The Reorganization and Historical Inheritance of the National Medical Institutions in Pusan around the Korean War : Focused on Pusan Medical Center and Pusan National University Hospital

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.

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Genetic Relatedness AmongCandida tropicalisIsolates From Sporadic Cases of Fungemia in Two University Hospitals in Korea

Infection Control and Hospital Epidemiology ◽

10.1086/502453 ◽

2004 ◽

Vol 25 (8) ◽

pp. 634-640 ◽

Cited By ~ 11

Author(s):

Jong Hee Shin ◽

Mi-Na Kim ◽

Dong Hyeon Shin ◽

Sook-In Jung ◽

Kwang Jin Kim ◽

...

Keyword(s):

Genetic Relatedness ◽

Medical Center ◽

Tertiary Care ◽

Venous Catheter ◽

University Hospital ◽

University Hospitals ◽

National University ◽

Average Similarity ◽

Asan Medical ◽

Sporadic Cases

AbstractObjective:To compare the epidemiology and genetic relatedness ofCandida tropicalisisolates causing bloodstream infection (BSI) in two hospitals.Setting:Two tertiary-care hospitals in Korea.Methods:A retrospective molecular epidemiologic analysis using pulsed-field gel electrophoresis (PFGE) was performed with 49C. tropicalisisolates from sporadic cases of BSI. The isolates were collected from 27 patients at Chonnam National University Hospital (CUH) during a 6-year period and 22 patients at Asan Medical Center (AMC) during a 2-year period.Results:Based on the PFGE patterns, the average similarity value (SAB) for the 27 isolates from CUH was 0.84 ± 0.08, which was significantly higher than that for the 22 isolates from AMC (0.78 ± 0.06;P< .001). Of the 49 strains from patients at the 2 hospitals, 9 isolates were placed into 3 subtypes with SABvalues of 1.0, which indicated that they were identical. All 9 of these strains were isolated from CUH patients, and each type strain was isolated sporadically during a period ranging from 4 months to 3 years. On comparison of the clinical characteristics of the patients of the 2 hospitals, the CUH strains were isolated more frequently from non-neutropenic patients and patients with central venous catheter–related fungemia; cases from CUH had a better outcome than those from AMC (P< .05).Conclusions:These data show that the clinical and epidemiologic characteristics ofC. tropicalisfungemia may differ markedly among hospitals and that some cases ofC. tropicalisfungemia may be caused by endemic strains within a hospital.

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Prognostic Significance of Gelsolin and MMP12 in Langerhans Cell Histiocytosis.

Blood ◽

10.1182/blood.v114.22.4431.4431 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4431-4431

Author(s):

Sun Young Kim ◽

Hee Jin Kim ◽

Keun Wook Bae ◽

Ho Joon Im ◽

Ji Yoon Kim ◽

...

Keyword(s):

Langerhans Cell Histiocytosis ◽

Conflicts Of Interest ◽

Medical Center ◽

Prognostic Significance ◽

Langerhans Cell ◽

University Hospital ◽

Cellular Mechanisms ◽

System Disease ◽

National University ◽

Paraffin Block

Abstract Abstract 4431 Background Langerhans cell histiocytosis (LCH) pathogenesis is hypothesized a genetic change may have a significant effect on the cellular mechanisms controlling proliferation and apoptosis of LCs. In LCH, the expression of MMP12 was observed most abundantly in multi-system disease, which has the poor prognosis, and high expression of GSN was reported but the clinical significance of GSN was unveiled until now. We will investigate the association between these proteins and clinical outcomes in patients diagnosed with LCH. Methods Archival paraffin block were retrieved from children diagnosed with LCH and followed up at Asan medical center and Chungnam National University Hospital between 1998 and 2008. Available formalin-fixed, paraffin-embedded specimens from these patients will be used for GSN, MMP12 immunohistochemistry. We will analyze the correlations between protein expression states and clinical features. Results The medical records of the patients with LCH was analyzed for the factors that affect relapse and overall survival. The specimens from 49 patients were available for immunohistochemistry. Of these, 2 slides were not suitable because the quality of staining was not good for evaluation or the tumor cells are too difficult to be differentiated. The median age of 49 patients was 9.5 years, range 5 months to 22 years with a definite diagnosis of LCH based on CD1a positivity. The gelsolin and MMP12 were expressed in various degrees except eight specimens and overexpression had a tendency of correlation with multisystem and risk organ involvement. Conclusion Gelsoin and MMP12 might be associated with the pathogenesis of LCH and the high expressions in LCH have a possibility of playing a role in the progression of LCH. Disclosures: No relevant conflicts of interest to declare.

