ABSTRACT
Background@#Human breast milk is essential and provides irreplaceable nutrients for early humans. However, breastfeeding is not easy for various reasons in medical institution environments. Therefore, in order to improve the breastfeeding environment, we investigated the difficult reality of breastfeeding through questionnaire responses from medical institution workers. @*Methods@#A survey was conducted among 179 medical institution workers with experience in childbirth within the last five years. The survey results of 175 people were analyzed, with incoherent answers excluded. @*Results@#Of the 175 people surveyed, a total of 108 people (61.7%) worked during the day, and 33 people (18.9%) worked in three shifts. Among 133 mothers who stayed with their babies in the same nursing room, 111 (93.3%) kept breastfeeding for more than a month, but among those who stayed apart, only 10 (71.4%) continued breastfeeding for more than a month (P = 0.024). Ninety-five (88.0%) of daytime workers, 32 (94.1%) two-shift workers, and 33 (100%) three-shift workers continued breastfeeding for more than a month (P = 0.026). Workers in general hospitals tended to breastfeed for significantly longer than those that worked in tertiary hospitals (P = 0.003). A difference was also noted between occupation categories (P = 0.019), but a more significant difference was found in the comparison between nurses and doctors (P = 0.012). Longer breastfeeding periods were noted when mothers worked three shifts (P = 0.037). Depending on the period planned for breastfeeding prior to childbirth, the actual breastfeeding maintenance period after birth showed a significant difference (P = 0.002). Of 112 mothers who responded to the question regarding difficulties in breastfeeding after returning to work, 87 (77.7%) mentioned a lack of time caused by being busy at work, 82 (73.2%) mentioned the need for places and appropriate circumstances. @*Conclusion@#In medical institutions, it is recommended that environmental improvements in medical institutions, the implementation of supporting policies, and the provision of specialized education on breastfeeding are necessary to promote breastfeeding.
ABSTRACT
A hospitalist system in Korea began in August 2016. Patient safety issues, resident law, and reduction of resident numbers in Korea are leading to an increase in the demand for hospitalist in Korea. The roles and responsibilities of GI hospitalists have not been established. Therefore, cooperation among the Korean society of gastroenterology, each hospital, and government is necessary. In particular, it is important to prepare an education program for gastroenterology hospitalists.
Subject(s)
Humans , Education , Gastroenterology , Hospitalists , Inpatients , Jurisprudence , Korea , Patient SafetyABSTRACT
A hospitalist system in Korea began in August 2016. Patient safety issues, resident law, and reduction of resident numbers in Korea are leading to an increase in the demand for hospitalist in Korea. The roles and responsibilities of GI hospitalists have not been established. Therefore, cooperation among the Korean society of gastroenterology, each hospital, and government is necessary. In particular, it is important to prepare an education program for gastroenterology hospitalists.
Subject(s)
Humans , Education , Gastroenterology , Hospitalists , Inpatients , Jurisprudence , Korea , Patient SafetyABSTRACT
Bullous pemphigoid is a rare nonhematologic autoimmune complication of chronic lymphocytic leukemia. There have been roughly 10 cases worldwide since 1974, and searches through Korean dermatological literature revealed no reported cases. A 72-year-old man had been diagnosed with chronic lymphocytic leukemia and treated with chemotherapy for 7 months. After that, he was in complete remission, and the chemotherapy was discontinued consequently. One month later, multiple erythematous blisters, papules, and crusts developed on his trunk and both extremities. Histopathologic examination and immunofluorescence of the tense blister revealed a bullous pemphigoid. We present this rare case as the first documented case report of bullous pemphigoid following chronic lymphocytic leukemia in the Korean dermatological literature.
Subject(s)
Aged , Humans , Blister , Drug Therapy , Extremities , Fluorescent Antibody Technique , Leukemia, Lymphocytic, Chronic, B-Cell , Pemphigoid, Bullous , Transcutaneous Electric Nerve StimulationABSTRACT
OBJECTIVE: There are many technical modifications of decompressive lumbar laminectomy. The purpose of this study was to report long-term clinical and radiological outcomes of central decompressive laminoplasty (CDL), the corresponding author’s own modification of lumbar laminectomy for lumbar spinal stenosis (LSS). METHODS: Among 100 patients who underwent CDL by a single surgeon between December 2010 and March 2014, 68 patients were included in this study. Mean follow-up time was 37.7 months. Clinical and radiological data were gathered prospectively and reviewed retrospectively. Clinical outcome was measured by using visual analog scale (VAS) for back/buttock and leg, and the Oswestry Disability Index (ODI). Radiological outcome was measured by neutral slippage percentage, dynamic slippage percentage, and dynamic intervertebral angel on sagittal X-ray. Outcomes after CDL were assessed by changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients’ effect as used to test for differences in the repeated measured clinical and radiological data. RESULTS: The patients had no serious complications with an uneventful recovery during the early postoperative period. In the early postoperative period, VAS scores for back/buttock and leg improved significantly and were kept with time (p < 0.001). ODI also improved significantly during the postoperative follow-up period (p < 0.001). The radiologic parameters were well maintained and showed no progression of instability. During the follow-up, a case of herniated disc at same level recurrence was noted after lifting trauma, and 2 adjacent foraminal stenosis needed additional surgery. CONCLUSION: CDL provides long-term pain relief and functional restoration without progression of radiological instability.
