• Title/Summary/Keyword: 중증

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Prevalence of severe fever with thrombocytopenia syndrome virus among ticks surveyed at Mt. Gwanak, Korea (관악산에서 참진드기 조사 및 중증열성혈소판감소증후군 바이러스 검출)

  • Chae, Jeong-Byoung;Kim, Tae-Hee;Jung, Jee-Ho;Park, Yoon-Ji;Park, Jin-Ho;Choi, Kyoung-Seong;Yu, Do-Hyeon;Park, Bae-Keun;Chae, Joon-Seok
    • Korean Journal of Veterinary Research
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    • v.57 no.3
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    • pp.169-174
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    • 2017
  • This study was performed to investigate the distribution of ticks and the rate of infection with severe fever with thrombocytopenia syndrome (SFTS) virus in ticks collected at Mt. Gwanak and the Seoul National University campus, Korea. Ticks (n = 273) were collected from May to October and included 76 Haemaphysalis longicornis (4 adult females, 72 nymphs), 49 Haemaphysalis flava (9 adult females, 3 adult males, 37 nymphs), and 148 Haemaphysalis spp. larvae. SFTS virus detection was performed by using one-step RT PCR and nested PCR. The SFTS virus was detected in 7 samples (1 Haemaphysalis longicornis nymph, 3 Haemaphysalis flava nymphs, and 3 Haemaphysalis spp. larva). The overall minimum field infection rate was 2.6%, whereas the minimum field infection rates of adult, nymphal, and larval ticks were 0%, 3.2%, and 2.0%, respectively. For a more accurate indication of the prevalence of SFTS virus in Korea, further in-depth investigations of tick species and SFTS virus occurrence over a larger area and longer period are needed.

Hetzer Technique for Surgical Correction of Ebstein's Anomaly (Hetzer 술기를 이용한 엡스타인 기형의 수술적 교정)

  • Chung, Jin-Woo;Im, Yu-Mi;Jung, Sung-Ho;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.473-479
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    • 2007
  • Background: The Hetzer procedure for the correction of Ebstein's anomaly has the advantages of technical feasibility and incorporation of the atrialized right ventricle (RV) into the functional RV. Material and Method: We preformed a retrospective review of 11 patients with Ebstein's anomaly and they had undergone a Hetzer procedure between March 2002 and December 2006. Result: The median age at operation was 19.8 years (range: 6 months ${\sim}56$ years). There were 4 males and 7 females. All patients showed severe tricuspid regurgitation (TR) preoperatively, and arterial desaturation (<95%) was present in 3 patients. The original Hetzer technique was employed in 6 patients with the Carpentier type A anomaly. In the remaining 5 patients with the Carpentier type B or C anomalies, valve competence was restored at the level of the displaced tricuspid valve mechanism. Adjunct bidirectional cavo-pulmonary shunt, or one and a half ventricle repair strategy was employed for all the patients. The median follow-up was 8.6 months (range: $0.8{\sim}51.9$ months). There was no early or late death, and the immediate postoperative TR was trivial to mild in 8 patients. The median cardio-thoracic ratios on chest X-ray at the preoperative period and at postoperative 0, 1 and 6 months were 65%, 62%, 55% and 55%, respectively. Conclusion: The original or modified Hetzer procedure for Ebstein's anomaly shows excellent intermediate-term outcomes.

Current State and Problem of the Transfer of Severely Injured Patients in One Regional Emergency Medical Center (일개 권역응급의료센터에서의 중증 외상환자의 전원 현황과 문제점)

  • Lee, Won-Chul;Jo, Choong-Hyun;Jung, Kyoung-Won;Min, Young-Gi;Choi, Sang-Cheon;Kim, Gi-Woon;Ahn, Jung-Hwan;Jung, Yong-Sik;Hwang, Sun-Ae;Kim, Ji-Yong;Lee, Kug-Jong;Jung, Yoon-Seok
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.6-15
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    • 2010
  • Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

Comparison of Severity in Organophosphate Insecticide Poisoning Patients Treated with Tracheostomy (기관절개술을 시행한 유기인계 살충제 중독 환자의 중증도 비교)

  • Choo, Dae-Hyuk;Park, Yong-Jin;Kim, Sun-Pyo;Kim, Seog-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.61-70
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    • 2011
  • Purpose: This study investigated the effect on survival rate for organophosphate intoxication patients who received trachostomy. This research was conducted to help identify appropriate treatment of patients who received a trachostomy. Methods: This research was retrospectively conducted using the medical records of 141 patients who arrived at the Chosun University Hospital emergency medical center between Jan 2007 and Dec 2010, suffering from organophosphate intoxication. They were placed in two groups including one which received trachostomy as part of their treatment and one that did not. The effect of each variable on mortality was evaluated by regressionanalysis. Results: Of 141 patients with organophosphate intoxication, 105 of them did not tracheostomy and 16 were dead cohorts (15.2%). Their size of pupil was 1mm. Factors such as amount of organophosphate ingested, PAM time after ingestion, average body temperature, arrival time, atropinization time after ingestion, AST/ALT, Bun/Cr all appeared to be significant factors in death cohorts (P<0.05). 36 patients among the total had tracheostomy and 11 ones of them were in dead cohort (30.6%) and their average age was 58 years. The facts affect the state of patients in dead cohort include the amount of intoxication which between $327.27{\pm}194.1ml$, performing intubation 686 mins after intubation, reaching to the hospital after 580mins, injecting PAM 744 mins after intoxication, injecting atropine 627 mins after intoxication. The largest cases of patient's state was found to be stupor with 14 patients (38.9%) the level of Cholinesterase in blood appeared to be significant in dead cohort as $391.00{\pm}353.9IU/L$ (P<0.05). Conclusion: Further planned studies are necessary on the use of tracheostomy for treatment of poisoning victims, especially those intoxicated by organophosphorus insecticides.

