimed to determine the experiences of the disaster response team 9 participants who participated in the disaster after the fire incident occurred in Jecheon Sports Center and their meaning and essence. Methods : Nine disaster response teams were the subjects of the study, and Individual in-depth interviews were conducted. Data were collected online between January 6 and April 30, 2021, from the software ZoomTM. This study was conducted as a qualitative study by applying Giorgi's phenomenological experiential research method, which has an advantage in revealing the essential structure and meaning of experience. Results : Three major themes were derived from the study results: the stimulus through unfamiliar experiences, the grievances due to work environment and regional characteristics, and dullness resulting from hiding and enduring. The following 17 sub-themes were identified: learning through unfamiliar experiences, frustration due to unexpected circumstances, shock from unfamiliar experiences, doing my best in the present, confidence due to increased experience, disunified system, intervention of various interests, the atmosphere that puts responsibility on others, inactive help, unforgettable regional characteristics, working without time to settle, tolerating it in my own way, memories left in the unconsciousness, sudden suffering from memories that come to mind, movement in anxiety and tension, dullness, work with colleagues in the same situation. Conclusion : This study is meaningful in that it attempted to provide basic data in preparing a long-term strategy for effective policy direction and institutional protection based on the systematic mental health management of the disaster response team. Additionally, this study's results can be used as primary data for future research among Disaster Response Team.

Ginsenoside Rg3-enriched Korean Red Ginseng extract attenuates Non-Alcoholic Fatty Liver Disease by way of suppressed VCAM-1 expression in liver sinusoidal endothelium

  • Seoung-Woo Lee ;Su-Min Baek ;Young-Jin Lee ;Tae-Un Kim ;Jae-Hyuk Yim ;Jun-Hyeok Son ;Hee-Yeon Kim;Kyung-Ku Kang ;Jong Hun Kim ;Man Hee Rhee ;Sang-Joon Park ;Seong-Kyoon Choi ;Jin-Kyu Park
    • Journal of Ginseng Research
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    • v.47 no.3
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    • pp.429-439
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    • 2023
  • Background: The incidence and clinical importance of nonalcoholic fatty liver disease (NAFLD) has emerged. However, effective therapeutic strategies for NAFLD have yet to be found. Panax ginseng (P. ginseng) is a traditional herb in Eastern Asia with therapeutic effects in many chronic disorders. However, the precise effects of ginseng extract on NAFLD are currently unknown. In present study, the therapeutic effects of Rg3-enriched red ginseng extract (Rg3-RGE) on the progression of NAFLD were explored. Methods: Twelve-week-old C57BL/6 male mice were fed a chow or western diet supplemented with high sugar water solution with or without Rg3-RGE. Histopathology, immunohistochemistry, immunofluorescence, serum biochemistry, western blot analysis, and quantitative RT-PCR were used for in vivo experiment. Conditionally immortalized human glomerular endothelial cell (CiGEnC) and primary liver sinusoidal endothelial cells (LSECs) were used for in vitro experiments. Results: Eight weeks of Rg3-RGE treatment significantly attenuated the inflammatory lesions of NAFLD. Furthermore, Rg3-RGE inhibited the inflammatory infiltrate in liver parenchyma and the expression of adhesive molecules to LSECs. Moreover, the Rg3-RGE exhibited similar patterns on the in vitro assays. Conclusion: The results demonstrate that Rg3-RGE treatment ameliorates NAFLD progression by inhibiting chemotaxis activities in LSECs.

Self-Monitoring of Blood Pressure and Feed-back Using APP in TReatment of UnconTrolled Hypertension (SMART-BP): A Randomized Clinical Trial

  • Dong-Ju Choi;Jin Joo Park;Minjae Yoon;Sung-Ji Park;Sang-Ho Jo;Eung Ju Kim;Soo-Joong Kim;Sungyoung Lee
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.785-794
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    • 2022
  • Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.