Subject(s)
Humans , Constriction, Pathologic , Follow-Up Studies , Intervertebral Disc Displacement , Laminectomy , Laminoplasty , Leg , Lifting , Patient Outcome Assessment , Postoperative Period , Prospective Studies , Recurrence , Retrospective Studies , Spinal Stenosis , Visual Analog ScaleABSTRACT
No abstract available.
Subject(s)
Female , Humans , Young Adult , Maxillary Sinus , Neoplasm Metastasis , RhabdomyosarcomaABSTRACT
Cryotherapy is a simple, relatively inexpensive therapeutic modality that is widely-used in clinical practice. It is especially appropriate for patients with an intolerance to anesthesia as well as high risk factors for developing hypertrophic scars after surgery. It can be applied to skin lesions located close to vital structures such as vessels and nerves. Potential side effects include pain, hemorrhage, edema, blisters, infection, hypopigmentation, and sensory damage. There are a numerous reports in the literature describing the side effects of cryotherapy. However, cases with severe complications have rarely been reported as yet. Herein, we report a case of serious complications of cryotherapy, a result of the course of treatment for linear porokeratosis.
Subject(s)
Humans , Anesthesia , Blister , Cicatrix, Hypertrophic , Cryotherapy , Edema , Hemorrhage , Hypopigmentation , Porokeratosis , Risk Factors , SkinABSTRACT
Mercury is traditionally used as a dye for making amulets in Korea. Inhaling the vapor produced by burning mercury damages major organs, such as the lungs, kidneys, and brain. We herein present a case of a 41-year-old man who complained of abdominal pain and dyspnea. A chest X-ray and computed tomography scan showed infiltration in both upper lung lobes. A thorough medical history revealed that the patient had made amulets prior to developing symptoms, and blood and urine tests confirmed elevated levels of mercury. Dimercaptosuccinic acid was used to chelate the mercury, and methylprednisolone was used to treat the acute lung injury. No kidney or nervous system complications were detected during follow-up. Inhalation of mercury vapor should be suspected in patients with acute lung injury involving both upper lobes.
Subject(s)
Adult , Humans , Abdominal Pain , Acute Lung Injury , Brain , Burns , Dyspnea , Follow-Up Studies , Inhalation , Kidney , Korea , Lung , Mercury Poisoning , Methylprednisolone , Nervous System , Succimer , ThoraxABSTRACT
BACKGROUND: Blastic plasmacytoid dendritic cell neoplasm (BPDCN), which is derived from the precursor of plasmacytoid dendritic cells, is a rare and highly aggressive hematologic malignancy. It has only recently been recognized as a distinct entity. BPDCN characteristically has a predilection for cutaneous involvement. OBJECTIVE: The aim of this study was to describe the clinical and pathological features of BPDCN, and to review the treatment courses to analyze the prognosis and the optimal therapeutic approach. METHODS: We retrospectively reviewed seven BPDCN cases registered in the Samsung Medical Center database between January 2010 and December 2014. RESULTS: The median age of the patients was 52 years (range, 18~79 years), and six patients were male. The clinical staging was as follows: skin (n=5), lymph node (n=6), bone marrow (n=4), and peripheral blood (n=2). The skin manifestations were bruise-like tumefaction (n=4), erythematous nodule (n=4), or multiple erythematous papules (n=1). The pathological evaluation revealed dense diffuse or nodular infiltration of neoplastic cells, which were positive for CD4, CD56, and CD123 in the immunohistochemical analysis. Six patients received multiagent chemotherapy as the first-line treatment, alone (n=4), or followed by stem cell transplantation (SCT, n=1) or concurrent radiotherapy (n=1). The median progression-free survival after the first-line treatment was 6 months (range, 2~12 months). CONCLUSION: Three different skin manifestations were observed, with pathological features analogous to each other. All patients who received chemotherapy without SCT achieved partial or complete response but experienced relapse. Furthermore, they showed various clinical courses irrelevant to the cutaneous involvement.
