Objectives: The goals of this study are to exploring critical factors and methods to improve Korean Community Care through the cases of GyeongsangNamdo. Methods: For this study, we performed in-depth interviews with 90 people involved in Community Care services of 6 regions, and the collected data were analyzed. The collected data were analyzed utilizing NVivo12. In the end, we reconfirmed the process through Topic Modeling analysis. Results: We conducted descriptive statistics and qualitative data analysis collected through surveys and in-depth interviews. In the case of qualitative analysis, we extracted principle codes (Need, Lack, Absence), and sorted the contents into sub-categories. The response rate of ‘Need to strengthen capabilities’ was the highest, ‘Need to communicate and share information’ was the second, and ‘Need for integrated operation and a control tower’ was the third. Conclusion As a result, we find the critical factors to improve Community Care. Based on them, we should conduct follow-up researches to propose concrete methods to apply to diverse regions.

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

No abstract available.
Child* ; Humans ; Meningitis* ; Plasma*

No abstract available.
Humans

Mobius syndrome is a rare congenital disease characterized by unilateral or bilateral limitation of abduction and facial palsy due to the 6th and 7th cranial nerve paralysis. In addition, it may be associated with limb anomalies and other cranial nerve paralysis. We experienced three cases of Mobius syndrome characterized by esodeviation associated with bilateral limitation of abduction, bilateral facial atroph, tongue atrophy, congenital amputation of limb, and congenital clubfoot. We performed a large amount of bilateral medial rectus recession and unilateral lateral rectus resection, and obtained cosmetically successful results that orthophoric or less than 10 prism diopter of esotropia in primary postition, but mild limitation of adduction was observed as a complication.
Amputation ; Atrophy ; Clubfoot ; Cranial Nerves ; Esotropia ; Extremities ; Facial Paralysis ; Mobius Syndrome* ; Paralysis ; Tongue

Histiocytosis X(Langerhans cell histiocytosis) is a rare prolifertive disorder of Langerhans cells that includes Lettere-Siwe disease, Hand-Shiiller-Christian his ase and eosinophilic granuloma. Since many authors have reported in anintermediate and poarl classified form histiocytosis X has a namenclatural had nosologic problem. We report a case benign cutaneous variant of histiocytisis X. A four-month-old boy had shown multiple skin-colour papules on the trunk, head and nik for one month. Extensive in- vestigations failed to detcct any systemic involvement. The clixron microscopic findings of the skin biopsy specimen were Qefinitely diagnostic for histiocytosi. X Since he did not sbow evidence of internal organ involvernent and any further progression of he skin lesion, no therapy was given. Over the next two months the disease underwent spontane us and complete remission.
Biopsy ; Eosinophilic Granuloma ; Head ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Male ; Remission, Spontaneous* ; Skin

The purpose of this study was to evaluate the association between glycated hemoglobin (HbA1c) and all-cause mortality in type 2 diabetes mellitus. We conducted a community-based prospective cohort study of 352 type 2 diabetic patients aged 30-92 who participated in a community diabetes complications screening program in Gokseng-gun, Jeollanamdo, Korea. HbA1c levels were categorized as <6.5%, 6.5-6.9%, 7.0-7.9%, 8.0-8.9% and ≥9.0%. Patients were followed up on for a mean of 6.9 years. The Cox proportional hazards model was used to evaluate the relationship between HbA1c levels and all-cause mortality. During the mean follow-up period of 6.9 years, 77 patients (21.9%) died. A J-shaped association was found between HbA1c and all-cause mortality, with the lowest mortality at 6.5-6.9% of HbA1c levels. Compared to patients with HbA1c of 6.5-6.9%, patients with <6.5%, 7.0-7.9%, 8.0-8.9% and ≥9.0% had an adjusted hazard ratio (95% confidence interval) for all-cause mortality of 1.71 (0.76-3.84), 1.23 (0.53-2.82), 1.32(0.51-3.44) and 2.66 (1.01-7.02), respectively. We found a J-shaped association between glycated hemoglobin and all-cause mortality in Korean type 2 diabetic patients.
Cohort Studies ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Follow-Up Studies ; Hemoglobin A, Glycosylated ; Humans ; Jeollanam-do ; Korea ; Mass Screening ; Mortality ; Proportional Hazards Models ; Prospective Studies

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

A study was to evaluate the efficacy and clinical utility of second look operation in the managements of malignant ovarian tumor at the Department of Obstetrics and Gynecology, Kosin medical colleage from January 1986 to September 1993. Of 220 patients diagnosed as ovarian cancer, 48 patients who had underwent primariy laparotomy were performed second look operation. Thirty-seven patients were found to have no evidence of disease. The result revealed that negative second look operation rate was noted 96.3% at stage I, 66.6% at stage II, 50.0% at stage III, and 42.9% at stage IV and total negative second look operation rate was 77.1%. The 2 year survival rate for stage I, II, III, IV were 85.2%, 66.6%, 50.0% and 42.9% respectively. The survival rate of negative second look operation was 86.5%, that of positive second look operation was 18.1%. In conclusion, second look operation in early stage ovarian cancer need to be justified.
Follow-Up Studies* ; Gynecology ; Humans ; Laparotomy* ; Obstetrics ; Ovarian Neoplasms* ; Survival Rate

No abstract available.
Acute Kidney Injury* ; Fever* ; Nephritis, Interstitial*