• Title/Summary/Keyword: access to medicine

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Current Status of Intraosseous Infusion Technique Use at Emergency Departments in Korea (국내 응급실에서의 골수강내 주입법 사용 현황)

  • Choi, Sang Cheon;Park, Hyun Soo;Kim, Jae Woo
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.6-11
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    • 2007
  • Purpose: Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments. Methods: We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique. Results: Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique. Conclusion: The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.

Correlation between Pediatric Balance Scale(PBS) and Gross Motor Function Measurement(GMFM) Scores in Children with Cerebral Palsy (뇌성마비 아동의 소아 균형검사(PBS)와 대동작기능평가(GMFM)와의 상관관계)

  • Ko, Myung-Sook;Chung, Jae-Hoon;Jeon, Hye-Seon
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.2
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    • pp.281-288
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    • 2010
  • Purpose : The purpose of this study was to examine the correlation between Pediatric Balance Scale(PBS) and Gross Motor Function Measurement(GMFM) with cerebral palsy(CP) children. Methods : 31 ambulatory children with CP were recruited for this study. PBS is a modified version of the Berg’s Balance Scale to access the children with motor impairments. To access the motor functions that directly influence to the functional independence of the ambulatory CP children, total scores of standing category and walking/running/jumping category of GMFM were selectively compared with PBS score by Spearman correlation coefficient analysis. Results : The results revealed high correlation between PBS and GMFM scores both in standing and walking/running/jumping categories(r=.9). Conclusions : Therefore, this study indicates that PBS can be applied not only as a tool to access balance, but also as a measurement to predict and access the level of standing and ambulatory related functions of children with CP.

Continuous Control of Acetaminophen Poisoning after Implementation of Regulation for Ease Access of Acetaminophen: Cohort Study from Emergency Department Based in-depth Injury Surveillance (아세트아미노펜 사용 편의성 증가 후 중독발생 위험의 지속적 관리 필요성)

  • Jo, Seung Jik;Gang, Hyun Young;Lee, Si Jin;Bae, Gyu Hyun;Lee, Eui Jung;Han, Kap Su;Kim, Su Jin;Lee, Sung Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.57-65
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    • 2020
  • Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

Technical Note of Arthroscopic Subtalar Arthrodesis Using Posterior Portals - Operative Technique - (후방 삽입구를 이용한 관절경적 거골하 관절 유합술- 수술 방법-)

  • Lee, Keun-Bae;Choi, Jin;Park, Yu-Bok;Seo, Hyeong-Yeon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.193-196
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    • 2005
  • A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.

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New Surgical Approach for Gastric Bezoar: "Hybrid Access Surgery" Combined Intragastric and Single Port Surgery

  • Son, Tae-Il;Inaba, Kazuki;Woo, Yang-Hee;Pak, Kyung-Ho;Hyung, Woo-Jin;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.230-233
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    • 2011
  • Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus.

Bare-Metal Stent in Dysfunctional Hemodialysis Access: An Assessment of Circuit Patency according to Access Type and Stent Location (혈액투석 접근로 기능부전에서의 비피복형 스텐트: 접근로 종류와 스텐트 위치에 따른 개통률 평가)

  • Kyungmin Lee;Je Hwan Won;Yohan Kwon;Su Hyung Lee;Jun Bae Bang;Jinoo Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.197-211
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    • 2023
  • Purpose To evaluate the circuit patency after nitinol bare-metal stent (BMS) placement according to the type of access and location of the stent in dysfunctional hemodialysis access. Materials and Methods Between January 2017 and December 2019, 159 patients (mean age, 64.1 ± 13.2 years) underwent nitinol BMS placement for dysfunctional access. The location of stents was as follows: 18 brachiocephalic vein, 51 cephalic arch, 40 upper arm vein, 10 juxta-anastomotic vein, 7 arteriovenous (AV) anastomosis, and 33 graft-vein (GV) anastomosis. Circuit patency was evaluated by the Kaplan-Meier method, and cox regression model. Results A total of 159 stents were successfully deployed in 103 AV fistula (AVF) and 56 AV graft (AVG). AVG showed lower primary and secondary patency at 12-months compared with AVF (primary patency; 25.0% vs. 44.7%; p = 0.005, secondary patency; 76.8% vs. 92.2%; p = 0.014). Cox regression model demonstrated poorer primary patency at 12 months after stenting in the cephalic arch and GV anastomosis compared with the other sites. Conclusion AVF showed better primary and secondary circuit patency at 12 months following the placement of BMS compared with AVG. Stents in the cephalic arch and GV anastomosis were associated with poorer primary patency at 12 months compared to those in other locations.

PEDIATRIC NUCLEAR CARDIOLOGY: CURRENT TRENDS IN A DEVELOPING TROPICAL COUNTRY

  • DaCosta, Homai;Bagwe, B.;Ahire, B.;Sewatkar, A.
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.45-47
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    • 1985
  • We conclude that Nuclear Medicine technology has much to offer in the diagnosis of cardiovascular pathologies. Its potnetials have yet to be fully appreciated by those who have access to the facility, as also by those who practise speciality with resigned pessimism.

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The Survey on the Health Status of an Islands-District Residents II. The Medical Utilization Pattern and Recognition of Medical Facilities (일부 도서지역의 보건의료에 대한 기초조사 II. 주민의 의료이용양상 및 의료기관에 대한 인식도)

  • Ko, Kee-Ho;Moon, Gang;Sohn, Seok-Joon;Choi, Jin-Su
    • Journal of agricultural medicine and community health
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    • v.17 no.2
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    • pp.113-121
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    • 1992
  • In order to estimate the pattern of medical care utilization and recognition for health factor among the inhabitants in Wan-do district which is located off the southern seashore from mainland Korea, household interview survey was performed from January 15 to 30, 1990 in Wan-do Gun area. The results observed were following: 1. Among the users of medical facilities 40.8% used public health facility as first contact facility. Lower the income level was and longer the residency duration was, the utilization rate of public health facilities was higher. By age groups and medical security status the utilization pattern was likely to disperse to local clinic and secondary contact medical resources. 2. Medical expense and access time were significantly different between primary contact and secondary contact medical resources. 3. Public health facility was recognized as the favoured institute having advantage of geographic and economic accessibility. 4. Statistically significant determinants in public health facility utilization among total medical service were the region, the medical expense, and the access time.

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Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

Radial Arteriovenous Fistula Developed Late after Coronary Angiography: A Case Report

  • Na, Kwon Joong;Kim, Myung A;Moon, Hyeon Jong;Lee, Jeong Sang;Choi, Jae-Sung
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.421-423
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    • 2012
  • Transradial access is a widely accepted method for percutaneous coronary diagnostic and interventional procedures, and it has dramatically reduced access site vascular complications compared to transfemoral access. Arteriovenous fistula formation at the access site is an especially rare complication in transradial access. We report an extremely rare case of delayed radial arteriovenous fistula that developed one year after transradial coronary angiography, which was successfully treated by surgical repair.