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Bean extract-based gargle for efficient diagnosing COVID-19 at early-stage using rapid antigen tests: a clinical, prospective, diagnostic study

10.1101/2021.08.13.21261463 ◽

2021 ◽

Author(s):

Joseph Kwon ◽

Euna Ko ◽

Se-Young Cho ◽

Young-Ho Lee ◽

Sangmi Jun ◽

...

Keyword(s):

Early Diagnosis ◽

Early Stage ◽

Medical Center ◽

High Sensitivity ◽

University Hospital ◽

Receptor Binding Domain ◽

Healthy Individuals ◽

Rt Pcr ◽

Self Testing ◽

National University

Importance: The antigen-based rapid diagnostic test (Ag-RDT), using saliva specimens, is fast, non-invasive and suitable for SARS-CoV-2 self-testing, unlike nasopharyngeal swab (NPS) testing. Objective: To assess the diagnostic sensitivity of a novel Beanguard gargleTM (BG)-based virus detection method for early diagnosis of COVID-19. Design: This clinical trial was conducted at Gunsan Medical Center, Namwon Medical Center, and Jeonbuk National University Hospital, between May 7 and July 7, 2021. Setting: Paired NPS and BG-based saliva specimens collected from COVID-19 patients and healthy individuals were analyzed using NPS-RT-PCR, BG-RT-PCR, and BG-Ag-RDTs. Participants: The study comprised 102 COVID-19-positive patients hospitalized after governmental screening process and 100 healthy individuals. Forty-five COVID-19 patients were sampled within 6 days of illness and 57 within 7–15 days; 27 were categorized as asymptomatic and 75, as symptomatic. Eight and 2 patients carried the SARS-CoV-2 Alpha and Delta variants, respectively. Intervention: The diagnostic performances of BG-Ag-RDT, BG-RT-PCR, and NPS-RT-PCR for detecting SARS-CoV-2 were compared. Main outcomes: The sensitivities of BG-Ag-RDT and BG-RT-PCR towards salivary viral detection were highly concordant, with no discrimination between symptomatic, asymptomatic, or SARS-CoV-2 variant cases. Results: Among total participants (mean age, 43.7 years), 51% were women. BG-Ag-RDTs showed high sensitivity (97.8%, [95% CI, 88.4% to 99.6%]) and specificity (100%, [95% CI, 96.3% to 100%) in 45 patients within 6 days of illness and could detect all cases of SARS-CoV-2 Alpha and Delta variants. In 11 asymptomatic early-stage cases, both BG-Ag-RDTs and BG-RT-PCR showed excellent sensitivity and specificity of 100% (95% CI, 74.1% to 100% and 95% CI, 20.7% to 100%, respectively). The interaction between SARS-CoV-2 spike proteins and truncated canavalin, an active ingredient from bean extract (BE) and the ultrastructural features of SARS-CoV-2 particles coated with BE were observed. The detachment of the SARS-CoV-2 receptor-binding domain from hACE2 increased as the BE concentration increased, allowing the release of the virus from hACE2 for early diagnosis. Conclusions and Relevance: Using BG-based saliva remarkably enhances the Ag-RDT diagnostic performance as an alternative to NPS and enables rapid and accurate COVID-19 self-testing and mass screening, supporting efficient COVID-19 management. Trial Registration: KCT0006438 Design: This clinical trial was conducted at Gunsan Medical Center, Namwon Medical Center, and Jeonbuk National University Hospital, between May 7 and July 7, 2021. Setting: Paired NPS and BG-based saliva specimens collected from COVID-19 patients and healthy individuals were analyzed using NPS-RT-PCR, BG-RT-PCR, and BG-Ag-RDTs. Participants: The study comprised 102 COVID-19-positive patients hospitalized after government screening and 100 healthy individuals. Forty-five COVID-19 patients were sampled within 6 days of illness and 57 within 7–15 days; 27 were categorized as asymptomatic and 75, as symptomatic. Eight and 2 patients carried the SARS-CoV-2 Alpha and Delta variants, respectively. Intervention: The diagnostic performances of BG-Ag-RDT, BG-RT-PCR, and NPS-RT-PCR for detecting SARS-CoV-2 were compared. Main outcomes: The sensitivities of BG-Ag-RDT and BG-RT-PCR towards salivary viral detection were highly concordant, with no discrimination between symptomatic, asymptomatic, or SARS-CoV-2 variant cases. Results: Among total participants (mean age, 43.7 years), 51% were women. BG-Ag-RDTs showed high sensitivity (97.8%, [95% CI, 88.4% to 99.6%]) and specificity (100%, [95% CI, 96.3% to 100%) in 45 patients within 6 days of illness and could detect all cases of SARS-CoV-2 Alpha and Delta variants. In 11 asymptomatic early-stage cases, both BG-Ag-RDTs and BG-RT-PCR showed excellent sensitivity and specificity of 100% (95% CI, 74.1% to 100% and 95% CI, 20.7% to 100%, respectively). The interaction between SARS-CoV-2 spike proteins and truncated canavalin, an active ingredient from bean extract (BE) and the ultrastructural features of SARS-CoV-2 particles coated with BE were observed. The detachment of the SARS-CoV-2 receptor-binding domain from hACE2 increased as the BE concentration increased, allowing the release of the virus from hACE2 for early diagnosis. Conclusions and Relevance: Using BG-based saliva remarkably enhances the Ag-RDT diagnostic performance as an alternative to NPS and enables rapid and accurate COVID-19 self-testing and mass screening, supporting efficient COVID-19 management.

