• Title/Summary/Keyword: distant education center

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Management of Diabetic Foot Ulcer (당뇨병성 족부 궤양의 치료)

  • Seo, Dong-Kyo;Lee, Ho Seong
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.1-7
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    • 2014
  • In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

Malignant Fibrous Histiocytoma Arising in Old Burn Scar on the Anterior Chest (흉벽의 오래된 화상 흉터에서 발행한 악성 섬유성 조직구종)

  • Choi, Eui Chul;Kwon, In Oh;Park, Eun Soo;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.743-747
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    • 2008
  • Purpose: Malignant changes of Marjolin's ulcer arising from chronic burn scar are rare. The majority of them are squamous cell carcinoma and basal cell carcinoma. Malignant fibrous histiocytoma is a deep seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. Methods: We report a 58-year-old male patient who was admitted due to $3.5{\times}5cm$ chronic ulceration of anterior chest wall on the center of old burn scar. His scar had been occurred by boiling oil and treated with conservative treatment 45 years ago. Preoperative punch biopsy showed suspicious malignant changes and contrast enhanced chest CT showed well-defined, irregular shape enhancing lesion on anterior chest wall without intrathoracic metastasis. Results: The tumor was widely excised and defect was covered with skin graft without infection, necrosis and any other complication. The pathologic findings are compatible with malignant fibrous histiocytoma(storiform - pleomorphic type). The patient underwent 3 cycles of chemotheraphy. Although distant metastasis to the lung developed 6 months later and the patient died 9 month later, there was no local reoccurrence. Conclusion: Aggressive and early excision is needed because malignant fibrous histiocytoma has characteristics of high malignancy with a propensity for early and distant spread. Furthermore, the patient's education about disease entity and postoperative regular follow-up for local recurrence or metastasis is very important. To prevent malignancy from secondly healing burn scar, early skin graft is recommended for patients with deep second degree burn.

A Phenomenological Study on the Experiences of Parenting Burden of Working Mother with Young Children in Korea (어린 아동을 둔 취업모의 양육부담감 경험에 대한 현상학적 연구)

  • Kim, Na Hyun;Lee, Eun Joo;Kwak, Su Young;Park, Mee Ra
    • Women's Health Nursing
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    • v.19 no.3
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    • pp.188-200
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    • 2013
  • Purpose: The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. Methods: Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. Results: Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. Conclusion: These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.

Conveniences & Inconveniences of Living in Residential Care Facilities Focused on Middle Class Paid Facilities in Rural Area- (양로원 생활의 장단점에 관한 연구 -농촌지역 중류층 유료시설을 중심으로-)

  • Lee, In-Soo
    • Journal of Families and Better Life
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    • v.20 no.5
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    • pp.113-124
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    • 2002
  • This study has been performed to explore conveniences and inconveniences of daily lives in rural residential care facilities among the elderly residents. In this study, five males and seven females aged 68 to 78 were asked about socio-familial and physical aspects of their daily lives in the facilities such as meals, social activities, family visits, recreation, and health care. The answers of the qualitative interview were drawn as follow; first, the residents perceived well planned regular meals and snacks, free visits of friends, regularly supervised daily sanitary activities, periodic outdoor activities, education programs provided by religious experts, and pastoral farming lives as most convenient aspects of the retirement facilities. In addition, some felt that facility life made them free of familial conflicts, while others appealed fear of being forgotten because of distant location. On the other hand, they perceived the supervised group activities and meals as major inconveniences. They also felt persistently depressed when closely observing serious illness or deaths of their co-residents. Therefore in this study, suggestions were made as follows: first, combination of normal family life and retirement facility should be developed in the mixed form of community welfare center and shared home. Second, intensive medical care facilities should be in collaboration with the retirement facilities, so that the residents are relieved from stressful contacts with extremely ill patients in the residential area.

Combined Expression of Metastasis Related Markers Naa10p, SNCG and PRL-3 and its Prognostic Value in Breast Cancer Patients

  • Min, Li;Ma, Ruo-Lan;Yuan, Hua;Liu, Cai-Yun;Dong, Bing;Zhang, Cheng;Zeng, Yan;Wang, Li;Guo, Jian-Ping;Qu, Li-Ke;Shou, Cheng-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2819-2826
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    • 2015
  • Combinations of multiple biomarkers representing distinct aspects of metastasis may have better prognostic value for breast cancer patients, especially those in late stages. In this study, we evaluated the protein levels of N-${\alpha}$-acetyltransferase 10 protein (Naa10p), synuclein-${\gamma}$ (SNCG), and phosphatase of regenerating liver-3 (PRL-3) in 365 patients with breast cancer by immunohistochemistry. Distinct prognostic subgroups of breast cancer were identified by combination of the three biomarkers. The Naa10p+SNCG-PRL-3-subgroup showed best prognosis with a median distant metastasis-free survival (DMFS) of 140 months, while the Naa10p-SNCG+PRL-3+subgroup had the worst prognosis with a median DMFS of 60.5 months. Multivariate analysis indicated Naa10p, SNCG, PRL-3, and the TNM classification were all independent prognostic factors for both DMFS and overall survival (OS). The three biomarker combination of Naa10p, SNCG and PRL-3 performed better in patients with lymph node metastasis, especially those with more advanced tumors than other subgroups. In conclusion, the combined expression profile of Naa10p, SNCG and PRL-3, alone or in combination with the TNM classification system, may provide a precise estimate of prognosis of breast cancer patients.