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THE TREATMENT RESULTS OF A DAY TREATMENT PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS (발달 장애 아동에게 시행된 주간 치료실 프로그램의 치료 결과에 대한 고찰)

  • Kwak, Young-Sook;Kang, Gyung-Mi;Lee, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.100-109
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    • 2000
  • Objective:This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods:49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results:The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion:Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.

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Factors Influencing on Musculoskeletal Symptoms of Care Workers in Long-Term Care Hospitals for Job Environment, Psychological Work Demand, Fatigue (요양병원 요양보호사의 작업환경, 심리적 업무요구, 피로가 근골격계 증상에 미치는 영향)

  • Oh, Jinyoung;Ha, Yeongmi
    • Journal of Digital Convergence
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    • v.18 no.11
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    • pp.559-569
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    • 2020
  • This study was conducted to examine relationships among job environment, psychological work demand, fatigue, musculoskeletal symptoms, then to investigate the factors influencing musculoskeletal symptoms of care workers in long-term care hospitals. A total of 128 care workers recruited from three long-term care hospitals in S city. Self-reported questionnaire survey was conducted from April to May, 2020. The results were as follows: The musculoskeletal symptoms of the care workers were the sum of the frequency of symptom occurrence, duration of symptoms, and intensity of pain in the three parts of the shoulder, hand/wrist/finger, and waist. The average score was 11.41±9.50 points out of 42. According to the hierarchical regression analysis, their musculoskeletal symptoms were significantly influenced by working department(β=.18, p=.034), psychological work demand(β=.21, p=.013) and fatigue(β=.25, p=.003), explained 21.6% of the total variance(F=6.87, p<.001). Based on our results, in order to reduce musculoskeletal symptoms of care workers in nursing hospitals, it is necessary to develop and apply an intervention program that can reduce psychological work demand and fatigue in consideration of the severity of the patient in charge.

Lung Volume Reduction Surgery in Patients with Severe Emphysema, 7 cases (중증 폐기종 환자에서의 폐용적 감축술, 7례)

  • Jin, Ung;Lee, Sun-Hee;Kim, Si-Hoon;Wang, Young-Pil;Cho, Kyu-Do;Park, Jae-Kil;Kwak, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.543-548
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    • 1999
  • Background: These days, lung volume reduction surgery (LVRS) is used as an alternative or a bridge operation to lung transplantation in treating patients with severe emphysema. The procedure can be used in patients with pulmonary nodules combined with severe emphysema. We report the results of 21 months follow up after lung volume reduction surgery in 7 cases including 2 cases of concurrent resection of pulmonary nodules. Material and Method: Seven patients with emphysema, including 2 cases of preoperatively suspected lung cancer were operated with LVRS technique between July 1996 and June 1997. Result: Postoperative mortality was observed in a case of squamous cell carcinoma in LUL with brain metastasis, detected at postoperative 13months. Average of 21months(19-25months) follow up was done for other cases without specific events. Conclusion: LVRS is a useful operation in the treatment of patients with severe emphysema, but further evaluation should be done about the long term results and precise criteria for patient selection. Simultaneous LVRS and tumor resection could be done in patients with emphysema with marginal reserve in the hope of maximizing postoperative lung functions.

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A Case Report and Review on Cross-Arch Fixed Partial Denture with Severely Reduced Periodontal Tissue Support (심하게 감소된 치주지지를 갖는 Cross-Arch Fixed Partial Denture에 대한 고찰 및 증례보고)

  • Oh, Sang-Chun;Kim, Yun-Sang;Kim, Yu-Jin;Kim, Min-Jeong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.309-318
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    • 2012
  • In advanced stages of periodontal disease, a lot of the periodontal tissue support are usually lost. The tissue destruction around some teeth is progressed to a level which requires either spontaneous exfoliation or extraction of several teeth due to their excessive mobility. In such cases, a comprehensive treatment plan encompassing the adequate periodontal and maintenance therapy, as well as perio-prosthetic treatment involving occlusal equilibration, is needed in order to restore health, function, and esthetics. Cross-arch fixed partial dentures(CAFPDs), one of the perio-prosthetic treatments, are used to stabilize the teeth with severely reduced periodontal tissue support. Unfortunately, however, a little is known about the occlusal scheme and biomechanical concept of CAFPDs. This paper will demonstrate summaries of the trauma from occlusion(TFO), Ante's law revisited, the treatment principles, the role of occlusion, and the long-term consequences for CAFPDs, and the possibility of CAFPDs through a case presentation.