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IgH Gene Rearrangements Are Strongly Associated with Hyperdiploidy Variant Multiple Myeloma in Korea: A Contradiction to the Pathogenetic Pathway of IgH Tranlocations in Non Hyperdiploidy Variant.

Blood ◽

10.1182/blood.v106.11.5084.5084 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5084-5084

Author(s):

Hee Won Moon ◽

Tae Young Kim ◽

Seong- Ho Kang ◽

Hyun-Sook Chi ◽

Eul Zu Seo ◽

...

Keyword(s):

Multiple Myeloma ◽

Medical Center ◽

Cytogenetic Study ◽

University Hospital ◽

Korean Patients ◽

National University ◽

Asan Medical ◽

Seoul National University

Abstract Recent studies proposed the classification of multiple myeloma (MM) by the pathways involved in the early pathogenesis; nonhyperdiploid variants with a high incidence of IgH translocations and hyperdiploid variants associated with no IgH translocation. Most studies applied cytogenetic study or flow cytometry to define the ploidy. In this study, we combined the cytogenetic results and fluorescent in situ hybridization results to define the ploidy and investigated IgH tranlocation and 13q deletion in relation to the ploidy level on Korean patients with MM. A total of 135 cases diagnosed as MM between 1997 and 2003 from Seoul National University Hospital and the Asan Medical center were enrolled in this study. Conventional cytogenetic studies and FISH studies with different probes specific for the regions containing the genes or chromosomes (RB1, D13S319, D13S25, IgH/FGFR3, IgH/BCL2, IGH dual color, break apart rearrangement probe, IgH/CCND1, 1q, p53, p16, MLL, CEP 7, 11, 12) were performed. Of 135 patients with MM, 62 (45.9%) patients had hyperdiploid karyotype by cytogenetics and FISH. IgH translocations were observed in 37.4% of Korean patients with MM and were more frequent (54.7%) in hyperdiploid variants than in nonhyperdiploid variants (17.4%). Incidence of deletion 13q was 34.7% and also more frequent in hyperdiploid variants (54.2%) than in nonhyperdiploid variants (16.1%). In conclusion, IgH translocations and 13q deletions were not associated with nonhyperdiploid MM and appeared more frequently in hyperdiploid variant in Korean patients with MM.

