• Title/Summary/Keyword: 병원 감염 관리

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Effect of ${\alpha}$-Interferon Treatment on Serum ALT Levels in Patients with Chronic Hepatitis C (만성 C형 간염에 대한 ${\alpha}$-interferon 치료 후 ALT치의 변화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.190-196
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    • 1993
  • The prognosis of chronic hepatitis C is very variable. In some, the disease is progressive and cirrhosis can develop from chronic hepatitis C. Hepatitis C virus(HCV) may act as a trigger towards hepatocellular carcinoma in patients with cirrhosis. Interferon has been used for the treatment of chronic hepatitis C in abroad, 16 patients with chronic C liver disease were treated with ${\alpha}$-interferon (alfa-2b; "Intron A" Schering Corp. Kenilworth. NJ). All patients were given ${\alpha}$-interferon in subcutaneous doses of 3 million units three times weekly for 1 to 9 months. During therapy, CBC and ALT levels were checked weakly to monthly. After therapy, patients were followed for 1 to 8 months. Among 16 patients treated with ${\alpha}$-interferon, progressive decrease of ALT levels was observed in 14(87.5%). In 11 patients(68.8%), ALT levels fell into the normal range during therapy, and in 9 of 11, within one month after therapy, 6 months after the completion of therapy in 4 of 9 patients(44.4%) whose ALT levels were in the normal range, ${\alpha}$-interferon seems to have effect in controlling disease activity in patients with chronic hepatitis C. But the changes in the usage of ${\alpha}$-interferon, dose and duration, long term follow up and more convenient and simple tests for HCV detection are recommended for the better effect and the exact evaluation on the effect of ${\alpha}$-interferon therapy in patients with chronic hepatitis C.

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Clinical Analysis of Acute Intrinsic Renal Failure in Neonates and Children (소아에서의 급성 신성신부전의 임상적 고찰)

  • Kwon, Eun-Ji;Jung, Ji-Mi;Chung, Woo-Yeung
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.30-37
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    • 2008
  • Purpose: The present study is an investigation of the progression and prognosis of acute intrinsic renal failure in neonates and children with a diagnosis of acute renal failure or other diseases on admission. Methods: This research is based on a retrospective analysis conducted on 59 patients(male: female=2.2:1) diagnosed with acute intrinsic renal failure between January 2000 and June 2006 at Busan Paik Hospital. The clinical diagnostic criteria of acute renal failure used was serum creatinine <1.2 mg/dL, oliguria with urine output$\leq$0.5 mL/kg/hr and anuria with urine output <50 mL per day. Results: Among those placed under investigation, 7 patients were neonates, 10 patients were 2 months-2 years old, 12 patients were 3-6 years old, 21 patients were 7-12 years old and 9 patients were 13-16 years old. It took 3.1${\pm}$2.8 days on average until the diagnosis was made. The urine output distribution was 21 persons for the oliguria group, and 36 persons for the non-oliguria group, and 2 persons for the anuria group. For the underlying causes, 30 persons were classified in the primary renal disease group, 14 persons in the infection group, 9 persons in the malignancy group, and 6 persons were categorized in another group. As for age distribution, the infected group was predominantly neonates, whereas the dominant age ranges for the primary renal disease and infection categories were 2 months to 2 years old. Also, the primary renal disease was dominant among older children, aged 3 and up. No difference was detected according to seasonal prevalence. However, there was a high morbidity rate among hemolytic uremic syndrome diagnosed in the summer. Peritoneal dialysis was used to treat 4 patients. It took 10.0${\pm}$6.7 days until the patients improved. 18 patients died. The non-oliguria group's mortality rate was lower than other groups. There was a high mortality rate in the neonates and malignancy group. Conclusion: Acute renal failure in childhood seems to take a better clinical course than in adulthood when there is an early diagnosis and proper treatment of underlying diseases.

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Change of Antimicrobial Use Density According to Application of Computerized Management Program for Restriction of Antimicrobials Use in a University Hospital (일개 대학병원에서 제한 항생제 전산 프로그램 운용에 따른 항생제 사용량 변화)

  • Lee, Bo Young;Kim, Chun Soo;Ryu, Seong Yeol;Kwon, Ki Yung;Lim, Jung Geun;Lim, Tae Jin;Min, Byung Woo;Ryoo, Nam Hee;Cha, Soon Do
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.155-162
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    • 2006
  • Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.

