• Title/Summary/Keyword: non-hospital

Search Result 5,947, Processing Time 0.038 seconds

Clinical Significance of Preoperative Embolization for Non-Hypervascular Metastatic Spine Tumors

  • Yoo, Sung-Lim;Kim, Young-Hoon;Park, Hyung-Youl;Kim, Sang-Il;Ha, Kee-Yong;Min, Hyung-Ki;Seo, Jun-Yeong;Oh, In-Soo;Chang, Dong-Gune;Ahn, Joo-Hyun;Kim, Yong-Woo
    • Journal of Korean Neurosurgical Society
    • /
    • v.62 no.1
    • /
    • pp.106-113
    • /
    • 2019
  • Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

The Role of Two Human Milk Oligosaccharides, 2'-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition

  • Hegar, Badriul;Wibowo, Yulianti;Basrowi, Ray Wagiu;Ranuh, Reza Gunadi;Sudarmo, Subianto Marto;Munasir, Zakiudin;Atthiyah, Alpha Fardah;Widodo, Ariani Dewi;Supriatmo, Supriatmo;Kadim, Muzal;Suryawan, Ahmad;Diana, Ninung Rose;Manoppo, Christy;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.22 no.4
    • /
    • pp.330-340
    • /
    • 2019
  • Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2'-FL and LNnT is a promising innovation for infant nutrition.

The Relationship between Medical Operating Income and Volume of Medical Services Provided at General Hospitals in Korea (종합병원에서 진료량과 의료이익의 관계)

  • Lim, Min Kyoung;Kim, Jeongha;Kim, Sunjea
    • Korea Journal of Hospital Management
    • /
    • v.26 no.3
    • /
    • pp.13-27
    • /
    • 2021
  • Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.

Bevacizumab Concomitant with Chemotherapy is Effective in Treating Chinese Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer

  • Sun, Jing;Hu, Yi;Wu, Bai-Shou;Wang, Jin-Liang;Tao, Hai-Tao;Zhang, Su-Jie
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.14
    • /
    • pp.5945-5950
    • /
    • 2014
  • Objectives: To retrospectively review the safety and clinical efficacy of bevacizumab concomitant with chemotherapy in Chinese patients with advanced non-squamous non-small cell lung cancer (NSNSCLC). Methods: Clinical data for 79 patients with NSNSCLC who received bevacizumab concomitant with chemotherapy in Chinese PLA General Hospital from April 28th 2009 to May 5th 2013 were retrospectively reviewed to analyze the clinical efficacy including disease control rate (DCR), overall response rate (ORR), progression-free survival (PFS), overall survival (OS), the Eastern Cooperative Oncology Group (ECOG) score and the safety. Results: The Eastern Cooperative Oncology Group (ECOG) score was 0-2. By the final cutoff date (June 9, 2013), 54 (68.4%) patients had disease progression and 37 (46.8%) died. The ORR was 32.9% and the DCR was 83.5%. The ORR of the first-, second-, and third- or later-line treatments were 51.4%, 25.0% and 12.5%, while the DCR were 94.3%, 80.0% and 70.8%, respectively. The median OS (mOS) and PFS (mPFS) were 13.5 and 5.83 months, respectively. The mOS of patients with the first-, second-, and third- or later- line treatments were 16.2, 10.9 and 8.30 months, while the mPFS were 7.27, 5.90 and 5.17 months, respectively. Chemotherapy-related adverse events included myelosuppression, vomiting, hepatic dysfunction and renal dysfunction, while the common serious bevacizumab-related adverse events were thromboembolic problems, gastrointestinal perforation and reversible posterior leukoencephalopathy syndrome, which could be well managed. Conclusions: Bevacizumab concomitant with chemotherapy is effective and the related toxicity can be well tolerated in Chinese patients with NSNSCLC.

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

  • Oh, Jae-Sang;Yoon, Seok-Mann;Shim, Jai-Joon;Doh, Jae-Won;Bae, Hack-Gun;Lee, Kyeong-Seok
    • Journal of Korean Neurosurgical Society
    • /
    • v.60 no.2
    • /
    • pp.155-164
    • /
    • 2017
  • Objective : To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. Methods : Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. Results : Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19 : 95% confidence interval, 1.07-25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). Conclusion : A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.