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Clinical and epidemiological features in 495 gastroenteropancreatic neuroendocrine patients in Mexico.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15687 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15687-e15687 ◽

Cited By ~ 1

Author(s):

Rafael Medrano Guzman

Keyword(s):

Social Security ◽

Medical Center ◽

Private Institutions ◽

Gastroenteropancreatic Neuroendocrine Tumors ◽

National Medical ◽

Academic Paper ◽

Medical Institutions ◽

Background Data ◽

Multi Center Study ◽

Social Security Institute

e15687 Background: Data, incidence and/or prevalence about gastroenteropancreatic neuroendocrine tumors remains unknown in Mexico. Also there is no evidence about any Mexican multicenter study reporting information such as clinical presentation, diagnostic approach and treatment. The biggest problem is the lack of clinical and therapeutic management results so physicians can validate the proper patient protocols. Methods: To know the clinical, epidemiological and therapeutic characteristics of NET-GEP patients treated at the 5 biggest Concentration Mexican Medical Institutions.This paper was developed with the support of 5 Public Medical Institutions: Mexican Social Security Institute (IMSS), Institute for Social Security and Services for State Workers (ISSSTE), Secretary of the Mexican Navy, Petroleos Mexicanos (PEMEX), Ministry of Public Health 495 Patients from 6 hospitals where included: Oncology Hospital, CMN XXI Century, Hospital No. 25 25, Monterrey IMSS, National Cancer Institute (INCAN), National Medical Center November 20, Naval General Hospital of High Specialty and Private Institutions. This was a observational and retrospective academic paper . Results: :Of 495 patients, 59.7% (296) were women and 40.32% (200) were men, 26% of them had around 50 years old. Diagnosis symptoms included: abdominal pain 47.27% (234), gastrointestinal bleeding 18.58% (92) no-predominant symptoms 28.88% (143). Around 32.25% (160) had Carcinoid syndrome and 67.74% (336) were nonfunctioning. The predominant location was pancreas 33.27% (165) and stomach 28.02% (139). 36% resulted circumscribed neoplasia (179), features polypoid 26% (129) and infiltrative 15% (73). The size was > 2cm in 49% (242) > 1-2cm: 36% (180) 0.5 to 1 cm 9% (45) < 0.5 cm 6% (29). Grade: GI 64% (316), GII 13% (66), GIII 23% (114). Metastasis positive ganglioanres (6%) (31), negative (94%) (465). Only seven cases extra nodal metastases (liver (3), lung (2), spleen (2)) Conclusions:This is the first multi-center study in Mexico. Which reflects the clinical characteristics of the NET_GET. The results differ in their epidemiology from that reported in other countries. However, the clinical and therapeutic results are very similar.

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Why a National University Hospital should Prioritize and Fund Research

Acta Medica Philippina ◽

10.47895/amp.v54i3.1690 ◽

2020 ◽

Vol 54 (3) ◽

Author(s):

Jean Anne B. Toral

Keyword(s):