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Rehospitalization Rate and Medical Cost of Infants in the First Year after Discharge from Neonatal Intensive Care Units (신생아중환자실 입원자의 퇴원 후 재입원의 빈도와 의료비용)

  • Bae, Chong-Woo;Shim, Kye-Shik;Hahn, Won-Ho;Kim, Ki-Soo;Kim, Beyong-Il;Shin, Son-Moon;Lee, Sang-Lak;Lim, Baek-Keun;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.13-20
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    • 2010
  • Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

A Study on the Development Plan for Promotion of Advanced Disaster-Safety Awareness (선진 재난안전의식의 활성화를 위한 방안 연구)

  • Lee, Jong-hyun;Kim, Mi-ra;Ko, Jae-chul
    • Journal of the Society of Disaster Information
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    • v.17 no.3
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    • pp.415-426
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    • 2021
  • Purpose: The purpose of this study is to create the deveopment plan for promotion of advanced disaster-safety awareness, which is noted as a major factor in the large disaster. Method: This study is to conduct theoretical review with regard to disaster management and safety awareness. Consciousness surveys on safety awareness and previous disaster case was analyzed to derive the cause of the disaster, and the development plan for promotion of advanced disaster-safety awareness was suggested. Result: In the survey on the public's sense of safety on the disaster management evaluation, 'Response' stage was well performed, but the 'Recovery' stage was not. Especially, it was found that disaster safety education at the 'Prevention' stage was very lacking. In the survey on the public's safety awareness, the awareness level of the evacuation facility was very low, information on infectious diseases and collapse accident was insufficient. Especially, it has been found that the awareness on safety regulation in daily life is very insufficient. Through the case study on previous disaster(COVID-19, Fire in Miryang Sejong Hospital, Forest fire in the east coas at 2004'), it was derived that the lack of safety awareness(such as safety insensitivity) was the main factor of the expansion of the damage scale. Conclusion: The development plan for promotion of advanced disaster-safety awareness are as follow. First, it is necessary to spread the safety culture movement through the expansion of safety education and safety promotion. Second, disaster confrontation training for the public should be implemented to improve the effectiveness of disaster response. Finally, it is necessary to change the individual awareness on safety. When these factors are implemented systematically, advanced disaster-safety awareness can be promoted. Ultimately, disaster accidents in our society can be reduced.

A STUDY ON 4 TYPE CONSTITUTION AND SIFE CHARACTER OF OBESE PATIENTS (비만인의 생활특성과 사상체질에 관한 연구)

  • KIM, DAL RAE
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.303-313
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    • 1997
  • Disease depends on the three factors, agent, host and environment. According to history of disease, by early 1900s the case of deaths is infectious disease, in late 1900s care of infectious diseases and tremendous scale of chronic disease, i.e., heart disease, diabetes, cancers and etc, makes care of chronic diseases be a most important theme. Now, life-style of diet is being westernized and in high industry-oriented society, obesity makes attack fate remarkably increase and life-expectancy become short, so that it causes severe problem of health. Chronic disease, such as obesity, is not affected by specific agent, but depends of interaction between host and environmental factors. There is the theory of constitutional medicine in Korean Medicine. According to it, all the people have constitutional specificity and disease. Because obesity is a kind of disease, there is the corresponding constituent being apt to be fat. Oriental Medicine utilizes herb-medication, acupuncture, and massage-therapy in treating obesity. Therefore study on relationship between constituent and obesity for OPD patients of Sangji-Oriental Medicine Hospital is carried out. The results are summarized as followings. 1. 70.2% of obesity patients are Taeumin(太陰人), 26.9% of those are Soyangin(少陽人), 2.9% of thoese are Soeumin(少陰人). 2. Most cases, high value of Free Fat Acid and Triglyceride not that of Total Cholesterol and Low Density Lipoprptein is meaningful in obesity patient blood. The corelationship between lipid test and Constitution is meaningful in Triglyceride and Free Fatty Acid. 3. Obesity is not related with gene. 4. Obesity is not related with Boyak(Herb-Med : 補藥). 5. Obesity mostly happens after delivery, contraception and operation. 6. Obese Patients are apt to eat between meals, especially food of wheat flour such as a snack. 7. The aim of treating obesity is not persuit of beauty but of keeping healthy. 8. 2.2Kg of body weight is lost after 4 week-treatment. 9. Common cause of obesity is overeating of carbohydrate and lipid than meat.

