• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4457-4461
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• 2016

Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2967-2971
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• 2013

Background: Extraskeletal Ewing sarcoma (EES)/primitive neuroectodermal tumours (PNET) are rare soft tissue sarcomas. Prognostic factors and optimal therapy are still unconfirmed. Materials and Methods: We performed a retrospective analysis on patients to explore the clinic characteristics and prognostic factors of this rare disease. A total of 37 patients older than 15 years referred to our institute from Jan., 2002 to Jan., 2012 were reviewed. The characteristics, treatment and outcome were collected and analyzed. Results: The median age was 28 years (range 15-65); the median size of primary tumours was 8.2 cm (range 2-19). Sixteen patients (43%) had metastatic disease at the initial presentation. Wide surgical margins were achieved in 14 cases (38%). Anthracycline or platinum-based chemotherapy was performed on 29 patients (74%). Radiotherapy was delivered in 13 (35%). At a median follow-up visit of 24 months (range 2-81), the media event-free survival (EFS) and overall survival (OS) were 15.8 and 30.2 months, respectively. The 3-year EFS and OS rates were 24% and 43%, respectively. Metastases at presentation and wide surgical margins were significantly associated with OS and EFS. Tumour size was significantly associated with OS but not EFS. There were no significant differences between anthracycline and platinum based chemotherapy regarding EFS and OS. Conclusions: EES/PNET is a malignant tumour with high recurrence and frequent distant metastasis. Multimodality therapy featuring wide surgical margins, aggressive chemotherapy and adjuvant local radiotherapy is necessary for this rare disease. Platinum-based chemotherapy can be used as an adjuvant therapy.

• Journal of Acupuncture Research
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• v.25 no.6
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• pp.35-46
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• 2008

Objectives : Chronic pain affects and is affected by physical and psychosocial factors. It also has a complicated and indefinite mechanism. This research is for clarifying relations with chronic pain, stress, and autonomic nerve system by comparing HRV and Stress Reaction Index(SRI) of chronic pain patients with those of acute pain patients. Methods : The subjects were 32 patients who visited Kangnam Kyunghee Hospital for nuchal pain or low back pain treatment from March 2008 to September 2008. Among them, 16 patients who suffered over 6 months are classified chronic pain group and 16 patients who suffered under 6 months as acute pain group. All subjects had their HRV(SA-2000E: Medicore Co..Ltd. Korea) and SRI measured at first visit. We studied the difference of HRV between two groups.(Statistics by Student t-test, p<0.05) Results : R-MSSD, TP, VLF, LF, HF and LF/HF ratio of the chronic pain group were significantly lower than those of the acute pain group. Compared with those of the acute pain group, total SRI of the chronic pain group were low but it's not significant except frustration. Conclusion : The results of HRV of the chronic pain group patients show that chronic pain is related to psychosocial factor and autonomic disturbance.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.86-90
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• 2018

Non-infectious complications of peritoneal dialysis (PD) are relatively less common than infectious complications but are a potentially serious problem in patients on chronic PD. Here, we present a case of a non-infectious complication of PD in a 13-year- old boy on chronic PD who presented with symptoms such as hypertension, edema, dyspnea, and decreased ultrafiltration. Chest and abdominal radiography showed pleural effusion and migration of the PD catheter tip. Laparoscopic PD catheter reposition was performed because PD catheter malfunction was suspected. However, pleural effusion relapsed whenever the dialysate volume increased. To identify peritoneal leakage, computed tomography (CT) peritoneography was performed, and a defect of the peritoneum in the left lower abdomen with contrast leakage to the left rectus and abdominis muscles was observed. He was treated conservatively by transiently decreasing the volume of night intermittent PD and gradually increasing the volume. At the 2-year follow-up visit, the patient had not experienced similar symptoms. Patients on PD who present with refractory or recurrent pleural effusion that does not respond to therapy should be assessed for the presence of infection, catheter malfunction, and pleuroperitoneal communication. Thoracentesis and CT peritoneography are useful for evaluating pleural effusion, and timely examination is important for identifying the defect or fistula.

• Health Policy and Management
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• v.8 no.2
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• pp.58-75
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• 1998

The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The objectives of this study is to find the performance of the administrative personnel in hospitals. The unit of analysis is the hospitals and data was collected form 144 staffs in 5 hospitals. Self administered questionnaire was given to analyze the general characteristics of staft such as age, sex, education, experience, and performance level in terms of frequency, ability, necessity of tasks. The major findings are as follows: 1. The 5 major tasks such as general affairs, insurance related affairs, hospital statistics, admission/discharge, and analysis of treatment cost were analyzed. Performance level of these tasks were not showed consistent level. It means that the same task was showed both high level performance and low level one. 2. The higher rates of performance level, ability and necessity were found, below 29 years of age, junior college graduates and university hospital than that of general one. 3. Factors mostly affected to performances were found as characteristics of hospital, age and education. 4. Concerning the various manpower management, On the job training, incentive mechanism and colose relationship among units were somewhat lack. In conclusion, most responded administrative personnel have performed actively in dealing with their tasks. however, the performance level and ability of the same task were showed differently, it means that such routine works were not standardized. Therefore, standardization and specification of tasks should be developed to strength the performance. Finally, this study is the first attempt to find out the performance of the administrative staffs and the study results imply that further study could be neeed to promote the performance of administrative personnel efficiently and effectively.

• Health Policy and Management
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• v.26 no.3
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• pp.233-241
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• 2016

Background: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. Methods: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level ($500{\times}500m$) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. Results: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. Conclusion: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.719-721
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• 2007

Patients with congenital pericardial defect display few symptoms and this is an unusual disease, so it is generally found incidentally in most of the cases. In some cases, symptoms such as chest pain are found due to partial cardiac herniation. We report here on a 14-year-old girl with dyspnea and chest pain that started during physical activity 3 months before the hospital visit. She was diagnosed with herniation of the left atrial appendage with a partial pericardium defect and she was treated with an operation.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.155-163
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• 2005

Objectives : This is a clinical report about neurogenic bladder patient with lumbar disc hernication. Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. Hypotonic (flaccid) neurogenic bladder can be caused by ruptured or herniated intervertebral disk. Methods : The patient was treated by Oriental medicine treatment with needle acupuncture, electropuncture, bee venom acua-acupuncture and Daeboonchungeum-gami etc. Voided volume and frequency, visual analogue scale and physical examination was used to estimate the efficacy of these treatment. Results : STZ As using these treatments, voided volume and frequency returns normal condition. Visual analogue scale dips as low as 2. Physical examination showed improvement as compared with the fist visit. And further, these treatment may influence on the recovery of neurogenic bladder patient with lumbar disc herniation. Conclusion : The results suggest that Oriental medicine treatment have an useful effect on neurogenic bladder patient's treatment and recovery.

• Journal of Korean Foot and Ankle Society
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• v.20 no.4
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• pp.158-162
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• 2016

Purpose: To evaluate the radiological and clinical effects of early weightbearing after distal reverse oblique osteotomy of bunionette. Materials and Methods: Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit. Results: The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group. Conclusion: Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.1
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• pp.52-56
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• 2015

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.