ABSTRACT
OBJECTIVES: The purpose of this study was to define the underserved emergency medical services (EMS) areas in Daejeon metropolitan city, as well as to identify their distinctive characteristics in public health perspectives. METHODS: An underserved EMS area was operationally defined as an area in which it is difficult to arrive at an emergency medical center within 30 minutes. Using a cost-weighted distance algorithm with a geographic information system (GIS), the underserved EMS area was calculated. The characteristics of the underserved areas were analyzed by the Chi-square test. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were two-sided, and a p-value<0.05 was considered statistically significant. RESULTS: Twelve administrative sectors ('Dong' in Korean) were included in the underserved areas, accounting for a population of approximately 8,100 citizens. The relationships between underserved EMS area and populations of agriculture, fishery, and forestry; citizens who are recipients of national basic livelihood security program; disabled; or aged 65 or older were statistically significant. CONCLUSION: It was found that 12 administrative sectors were included in the underserved EMS areas. Revealing underserved EMS areas using GIS analysis based on a cost-weighted distance algorithm of road data was an effective analytic method. However, as this study was confined to Daejeon City, South Korea, a nation-wide study should be performed to provide a more accurate conclusion.
Subject(s)
Aged , Humans , Accounting , Agriculture , Emergencies , Emergency Medical Services , Fisheries , Geographic Information Systems , Public Health , Republic of KoreaABSTRACT
N-terminal pro-brain natriuretic peptide (NT-proBNP) can be a useful marker for left ventricular (LV) dysfunction in patients without kidney disease. This study was conducted to clarify the relationship between NT-proBNP and LV systolic function in patients with decreased renal function. We studied 256 chronic kidney disease (CKD) patients, patients on dialysis were excluded. The median glomerular filtration rate was 24 (13-36) mL/min/1.73 m(2) and the median NT-proBNP was 4,849 (1,310- 19,009) pg/mL. The prevalence of LV systolic dysfunction increased from the lower to the upper NT-proBNP quartiles (I, 17%; II, 34%; III, 61%; and IV, 72%; p<0.001 for trend). The NT-proBNP quartile was an independent predictor of LV systolic dysfunction after adjustment for renal function, compared with quartile I: II, odds ratio (OR) 3.99 (95% confidence interval [CI],1.34-11.93); III, OR 11.28 (95% CI, 3.74-33.95); and IV, OR 36.97 (95% CI, 11.47-119.1). Area under the curve and optimum cut points for NT-proBNP to detect LV systolic dysfunction were 0.781 and 2,165 pg/mL in CKD stage 3, 0.812 and 4,740 pg/mL in CKD stage 4, and 0.745 and 15,892 pg/ mL in CKD stage 5. The NT-proBNP level was a predictor of LV systolic dysfunction in CKD patients. Optimum cut points should be stratified according to renal function.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Area Under Curve , Glomerular Filtration Rate , Kidney Failure, Chronic/complications , Natriuretic Peptide, Brain/blood , Peptide Fragments , Prevalence , Protein Structure, Tertiary , Sensitivity and Specificity , Ventricular Dysfunction, Left/complications , Ventricular Function, LeftABSTRACT
PURPOSES: To compare the radiologic results in the minimally invasive quadriceps sparing total knee arthroplasty(MIS-QS TKA) with those in conventional total knee arthroplasty(TKA). MATERIALS AND METHODS: Between June 2004 and December 2004, we underwent 20 MIS-QS TKAs (group I) and 20 conventional TKAs(group II). All cases were female with osteoarthritis. The average age was 68.0 years in group I and 65.0 years in group II. The mechanical axis and the implant position were measured by 2 observers according to the reontgenographic evaluation system of the American Knee Society. RESULTS: The mean length of skin incision was 9.2 cm in group I and 16.1 cm in group II. The mean operative time was 127 minutes in group I and 85 minutes in group II. The mean postoperative mechanical axis was varus 1.35 degrees in group I and varus 0.37 degrees in group II. And the mean alpha, beta, gamma and delta angle were 94.9, 90.6, 4.5 and 85.5 degrees in group I, and 94.3, 91.4, 4.7 and 84.6 degrees in group II, respectively. There was no significant difference in the radiologic results between both groups. CONCLUSIONS: There was no significant difference in the implant position and mechanical axis between MIS-QS TKA group and conventional TKA group. Average skin incision was shorter in MIS-QS TKA, but longer operation time taken compared to that of conventional TKA.
Subject(s)
Female , Humans , Arthroplasty , Axis, Cervical Vertebra , Knee , Operative Time , Osteoarthritis , Skin , Minimally Invasive Surgical ProceduresABSTRACT
Rhabdomyosarcoma is the most common sarcoma of children and adolescents. Rhabdomyosarcoma is a highly malignant soft tissue sarcoma that can arise in any site of the body containing striated muscle or its mesenchymal analogue. The common primary sites were head and neck including orbit, extremities, genitourinary tract, trunk, retroperitoneum, gastrointestinal tract, and thorax. There are basically three types of rhabdomyosarcoma: embryonal, alveolar, and pleomorphic; these categories may overlap histologically. Retroperitoneal rhabdomyosarcoma of embryonal type is rarely reported in an adult. Since we experienced a case of 25 X 20 X 12cm-sized retroperitoneal rhabdomyosarcoma of embryonal type, we report this with a review of literatures.
Subject(s)
Adolescent , Adult , Child , Humans , Extremities , Gastrointestinal Tract , Head , Muscle, Striated , Neck , Orbit , Rhabdomyosarcoma , Sarcoma , ThoraxABSTRACT
Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.
Subject(s)
Adenoma , Classification , Incidence , Japan , Lymph Nodes , Mucous Membrane , Neoplasm Metastasis , Stomach , Stomach NeoplasmsABSTRACT
Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.