• Title/Summary/Keyword: 중증

Search Result 1,418, Processing Time 0.022 seconds

Surgical Treatment of Thymoma (흉선종의 외과적 치료)

  • Jang, Jae-Han;Kim, Min-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
    • /
    • v.29 no.4
    • /
    • pp.427-432
    • /
    • 1996
  • Eighteen patients operated on for thymoma from 1985 to 1994 were evaluated, 3 with myasthenia gravis and 15 without. Masaoka's clinical staging revealed stage I disease in 5(27.8%), stage ll in 6 (33.3%), stage 111 in 6(33.3%), and stage IV in 1 (5.6%). Of the 18 patients, 10 had surgical resection as the only treatment and the remaining 8 (stage II : 1 patient, stage III : 6 patients, stage IV: 1 patient) had surgical resection with adjuvant preoperative or postoperative radiotherapy and/or chemotherapy There was no operative mortality. Currently, 15 patients are alive, 3 are dead. The mean follow up time for all patients was 3.4 years. Acturlal survival at 5 years was 82.2 $\pm$ 9% for all patients' 100% for those in stage I and II, and 62.5% for those in stage III. Pleural and mediastinal recurrence developed in one patient in stage II which was considered to have noninvasive disease on the operating field. Two patients underwent reoperation for recurrence of thymoma a intervals of 14 months and 52 months. Clinical stage and resectability had a significant prognostic value(p < 0.05). The presence of myasthenia gravis is no longer considered as an adverse factor in survival.

  • PDF

Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients (응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구)

  • Moon, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.10
    • /
    • pp.222-230
    • /
    • 2018
  • This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

Can Endometriosis Affect the Clinical Outcomes in Patients Undergoing IVF-ET ? (자궁내막증을 갖는 불임환자의 체외수정시술에 관한 연구)

  • Jung, Byeong-Jun;Song, Hyun-Jin;Oh, Ik-Hwan
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.29 no.3
    • /
    • pp.223-227
    • /
    • 2002
  • 연구목적: 전반적인 자궁내막증이 체외수정시술에 미치는 영향을 알아보고, 특히 stage III-IV 자궁내막증을 갖는 불임환자 체외수정시술 결과에 대하여 알아보고자 본 연구를 시행하였다. 연구재료 및 방법: 1998년 9월부터 2001년 9월까지 진단복강경을 통해 자궁내막증으로 진단된 환자 중 체외수정시술을 시행 받은 91명 131주기를 대상으로 하였으며 이중 stage III-IV의 자궁내막증을 갖는 환자는 27명 34주기였다. 비교군은 이시기에 진단된 순수 난관원인으로 체외수정시술을 시행한 40명 56주기를 대상으로 하였다. 통계학적 검사는 Student's t-test와 Chi-square test를 시행하였고, p<0.05를 유의성이 있는 것으로 판정하였다. 결 과: 전체 자궁내막증 환자와 난관인자의 체외수정시술에서 두 군간의 나이는 $31.6{\pm}3.3$, $32.6{\pm}3.6$세로 비슷하였다. 채취된 난자의 수 ($10.3{\pm}6.6$ vs $11.7{\pm}5.1$), 성숙난자 수 ($7.4{\pm}4.7$ vs $7.7{\pm}4.9$), 수정율 ($70.2{\pm}32.4%$ vs $73.7{\pm}20.0%$), Good embryo quality rate (8세포 (G1+G2)를 2PN의 개수로 나눈 값) (32.6% vs 32.4%) 및 배아이식 수 ($4.6{\pm}1.4$ vs $4.8{\pm}1.1$)로 두 군간에 차이는 없었다. 또한 임상적 임신율의 경우도 각각 30.7%, 42.8%로 비슷하였다. 중등도 및 중증의 자궁내막증과 난관인자의 비교에서 성숙난자 및 채취된 난자의 개수는 각각 $8.8{\pm}4.9$, $7.7{\pm}3.9$, $11.3{\pm}7.0$, $11.7{\pm}5.1$개로 두 군간에 차이는 없었다. 수정율은 stage III와 IV 군에서 감소되는 경향을 보였으나 통계학적인 유의성은 없었다 ($66.2{\pm}30.0%$ vs $73.7{\pm}20.0%$). Good qulity embryo rate (GQER)는 stage III-IV 자궁내막증 환자군에서 22.0%로 순수 난관인자의 32.4%에 비하여 감소하는 경향을 보였으나 통계학적인 유의성은 없었다 (p=0.15, Chi-square test). 배아이식 수의 경우는 각각 $4.7{\pm}1.5$, $4.8{\pm}1.1$개로 차이가 없었다. 배아이식 주기당 임상적 임신율의 경우는 stage III-IV군에서 25.0% (8/32), 난관인자 군의 42.8% (24/56)로 통계학적인 유의성은 없었으나 (p=0.06, Chi-square test), 중등도 및 중증의 자궁내막증을 갖는 환자에서 임신율이 감소하는 경향을 보였다. 결 론: 체외수정시술시 자궁내막증이 임신율에 나쁜 영향을 미치지 않지만, 중등도 및 중증의 자궁 내막증을 갖는 불임환자의 체외수정시술에서는 임신율에 나쁜 영향을 끼칠 가능성이 있을 것으로 사료된다.