Study of Emergency Medical Transport by Helicopter in Ulleung Island during 4 Years (최근 4년간 울릉군 지역의 헬리콥터를 이용한 응급 환자 이송의 고찰)

  • Bae, Jung-Min;Jung, Man-Jin;Jung, Ki-Hoon;Bae, Sung-Han
    • Journal of agricultural medicine and community health
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    • v.30 no.3
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    • pp.255-262
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    • 2005
  • Purpose: In Ulleung island, emergency medical transport by helicopter is very important. So, we analysized our experience with emergency medical transport by helicopter for 4 years and we were compared our data with other data for 1997-2001. Therefore we need to research public health development direction. Method: We analysized patient's medical record for 4 years. Result: During 4 years, 104 transports were done and 130 patients were trasported to tertiary hospital center, there was more increased than that from 1997 to 2001. Helicopters from Pohang coast guard, Donghae coast guard, Navy, and 119 rescue etc. were used, but 119 rescue transport was decreased more and more. The 60's patients was most, 22.3% and teenager's and 80's patients was lowest. The male was 65% but the female was increased more and more annually. In addition, the older patients was the more portion of female patient. The transport was concentrated in daytime. The traumatic patient was much in winter period. The cerebrovascular accident was 1st cause of patient and fracture was many also. Conclusioon: Except Fire service's helicopter, the other helicopter was not apt to emergency medical tansport. But Fire service's helicopter was not used commonly because Fire service's helicopter was in Daegu, so distant and time consumed. As a result, emergency medical transport helicopter is needed in east coast like Fire service's helicopter. In addition, trauma prevention education and public health education for hypertension and diabetes will be essential and public health system in Ulleung island will be prepared for aging society.

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The bactericidal effect of an atmospheric-pressure plasma jet on Porphyromonas gingivalis biofilms on sandblasted and acid-etched titanium discs

  • Lee, Ji-Yoon;Kim, Kyoung-Hwa;Park, Shin-Young;Yoon, Sung-Young;Kim, Gon-Ho;Lee, Yong-Moo;Rhyu, In-Chul;Seol, Yang-Jo
    • Journal of Periodontal and Implant Science
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    • v.49 no.5
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    • pp.319-329
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    • 2019
  • Purpose: Direct application of atmospheric-pressure plasma jets (APPJs) has been established as an effective method of microbial decontamination. This study aimed to investigate the bactericidal effect of direct application of an APPJ using helium gas (He-APPJ) on Porphyromonas gingivalis biofilms on sandblasted and acid-etched (SLA) titanium discs. Methods: On the SLA discs covered by P. gingivalis biofilms, an APPJ with helium (He) as a discharge gas was applied at 3 different time intervals (0, 3, and 5 minutes). To evaluate the effect of the plasma itself, the He gas-only group was used as the control group. The bactericidal effect of the He-APPJ was determined by the number of colony-forming units. Bacterial viability was observed by confocal laser scanning microscopy (CLSM), and bacterial morphology was examined by scanning electron microscopy (SEM). Results: As the plasma treatment time increased, the amount of P. gingivalis decreased, and the difference was statistically significant. In the SEM images, compared to the control group, the bacterial biofilm structure on SLA discs treated by the He-APPJ for more than 3 minutes was destroyed. In addition, the CLSM images showed consistent results. Even in sites distant from the area of direct He-APPJ exposure, decontamination effects were observed in both SEM and CLSM images. Conclusions: He-APPJ application was effective in removing P. gingivalis biofilm on SLA titanium discs in an in vitro experiment.

Risk Factors for Stage IV Breast Cancer at the Time of Presentation in Turkey

  • Uyeturk, Ummugul;Tatli, Ali Murat;Gucuk, Sebahat;Oksuzoglu, Berna;Ulas, Arife;Avci, Nilufer;Ozbay, Mehmet Fatih;Gunduz, Seyda;Akinci, Muhammed Bulent;Salim, Derya Kivrak;Sonmez, Ozlem Uysal;Akdag, Fatma;Ergenc, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7445-7449
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    • 2013
  • Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.

Self-Efficacy, Self-Care Behavior, Posttraumatic Growth, and Quality of Life in Patients with Cancer according to Disease Characteristics (질병관련 특성에 따른 암환자의 자기효능감, 자가간호행위, 외상 후 성장, 삶의 질)

  • Choi, Jinho;Lee, Sunyoung;An, Byungduck
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.170-179
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    • 2016
  • Purpose: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. Methods: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. Results: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. Conclusion: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.