Analysis of Job Satisfaction between Regular Radiologists and Non-Regular Radiologists in General Hospital (종합병원에 근무하는 방사선사의 직무만족도 분석 -정규직과 비정규직 중심으로-)

  • Kang Yeong-Han
    • Journal of The Korean Radiological Technologist Association
    • /
    • v.30 no.1
    • /
    • pp.28-35
    • /
    • 2004
  • Purpose : The purpose of this study is to compare the job satisfaction between regular radiologists and non-regular radiologists in general hospital and to research the factors of affecting job satisfaction. Materials and Methods : The subject is 120 radi

  • PDF

Urine Cotinine for Assessing Tobacco Smoke Exposure in Korean: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES)

  • Jung, Sungmo;Lee, In Seon;Kim, Sae Byol;Moon, Chan Soo;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Eun Young
    • Tuberculosis and Respiratory Diseases
    • /
    • v.73 no.4
    • /
    • pp.210-218
    • /
    • 2012
  • Background: The level of urine cotinine is an indicator of tobacco smoke exposure. The purpose of this study is to investigate urine cotinine for the purpose of assessing the smoking status of Korean smokers and non-smokers exposed to tobacco smoke. Methods: The subjects were identified from the 2007-2009 and the 2010 data sets of the Korea National Health and Nutrition Examination Survey (KNHANES). They were assigned as non-smokers, current smokers and ex-smokers. Non-smokers were also divided into three subset groups according to the duration of smoke exposure. Each group was stratified by gender prior to analysis. Results: The median value of urine cotinine in the male current smokers was 1,221.93 ng/mL which was the highest among all groups. The difference between levels of urine cotinine for male and the female groups was statistically significant (p<0.01). In the female group, passive smoke exposure groups reported higher urine cotinine levels than non-exposure groups (p=0.01). The cutoff point for the discrimination of current smokers from non-smokers was 95.6 ng/mL in males and 96.8 ng/mL in females. The sensitivity and specificity were 95.2% and 97.1%, respectively, in males, 96.1% and 96.5% in females. However, the determination of urine cotinine level was not useful in distinguishing between passive smoke exposure groups and non-exposure groups. Conclusion: Urine cotinine concentration is a useful biomarker for discriminating non-smokers from current smokers. However, careful interpretation is necessary for assessing passive smoke exposure by urine cotinine concentration.

Non-invasive different modalities of treatment for temporomandibular disorders: review of literature

  • Abouelhuda, Amira Mokhtar;khalifa, Ahmad Khalifa;Kim, Young-Kyun;Hegazy, Salah Abdelftah
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.44 no.2
    • /
    • pp.43-51
    • /
    • 2018
  • Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs.

Hospital Services Utilization by Insured and Non-insured Patients for Cesarean Section in a University Hospital (의료보험환자(醫療保險患者)와 비보험환자(非保險患者)의 의료(醫療)서비스 내용(內容) 비교(比較) -한 종합병원(綜合病院)의 제왕절개(帝王切開) 수술환자(手術患者)를 대상(對象)으로-)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Oh, Dai-Kyu
    • Journal of Preventive Medicine and Public Health
    • /
    • v.14 no.1
    • /
    • pp.53-58
    • /
    • 1981
  • In order to discover differences that may exist in quantity of medical care services, length of stay and hospital charges between insured and non-insured patients, records for primary Cesarean section patients discharged between July 1978 and June 1980 from a university hospital were examined. In addition, Cesarean section rates among the total deliveries for a two-year period between the two groups were studied. The results shelved that volume of services was greater and length of stay was longer among the insured, however, charges were higher among the non-insured. Cesarean section rates were statistically significantly different between insured and non-insured patients for every age group except the group of 35 or more.

  • PDF

Understanding of National Health Insurance Non-benefit (건강보험 비급여의 이해)

  • Moon, Kitae
    • The Journal of the Korean life insurance medical association
    • /
    • v.33 no.2
    • /
    • pp.15-17
    • /
    • 2014
  • All Korean people are eligible for National Health Insurance(NHI). But large non-coverage of NHI is a big problem. The origin of this problem is from medical fee schedules. NHI calculate all hospital income including insurance medical practice, non-insurance medical practice and non-medical income(i.e. a funeral hall, a parking lot, stores in hospital).

  • PDF