Sentinel Node Biopsy (SNB) is beneficial for reducing axillary functional impairment and lymphedema due to extended lymph node dissection. We used the Indigo Carmine dye instead of radioisotope, since it can simplify the complicated multistep identifying procedures and has economic benefit because it requires no radioisotope detection equipment. The operation for small breast cancer is continuously changing from a modified radical mastectomy to various type of breast conserving operations. Among these we performed a partial mastectomy with rotation flap using remnant breast tissue (RFB). This method needs small operation field, so we could reduce trauma to the patient, shorten the operation time, and use natural blood supplies and tissues without destructing other organ structures. The cosmetic effect is desirable to Korean women considering their relatively small breast size as to that of western people. In SNB, 5cc indigocarmine was injected intradermally just around main lesion. Sentinel node was able to be identified easily if a proper dose was used. Its approach was achieved in 15 to 20 minutes. Partial mastectomy (quadrantectomy) was done with cancer free margins. Rotation flap which is covering the defect included as much breast tissue as possible sparing the nipple areolar complex. Sentinel node biopsy and rotation flap brought out both satisfactory cosmetic result and cost effective outcome, so this breast conserving method is recommendable to small breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Equipment and Supplies ; Female ; Humans ; Indigo Carmine ; Lymph Node Excision ; Lymphedema ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Nipples

As the rapid growth of internet users, the implementation of e-commerce and e-community are becoming popular also in health fields. Especially, the marketing strategy through joint purchasing for health services such as lasik, plastic surgery, etc. has increasingly been an important issue in clinics and health portals. Therefore, this study purposes to investigate the current status of joint purchasing for health services and estimate the demand on them. Since the university students use an internet most frequently and tend to purchase the goods and services actively through it, the intention for health services were targeted to university students. Only 29% of respondents acknowledged the joint purchasing system for health services. And the purchasing intention was higher in the university students who experienced the joint purchasing for general goods than those who did not experience. Non-surgery items such as stress clinic, dental scaling showed higher intention. Meanwhile when respondents purchase the health services through an internet, they consider the reliability of quality for health services at most. Considering this, if the legal regulations and ethical standards for reliable health services are systematically prepared, positive attitudes and behavioral intention on joint purchasing for health services will be increased and the market of joint purchasing will be enlarged.
Surveys and Questionnaires ; Dental Clinics ; Group Purchasing* ; Health Services* ; Humans ; Intention ; Internet ; Joints* ; Keratomileusis, Laser In Situ ; Marketing ; Public Opinion* ; Social Control, Formal ; Surgery, Plastic

Purpose: The purpose of this study was to develop a program for reinforcing the resilience of new nurses and relation-oriented organizational culture. Methods An Intervention Research (IR) model was used to develop a program. Literature review, focus group interviews with nurses and need surveys were conducted from August to December 2018. Based on the results of the investigation, the researcher developed the content of a program. The program was revised by nurse managers for the content validation. Results: According to the results of the need surveys, 58.8% of the participants thought relation-oriented culture was the most ideal, and 61.8% of the participants wanted to participate in a program for organizational culture improvement. In the focus group interview, not only new nurses but also wards and nursing organizations should be a target subject of the program. Reinforcement of resilience and relation (3R) program was developed as a one-year course, which includes a ‘mentor-mentee’ program and a ‘thanks’ program. Conclusion: It would contribute to improving the resilience of new nurses and creating a relation-oriented organizational culture by 3R program.The 3R program could play a role as expanded program from an existing pragmatic short-term training program for improving the competencies or communication skills of new nurses.

Objective: We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Methods: Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Results: Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence). Conclusion In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Objective: We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Methods: Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Results: Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence). Conclusion In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Objective: We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Methods: Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Results: Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence). Conclusion In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Objective: We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Methods: Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Results: Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence). Conclusion In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Objective: We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Methods: Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Results: Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence). Conclusion In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Background: Automated hematology analyzers report various research parameters. Certain parameters may have clinical implications, whereas others are used to set flags in automated hematology analyzers. In this study, we established sex-specific reference intervals for one reticulocyte parameter and two platelet clump parameters in Korean adults and examined the necessity of separate reference intervals for each sex. Methods: A total of 264 healthy adults (157 men and 107 women) aged between 18 and 65 years who underwent regular health check-ups were enrolled. Complete blood cell count was measured using Advia2120i (Siemens, Germany) within 4 hours of phlebotomy. Reference intervals were established according to the Clinical and Laboratory Standards Institute EP28-A3 guideline, and the necessity of separate sex-specific reference intervals was examined according to the method outlined by Harris and Boyd. Results: The reference intervals for each parameter were as follows:reticulocyte hemoglobin (g/L), 132.8–172.0 (men), 96.7–162.8 (women); the number of platelet clumps (# platelet clumps), 10.8–61.0 (men), －22.5–64.4 (women); and %platelet clumps, 0.20–1.49 (men), －0.57–1.53 (women).Reticulocyte hemoglobin showed a significant difference between men and women, whereas # platelet clumps and %platelet clumps did not; however, all three parameters needed separate sex-specific reference intervals. Conclusions We established sex-specific reference intervals for a reticulocyte parameter and platelet clumps parameters in Korean adults for the first time.The results could provide helpful information in clinical decision-making and instrument setting.

BACKGROUND: Different age groups may have different reference intervals. However, the currently used reference interval for complete blood count (CBC) in clinical laboratories is based on results from healthy adults between 20 and 50 years of age. In this study, we aimed to establish reference intervals for 16 CBC parameters in Korean healthy elderly individuals. METHODS: A total of 3,359 healthy adults were selected from 4,253 adults (aged ≥20 years) who underwent regular health check-ups, based on a medical examination by interview. The reference intervals for CBC in two groups (aged <60 and ≥60 years), and the partitioning of reference intervals between the two age groups were established. RESULTS: Most CBC parameters showed no significant differences in reference intervals between the two age groups. Among the men, platelet distribution width (PDW) was the only parameter that required a separate reference interval between the two age groups. Among the women, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and eosinophil % required separate reference intervals between the two age groups. CONCLUSIONS: The reference intervals for most CBC parameters were not significantly different between the two age groups. Except for PDW in men and MCV, MCHC, RDW, and eosinophil % in women, reference intervals for CBC parameters in individuals younger than 60 years of age could also be applied to those that are 60 years of age or older.
Adult ; Aged* ; Blood Cell Count* ; Blood Cells* ; Blood Platelets ; Eosinophils ; Erythrocyte Indices ; Female ; Humans ; Male