• Title/Summary/Keyword: 후향적 조사

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Changes in Pathogens and Antibiotic Sensitivities in very Low Birth Weight Infants with Neonatal Sepsis (극소저출생체중아에서 신생아 패혈증의 원인균 및 항생제 감수성의 변화)

  • Kim, Kyung-Nam;Park, Ho-Jin
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.54-60
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    • 2008
  • Purpose : To set up an appropriate treatment plan for neonatal sepsis by investigating changes in pathogens and antibiotic sensitivities. Methods : The medical records of very low birth weight infants (VLBWI) admitted to the neonatal intensive care unit (NICU) of the Eulji University Hospital between January 2000 and June 2006 were retrospectively reviewed. The culture reports were analyzed for causative microorganisms and antibiotic sensitivities. Results : Among 164 neonates, 19 neonates (11.6%) had 26 episodes of culture-proven sepsis. Very late onset sepsis was the most common type. The dominant pathogens of sepsis included Klebsiella pneumoniae, Streptococcus spp., coagulase negative Staphylococcus and Enterobacter spp., and were mostly multi-drug resistant. Conclusion : For the appropriate treatment of neonatal sepsis, proper use of antibiotics through the periodic review and understanding of changes of the microorganisms and antimicrobial sensitivities is necessary to prevent multi-drug resistant microorganisms and to avoid excessive use of broad-spectrum empiric antibiotics.

Surgical Treatment of Esophageal Perforation (식도천공의 외과적 치료)

  • Park Jae Hong;Chei Chang Seck;Kim Dae Hwan;Hwang Sang Won;Yoo Byung Ha;Kim Han Yong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.214-219
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    • 2006
  • Background: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. Material and Method: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours., Esophageal repair was performed in 21 ($75\%$) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. Result: Hospital mortality was $18\%$ and iatrogenic was increase the mortality rate (p < 0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. Conclusion: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful management of patients.

A Clinical Analysis of 20 cases of Diaphragmic Rupture (외상에 의한 횡격막 파열의 임상적 고찰)

  • 이계선;정진악;금동윤;안정태;이재원;신제균
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.394-398
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    • 1999
  • Background: According to the changes in the Environmental factors, traumatic diaphragmic rupture is seen in increasing frequency. Many reports described the early diagnostic methods and treatment modalities. In our institution, a study was retrospectively performed to obtain the early diagnostic and treatment methods of diaphragmic ruptures. Material and Method: From January 1994 to April 1998, 20 patients with traumatic rupture of the diaphragm were treated in our institution and We analyzed the patients in preoperative clinical presentations, diagnostic accuracies, associated injuries and postoperative complications. Result: Socially active male patients were affected most. 75% of patients had blunt trauma and 25% had penetrating injury. There were 16 cases of ruptured right diaphragm, 3 cases of left diaphragm and 1 case on both. Preoperative diagnosis were possible in 10 patients (50%) and 6 patients(30%) were diagnosed intraoperatively, but 4 patients (20%) were diagnosed in the late stages. Most common postoperative complication was wound infection, and two died of associated injuries. Conclusion: We conclude that if there is suspicion of diaphragmic rupture after a trauma, careful study and examination is essential and interdepartmental collaboration is very important.

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Surgical Treatment of Cardiac Tumor (심장에 발생한 종양의 수술적 치료)

  • Jung, Tae-Eun;Han, Sung-Sae;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.810-814
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    • 2006
  • Background: Tumors of the heart are uncommon. The aim of this study is to review our clinical experience and outcome of surgical treatment of cardiac neoplasm. Material and Method: From March 1990 to December 2005, 35 patients(14 males and 21 females) with mean age of 52.4 years underwent surgical treatment of cardiac neoplasm. The clinical and pathologic data were analyzed retrospectively. Surgical treatment consisted in complete resection of the tumor in all cases but 1 patient who was left ventricular fibroma received biopsy only. Result: Thirty cases were benign and five cases were malignant tumor. Benign tumors were myxoma(29 cases) and fibroma(1 case). Five malignant tumors were osteosarcoma, hepatocellular carcinoma, renal cell cancer, yolk sac tumor, and unclassified myxoid spindle cell type sarcoma. There were no operative mortality in benign cases and twenty seven cases of myxoma were followed up for 8 months to 15 years without recurrence. But four patients of malignant tumor were expired within six months after operation. Conclusion: Left atrial myxomas are most common benign neoplasm. Surgical treatment is effective for the benign cardiac tumors but prognosis is poor in patients with malignant cardiac tumors.

Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Retrospective Study of Clinical Characteristics and Treatments in Natal and Neonatal Teeth (선천치와 신생치의 임상적 특성과 치료에 관한 후향적 연구)

  • Cho, Wonchang;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Kim, Kwangchul;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.188-193
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    • 2017
  • Natal teeth that are already present at birth and neonatal teeth that erupt shortly after birth may cause various complications. The purpose of this study is to evaluate the characteristics of natal/neonatal teeth in Korean infants who visited to Kyung Hee University Dental Hospital from 2006 to 2015. A retrospective review of clinical data, including the sex of the patients, chief complaints of the mothers, clinical appearances and locations of the natal/neonatal teeth, and associated complications and treatments, was collected. Overall, a total of 75 teeth were found in 48 patients and 69% of the infants had natal teeth, while 31% had neonatal teeth, all of which were mandibular incisors. Females showed more natal/neonatal teeth than males. Major reasons for visiting the dental clinic were parental anxiety, referrals from other clinics, Riga-Fede disease, and pain during breastfeeding. Extraction was the most common treatment choice; observation and grinding were also used.