Acute Fulminating Myasthenia Gravis in a Shih-tzu Dog (시츄 견에서 발생한 급성 전격 중증 근육무력증)

  • Kang, Byeong-Teck;Yoo, Jong-Hyun;Park, Hyo-Jin;Jung, Dong-In;Park, Chul;Gu, Su-Hyun;Jeon, Hyo-Won;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Cho, Sue-Kyung;Lee, So-Young;Heo, Ra-Young
    • Journal of Veterinary Clinics
    • /
    • v.23 no.4
    • /
    • pp.465-468
    • /
    • 2006
  • A 3-year-old, spayed female Shih-tzu dog was presented due to acute vomiting, diarrhea, and generalized weakness. The dog had generalized weakness, increased respiratory rate, and respiratory muscle effect. Neurologic examination revealed appendicular muscular weakness and decreased in tone of the anal sphincter. Megaesophagus was confirmed by radiographic examinations. Other than type 2 fiber atrophy, no specific abnormalities were identified in histopathologic examinations of muscle biopsies from the left pelvic limb. Serum acetylcholine receptor (AChR) antibody titer was increased (0.78 nmol/L reference range, less than 0.6 nmol/L), confirming a diagnosis of acute fulminating myasthenia gravis. The dog dramatically responded to pyridostigmine bromide and had marked improvement in muscle strength, megaesophagus, and respiratory function. The dog has been successfully managed for 7 months after initial treatment.

Pattern of Asthma Management by Primary Physicians in Seoul (서울 지역 내과 개원의 천식 진료 양상)

  • Lee, Eui Kyung;Bae, Eun Young;Park, Eun Ja;Lee, Suk Hyang;Oh, Yeon-Mok;In, Kwang Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
    • /
    • v.55 no.2
    • /
    • pp.165-174
    • /
    • 2003
  • Background : Asthma is one of the most prevalent diseases in Korea. Although the guidelines of asthma management were reported in Korea, the present pattern of asthma management by primary physicians has not been studied. The purpose of this study is to elucidate the pattern of asthma management by primary physicians. Methods : In November 2002, 710 primary physicians specializing in internal medicine in Seoul, Korea were provided with two scenarios of asthmatic patients, one mild and the other severe. By mail or interview, the physicians were asked several questions about their present pattern of asthma management for the patients in each scenario. Results : Among 710 primary physicians, we obtained the answers from 325 physicians (response rate 46%). The most preferred prescription was oral theophylline. 71% and 81% of the physicians answered that they would prescribe oral theophylline for the mild and severe asthmatics, respectively. The next prescription preferred were mucolytics and oral ${\beta}_2$-agonist, in that order. However, 36% and 56% of the physicians answered that they would prescribe inhaled steroids for the mild and severe asthmatics, respectively. Among diagnostic tests, physicians preferred pulmonary function test to the rank next to chest radiography. Conclusion : The primary physicians in Seoul prefer oral bronchodilators to inhaled steroids in asthma management. More efforts should be made to reduce the difference between the present pattern of asthma management by primary physicians and the asthma guidelines.