Clinical Research ◽

General Hospital ◽

Medical Center ◽

Academic Medical Center ◽

Implementation Process ◽

The Philippines ◽

University Hospital ◽

Academic Medical ◽

National University ◽

Facilitative Role

The Philippine General Hospital (PGH) is the designated National University Hospital, state-owned, administered and operated by the University of the Philippines Manila. It was created under Act No. 1688 of the Philippine Commission on the 17th of August 1907.1What used to be a 330-bed hospital back in 1910 when it first opened is now a 1,500-bed hospital. Over the years, it has undergone major renovations and has expanded its services. The Out-Patient Service alone sees close to 600,000 patients in a year. It caters to 18 fully accredited residency and 65 post-residency fellowship training programs. The PGH vision remains clear, that is, to be “globally competitive and committed to the health of the Filipino people, through a system of networking and teamwork of competent, compassionate and ethical professionals, and shall be the center of excellence and leadership in health care training and research that impacts on health policies”.2Its mission for research is to undertake biomedical and health system researches that will serve as basis for relevant health policies. Why should a national university hospital take the tab on research? Research in the health sciences can really be expensive. There is manpower, equipment, diagnostics, and workspace needed. Though it is also true that science should be able to adopt to the environment where research can be done. Researchers would always say the environment can be made more conducive for the conduct of research. At the turn of the century, Dr. William Pinsky of the Alton Oschner Medical Foundation of New Orleans identified the roles of the academic medical center in research.3Research can take many forms from bench to health services to clinics. Clinical research, in particular, aims to promote health. Clinical trials find home in these centers. But the clear edge is in the large and diverse population of patients coupled with interested and experienced investigators. Having organizational support and infrastructure to carry the research make the process even better. Philippine General Hospital has taken gradual steps to make the institution more conducive for research. A research agenda was developed which was consistent with the National Unified Health Research Agenda (NUHRA). A dedicated research fund was established which its research office coordinates. Humble research grants have been given to trainees, faculty, nurses, and paramedicals now on its third year. Subscription to 2 lead journals has been made where constituents can publish their works. The question now is what is the role of PGH as a funder? Is it taking the traditional role? Or is a stepping up on its way? Kessler and Glasgow defined the traditional funder’s role as following these steps: receive grant applications, evaluate the applicants, fund the most suitable ones, and evaluate research outputs.4 There is a necessity, however, for an emergent role for research funders. This is what Brantnell et al define as facilitative.5 The facilitative role has something to do with implementation: facilitating the steps leading to implementation and the implementation itself. They further gave examples of facilitate roles as follows: Involvement in implementation of innovations in health care; advocating for the use of research results; managing implementation programs; creating interaction between researchers and research users; making sure that researchers submit an implementation plan together with their grant application; and disseminating research findings. Implementation needs initiators, facilitators, and persons responsible for it. There has to be a monitoring process for the implementation outcomes. The effectiveness of interventions found in research finds its true value when applied to the end-users. Imperative to this implementation process is also adopting to expansions in clinical research including “big data” repositories across clinical networks, involvement of communities, and focusing on quality improvement, patient satisfaction, efficiency, and integration of these in healthcare delivery.6 This facilitative role and the implementation process may be the answer to the problems of wide knowledge-practice gap, inadequate implementation of clinical research, and ultimately optimal patient care in the setting of a national university hospital. This is the direction the national university hospital as a researcher and funder has to take for a better health service delivery to the constituents it dutifully serves. Jean Anne B. Toral, MD, MScCoordinator for ResearchPhilippine General Hospital REFERENCES1. Acts of the Philippine Commission [Internet]. [cited 2020 June 4]. Available from: www.officialgazette.gov.ph.2. Habana MAE, editor. University of the Philippines Manila Philippine General Hospital Training Manual 2017, published by the Office of theDeputy Director for Health Operations.3. Pinsky WW. The roles of research in an academic medical center. Ochsner J. 2000; 2(4):201-2.4. Kessler R, Glasgow RE. A proposal to speed translation of healthcare research into practice: dramatic change is needed. Am J Prev Med. 2011;40(6):637-44.5. Brantnell A, Baraldi E, van Achterberg T, Winblad U. Research funders’ roles and perceived responsibilities in relation to the implementation ofclinical research results: a multiple case study of Swedish research funders. Implement Sci. 2015; 10:100.6. Konstam MA, Hill JA, Kovacs RJ, Harrington RA, Arrighi JA, Khera A. The Academic Medical System: reinvention to survive the revolution inhealth care. J Am Coll Cardiol. 2017; 69(10):1305-12.

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