Cost-Effectiveness of VATS Versus Open Thoracotomy for Primary Spontaneous Pneumothorax (일차성 자연기흉의 수술 방법에 따른 비용효용 비교)

  • 장운하;오태윤;김미혜;최주원
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.898-903
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    • 2000
  • 배경 및 목적: 최근 비디오 흉강경술은 최소 침습적인 수술 방법으로서 자연 기흉의 일반적 치료법으로 인정되고 있으나 비교적 높은 재발율과 비용-효용 관계에 대해서는 논란이 있다. 비디오 흉강경을 이용한 기포 절제술 후의 재발율은 평균 5-10%정도로 보고되고 있으며 이는 개흉술에 비해 상당히 높은 것이다. 또한 국내 의료 실정에서의 개흉술과 비디오 흉강경술의 비용효용에 대한 비교 통계는 없는 상황이다. 대상 및 방법: 1997년 1월부터 1999년 7월까지 일차성 자연기흉으로 성균관 의대 강북삼성병원 흉부외과에서 수술을 시행한 173예를 대상으로 후향적 조사하였다. 비디오 흉강경술로 시행한 104예와 개흉술로 시행한 69예를 양군으로 나누어 성별 및 연령, 발병부위, 수술의 적응증, 수술시간, 술 후 흉관 삽입기간 및 재원 일수, 술후 합병증, 재발율, 수술 경비 및 총치료경비 등을 비교하였다. 결과: 양군의 성별, 연령, 발병부위 등에는 차이가 없었다. 수술 시간은 흉강경군이 73.1$\pm$29.5분, 개흉군이 141$\pm$52분이었다.(p<0.05). 술 후 평균 흉관의 거치기간 및 재원일수는 흉강경군이 각각 3.93일 및 7.5일, 개흉군이 7.0일 및 13.4일이었다.(P<0.05, P<0.05). 술 후 재발한 경우가 비디오 흉강경군에서 6예(5.6%), 개흉군에서 1예(1.4%) 있었다(P<0.05). 본원에서 시행한 비디오 흉강경술과 개흉술의 비교에서 수술로 발생하는 비용은 비디오 흉강경군이 유의하게 높았으나 (1,202,192$\pm$178,992원, 1,005,669$\pm$311,531원; P<0.05) 총 치료비의 비교에서는 유의한 차이가 없었다.(1,946,110$\pm$487,440원, 1,793,912$\pm$308,079원; P=0.18). 결론: 비용 효용관계 및 재발율은 병원마다의 수술 수기 및 퇴원 정책등에 따라서 다소간의 차이가 있을 수 있으나 본원의 조사 결과에서는 비디오 흉강경술이 개흉술에 비해 비용-효과가 있다고 볼 수 없으며 재발율도 높았다.

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Comparison of Obstetric Outcomes between Married Immigrant and Korean Pregnant Women in University Hospital (일 대학병원 결혼이주여성과 한국여성의 산과적 결과 비교)

  • Lee, Eun-Sook;Moon, Hee
    • Journal of the Korea Convergence Society
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    • v.9 no.3
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    • pp.279-287
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    • 2018
  • This study was to investigate the factors affecting the obstetric outcomes of married immigrant women and to compare the results with the Korean women's and to provide basic data for establishing effective nursing interventions for the married immigrant women. The subjects were 302 married immigrant women and Korean women who were delivered in the university hospital from 2011 to 2015. Data were analyzed using frequency, mean, standard deviation and logistic regression using SPSS WIN 24.0 program. Factors affecting obstetric outcome were premature rupture of membranes, gestational hypertension, amniotic fluid abnormalities, and medical illness in both married immigrant women and Korean women. In addition, age, spouse's age, occupation, hemoglobin level, and placental abnormality were found to have an effect on obstetrical outcome in married immigrant women. Therefore, in order to improve the obstetric outcome of married immigrant women, a prenatal care program considering these influencing factors will be needed.

Analysis of Bystander Cardiopulmonary Resuscitation and Public Access Defibrillation Utilization -Convergence Study based on the Data of Daegu - (목격자에 의해 시행된 심폐소생술 및 자동심장충격기 시행률 분석 -대구광역시 자료기반 법률 및 지침 고찰을 통한 융합연구-)

  • Park, Si-Eun
    • Journal of the Korea Convergence Society
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    • v.13 no.3
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    • pp.265-274
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    • 2022
  • This study was conducted on 3,418 cases of cardiopulmonary arrest patients' detailed status table (2020, raw data) collected in 2020. Also, it is a retrospective narrative research that investigates and examines related laws and guidelines. The main findings are as follows. First, the implementation rate of 'bystander CPR' was 30.66% (1047 cases) and it was a remarkable result. It can be inferred the quality of the relevant laws and guidelines. Second, 'Public access defibrillation (shock)' accounted for only 0.10%(5 cases). it is considered that the relevant laws and guidelines are weighted towards 'stock and obligation.' Strategic differentiation of response by region is needed. Third, out-of-hospital cardiac arrest occurred at house was 71.97%(2,640 cases). To operate the 'special ambulance team' efficiently, it is necessary to analyze regional data more closely and develop an efficient strategy in the future.