Comparing the Cause and Symptom Severity of Children with Acute Gastroenteritis (급성위장관염 소아에서 원인체의 분석과 임상증상의 중증도에 대한 연구)

  • Ahn, Seung Hee;Lim, Hyun Chul;Kim, Hwang Min;Uh, Young;Seok, Won Seok
    • Pediatric Infection and Vaccine
    • /
    • v.15 no.2
    • /
    • pp.138-145
    • /
    • 2008
  • Purpose : Acute gastroenteritis is a frequent childhood disease. The purpose of this study is to determine if certain pathogens are related to more severe clinical disease in children with acute gastroenteritis. Methods : Two hundred seventy one stool samples were obtained from pediatric patients with acute gastroenteritis that was associated with virus, bacteria and protozoa infection between January 2006 and December 2006. The clinical severity was assessed by using the 24 point scale Clark score. We evaluate the Clark score according to the pathogens. Results : One hundred thirty seven children were noted to have virus, bacteria or protozoal infection. Rotavirus was the most common pathogen found in the children with gastroenteritis (20.6%). Other frequent pathogens were norovirus (10.7%) and E. coli (12.9%). Vomiting (P=0.049) and diarrhea (P=0.003) symptoms were more frequent in the rotavirus group than that in the rotavirus negative group. There were no statistical differences in the Clark score between the virus positive group and the virus negative group. Conclusion : We concluded that rotavirus was the most common pathogen in children with gastroenteritis, yet the clinical severity was not dependent on the presence of viral or bacterial pathogens.

  • PDF

A Study on the Injury Charateristics of Trauma Patients by Madical information -Focused on the Patients in a Regional Emergency Medical center in Gwangju

  • Jeun, Young-Ju
    • Journal of the Korea Society of Computer and Information
    • /
    • v.25 no.11
    • /
    • pp.239-244
    • /
    • 2020
  • The purpose of this study is to provide basic data for injury prevention measures through the risk factors of injury occurrence by comprehending injury characteristics of the trauma patients visiting a regional emergency medical center according to distribution based on external causes and injury severity score. This study was analyzed using SPSS-Window(ver. 20.1) for 2585 trauma patients who visited a regional emergency medical center and the research period is for four months from 1st of September, 2019 to 31th of December, 2019. The following were the results of the research. First, it is shown from the analyzed data that the proportion of males (61.3%) is greater than that of females (38.7%) and the group aged from 20 to 50 had a significantly higher occurrence rate of injury but in terms of injury severity, 50 takes up the great proportion(P<.001). Second, roads and traffic areas (35.1%) were the highest in the place of occurrence of injury(P<.001). Third, the time of injury occurrence was as high as 12-18 hours(35.8%)(P<.001). Fourth, the injury part was highest in the head and face (55.4%)(P<.001). Fifth, the type of injury was higher in open wounds (31.2%)(P<.001). Therefore, it is required to establish detailed injury prevention policies according to the characteristics of injury severity.

Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.7 no.2
    • /
    • pp.264-274
    • /
    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

  • PDF

Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD) (만성폐쇄성폐질환 환자의 호흡곤란 평가에서 우심실 박출계수의 의의)

  • Lee, Jung Eun;Min, Bo Ram;Park, Jae Seok;Park, Hun Pyo;Jun, Mi Jung;Won, Kyung Sook;Choi, Won Il
    • Tuberculosis and Respiratory Diseases
    • /
    • v.60 no.6
    • /
    • pp.631-637
    • /
    • 2006
  • Background: Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient. Methods: The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively. Results: The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate $160{\pm}27$, severe $210{\pm}87$, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group ($25{\pm}8$) than in the moderate group ($35{\pm}6$). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02). Conclusion: This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function.

The Analysis of Hospital Characteristics affecting Blood Transfusion to the patients under Knee or Hip Total Replacement Arthroplasty (슬관절과 고관절 전치환술 환자의 수혈에 영향을 미치는 병원특성 요인 분석)

  • Oh, Ji-Young;Kim, Sang-Mi;Lee, Seong-A
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.16 no.6
    • /
    • pp.4031-4039
    • /
    • 2015
  • The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.