Diagnosis and Treatment of Latent Tuberculosis Infection in Korea (국내에서 잠복결핵의 진단 및 치료)

  • Shim, Tae Sun;Koh, Won-Jung;Yim, Jae-Joon;Lew, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.101-117
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    • 2004
  • 현증 결핵환자가 감소하고, 면역억제환자가 증가하고 있는 국내 추세에서 잠복결핵(latent tuberculosis)의 진단 및 치료 지침이 필요한 실정이다. 그러나 결핵의 유병률, 발생률 그리고 비씨지 접종률 등이 외국과 다른 국내의 현실에서 현증이 없는 잠복결핵의 진단 및 치료에 대한 방침은 필연적으로 외국과 다를 수 밖에 없으며, 현 시점에 국내에서 이에 대한 자료가 불충분하여 국내의 환경에 적합한 근거 중심의 지침을 설정하기는 어려운 상황이다. 그러나 결핵의 기본 병태 생리를 근거로 하여 최소한 결핵균 감염 이후 결핵 발병의 위험성이 높은 대상 환자에서는 잠복결핵 진단을 위한 검사를 시행하여 치료 여부를 결정하여야 한다. 고위험군은 사람면역결핍바이러스(human immunodeficiency virus, HIV) 감염자, 장기이식환자, 면역억제제를 장기간 사용하는 환자, 6세 이하의 소아 중 최근 전염성 결핵환자 접촉자 등을 우선적으로 고려해야 한다. 미국은 발병 위험도의 고, 중, 저에 따라 투베르쿨린 검사(tuberculin skin test, Mantoux test)의 양성기준을 달리 하여 잠복결핵을 진단하고 있으나, 국내에는 아직 이에 대한 자료가 부족하므로 발병의 위험이 높은 상기 고위험군을 대상으로 하여 PPD RT-23 2TU (Tuberculin unit)를 이용한 피부반응검사에서 10mm이상의 경결(induration)이 생성되는 경우를 양성으로 정하고 추후 연구 결과에 따라 재조정이 필요하다. 그 동안은 투베르쿨린 검사 결과 5-10 mm 사이의 경결반응을 보이는 면역억제 환자에 대하여는 개별적으로 의사의 판단에 따라 잠복결핵의 진단 및 치료 여부를 결정한다. 그러나 면역억제제를 사용하는 등 결핵 발병의 고위험군에서는 피부반응검사상 음성이라도 과거 결핵 치료력이 없이 흉부사진상 명백하게 과거에 결핵을 앓은 흉터가 남아있는 경우(석회화된 1차 결핵 소견은 제외)에는 잠복결핵의 치료를 시행한다. 상기 잠복결핵의 진단 및 검사의 적응증은 최소한 시행하여야 할 경우를 나열한 것으로 이외의 환자에 대하여는 환경 및 대상에 따라 개별화되어야 한다. 치료제로는 isoniazid (INH) 9개월 매일 치료(최소 한 6개월 이상, HIV양성 환자인 경우는 9개월), rifa-mpicin (RFP) 4개월 치료 및 INH/RFP 3개월 매일 치료를 시행할 수 있다. 상기 치료가 어려운 경우에는 RFP/pyrazinamide (PZA) 2개월 매일 치료를 고려할 수 있으나 중증 간독성의 가능성에 대한 철저한 교육 및 추적검사가 필요하다. 향후 국내 환경의 변화 및 연구결과에 따라 추후 부족한 부분에 대한 지침의 재정립이 필요하다.

The Clinical Evaluation of Anomalous Bronchi Arising From The Trachea and Main Bronchi (기관 및 주기관지에서 발생한 기관지기형의 임상적 고찰)

  • Kim, Jun Chul;Kim, Yeon Jae;Kang, Byung Jun;Youn, Young Deuk;Lee, Se Young;Kwon, Young Lan;Lee, Soo Ok;Jeong, Chi Yeong;Lee, Byung Ki
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.664-669
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    • 2005
  • Objectives : To evaluate the clinical significance of abnormal bronchi originating from the trachea or main bronchi. Methods : 21 patients (male:female ratio, 13:8; mean age, 58.2 years, range 34-77), who were diagnosed with major tracheobronchial anomalies by bronchoscopy from January 2001 to March 2005, were enrolled in this study. The anomalous bronchi consisted of 13 tracheal bronchi and 8 cardiac accessory bronchus. The clinical features, bronchoscopic findings, and outcomes were analyzed retrospectively. Results : Common symptoms, including hemoptysis, cough and dyspnea, resulted from the underlying lung disease regardless of the bronchial anomalies. In this series of 13 tracheal bronchi, 7 cases originated from the trachea within 1cm of the carina (carinal type) and 6 cases originated at a higher level(tracheal type). Most patients had favorable outcome with conservative treatment for the underlying lung disease. Conclusion : Most tracheobronchial anomalies are found incidentally in the process of diagnosing lung disease. The clinical outcome of patients with a bronchial anomaly depends on the underlying lung disease.