Subject(s)
Humans , Male , Bone Marrow , Dendritic Cells , Disease-Free Survival , Drug Therapy , Hematologic Neoplasms , Lymph Nodes , Prognosis , Radiotherapy , Recurrence , Retrospective Studies , Skin , Skin Manifestations , Stem Cell Transplantation , Treatment OutcomeABSTRACT
Eccrine porocarcinoma is a rare, malignant skin tumor that originates from the eccrine sweat gland. This disease affects elderly people, primarily. It is clinically present in varied forms and the location is not related to sweat-gland distribution, which occurs on the lower limb, trunk, and head. Herein, we report a rare case of pedunculated eccrine porocarcinoma, which had developed on the flank of a 79-year-old woman.
Subject(s)
Aged , Female , Humans , Eccrine Porocarcinoma , Head , Lower Extremity , Skin , Sweat GlandsABSTRACT
BACKGROUND AND OBJECTIVES: It has been demonstrated that the anomalous origin of coronary arteries (AOCA) are generally asymptomatic and rare diseases. However, some cases can cause severe life threatening events. To detect these anomalies, coronary angiographies and autopsies were used to detect coronary artery anomalies, but these procedures have limitations because of their invasiveness. The new device, Multidetector Computed Tomography (MDCT), now replaces the method of choice for detecting coronary anomalies. The prevalence of these anomalies in Korea has not been studied yet. This present analysis attempted to determine the prevalence of AOCA in Korean men by MDCT. SUBJECTS AND METHODS: 1582 Korean male police officers underwent coronary MDCT for their health screening voluntarily. After reconstruction of CT images, we could confirm coronary artery anomalies. RESULTS: The prevalence of AOCA in Korean men was 1.14% (18 out of 1582 cases). The most common abnormality (11 cases, 0.70%) was the origin of the coronary artery. Anomalies of the coronary artery end point were observed in 5 cases (0.32%). The anomalous location of coronary ostium on the aortic root was observed in 1 case (0.06%). An anomalous collateral vessel was observed in 1 case (0.06%). CONCLUSION: The prevalence of coronary artery anomalies in Korean men was 1.14%. Coronary CT is a safe and noninvasive modality for detecting coronary anomalies.
Subject(s)
Humans , Male , Autopsy , Coronary Angiography , Coronary Vessel Anomalies , Coronary Vessels , Korea , Mass Screening , Multidetector Computed Tomography , Police , Prevalence , Rare DiseasesABSTRACT
Role of iron in hair loss is not clear yet. The purpose of this study was to evaluate the relationship between iron and hair loss. Retrospective chart review was conducted on patients with female pattern hair loss (FPHL) and male pattern hair loss (MPHL). All patients underwent screening including serum ferritin, iron, and total iron binding capacity (TIBC), CBC, ESR and thyroid function test. For normal healthy controls, age-sex matched subjects who had visited the hospital for a check-up with no serious disease were selected. A total 210 patients with FPHL (n = 113) and MPHL (n = 97) with 210 healthy controls were analyzed. Serum ferritin concentration (FC) was lower in patients with FPHL (49.27 +/- 55.8 microg/L), compared with normal healthy women (77.89 +/- 48.32 microg/L) (P < 0.001). Premenopausal FPHL patients turned out to show much lower serum ferritin than age/sex-matched controls (P < 0.001). Among MPHL patients, 22.7% of them showed serum FC lower than 70 microg/L, while no one had serum FC lower 70 microg/L in healthy age matched males. These results suggest that iron may play a certain role especially in premenopausal FPHL. The initial screening of iron status could be of help for hair loss patients.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Administration, Oral , Alopecia/blood , Dietary Supplements , Ferritins/blood , Ferrous Compounds/therapeutic use , Hemoglobins/analysis , Iron/blood , Premenopause , Retrospective Studies , Thyroid Function TestsABSTRACT
Acinetobacter baumannii infections have become significant pathogen in hospitalized patients, especially in the intensive care unit setting. Community-acquired Acinetobacter meningitis in adults is a very rare infection of the central nervous system. Most community-acquired Acinetobacter infections have been reported from countries with a tropical or subtropical climate. Acinetobacter infections mainly affect patients with some form of comorbidity and are also associated with heavy smoking and excess alcohol consumption. In our case, a 62-year-old male patient with DM, hypertension, and excess alcohol consumption developed meningitis. Bulging membrane and inflammation were observed in the right ear. A. baumannii meningitis was confirmed by blood, CSF, and ear discharge culture. The patient was treated effectively with meropenem for 21 days. After antibiotic treatment, follow-up cultures of CSF, blood, and ear discharge showed a negative result, and the CSF cell profile was normalized. However, the patient died of recurrent pneumonia on hospital day 45. We report on a case of community-acquired Acinetobacter meningitis in an adult in Korea.