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Molecular Subtyping of Methicillin-Resistant Staphylococcus aureus Isolated from Patients' Nasal Cavity (환자의 비강으로부터 분리된 메티실린 내성 황색 포도알균의 분자 아형 분석)

  • Kim, Sang-Ha;Park, Sung-Bae;Park, Heechul;Kim, Jun Seong;Kim, Jungho;Lee, Jiyoung;Lim, Jaewon;Kim, Young Kwon;Kim, Sunghyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.128-135
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    • 2020
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body and causes skin and soft tissue infections (SSTI). The present study examined the antimicrobial resistance patterns and molecular epidemiological characteristics of MRSA isolated from nasal swabs in clinical patients. SCCmec type of MRSA isolates from clinical patients were analyzed: 24 cases were SCCmec type-II; two cases were type-II/IVa; one case was type-II/V; one case was type-IVa; 11 cases were not-typeable. The mec complex type of MRSA isolates from clinical patients were analyzed: 29 cases were mec complex type A, and 10 cases were not-typeable, but type B was not found in the present study. In conclusion, SCCmec type-II and mec complex type A were the most dominant MRSA subtypes among the MRSA isolates from a nasal swab of patients, and the results were similar to other studies on hospital-acquired MRSA (HA-MRSA). These results can not only provide basic data for hospital infection management but also be a good guideline for MRSA infections in the Republic of Korea.

Aquatic animal health management in stock enhancement (방류용 수산종묘의 질병 관리에 대한 고찰)

  • Seo, Jang-Woo;Cho, Mi-Young;Kim, Jin-Woo;Park, Gyeong-Hyun;Jee, Bo-Young;Choi, Dong-Lim;Park, Myoung-Ae;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.23 no.1
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    • pp.85-98
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    • 2010
  • Ministry of Agriculture, Fisheries and Food (MAFF) and National Fisheries Research and Development Institute (NFRDI) have inspected the hatchery-reared seeds of 22 marine species and 11 freshwater species for aquatic animal diseases in stock enhancement program in 2009. Results showed that total 12 local selfgovernments have been restocking the sea with cultured juveniles. Gyeongsangnam-do, Jeollanam-do, Jejudo and Chungcheongnam-do have a preference for marine species seeds to freshwater species. On the contrary, freshwater species were released mostly in Gyeonggi-do, Jeollabuk-do and Chungcheongbuk-do. In the marine species group, abalone was the most abundant as 24.5%, and then sea cucumber (15.2%), olive flounder (11.5%), swimming crab (5.6%), black sea bream and rockfish (6.8%), rock bream (5.1%), black rockfish (4.6%) and scorpionfish (4.5%) were followed. Crucian carp was the most abundant as 19.4%, and then eel (17.0%), Korean bullhead (12.3%), melanian snail (12.0%), catfish (8.4%) were followed in the freshwater species group. The total number of inspection cases in this study were 1,080 and disqualification cases were 19 by detection of aquatic animals pathogens such as red sea bream iridovirus (RSIV), koi herpesvirus (KHV) or white spot syndrome virus (WSSV).

$CO_2$ Laser Application for Treatment of the Hairy Tongue (이산화탄소 레이저를 이용한 모설의 치료)

  • Jung, Da-Woon;Cho, Eunae;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.97-101
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    • 2013
  • Hairy tongue is a disease caused by hypertrophy of filiform papillae on the tongue dorsum. Clinically, it occurs on the posterior 1/3 of the tongue dorsum and is rarely observed on the lateral and tip of the tongue. Several types of colored pigmentation from white to brown and black appear depending on the ingested food and the existing pigmentation inducing bacteria. Although clinically asymptomatic, patients will visit the clinic for esthetic problems and at rare intervals experience nausea, halitosis, dysgeusia and unpleasant sensation. The exact etiology is yet not known but causes such as inappropriate oral hygiene control, a shift in oral bacterium, infection, radiotherapy, use of antibacterial drugs or immunosuppressants, excessive smoking or alcohol drinking and decrease of salivary flow rate may be a factor of the disease. Clinical symptoms are quite typical and diagnosis may be made simply by observation, not necessarily biopsy. Treatment of hairy tongue is done by eliminating the etiology factors, brushing the tongue gently with a tongue cleaner and in some cases using keratolytic agent. Although it is rare to treat hairy tongue surgically, we will introduce a case successfully treated using carbondioxide laser($CO_2$ laser), after no sufficient improvement had been made by conservative treatment.

A study of the impacts of medical institution information on daily medical expenses and medical expense reduction rate in convergence age (융복합시대에 의료기관 정보가 일당진료비와 삭감율에 미치는 영향에 관한 연구)

  • Yang, Yu-Jeong;Lee, Hye-Seung
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.259-268
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    • 2015
  • This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.