Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.
Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.
Lee, Mi Seon;Lee, Rosie;Ko, Cheol Woo;Moon, Jung Eun
Journal of Yeungnam Medical Science
/
v.39
no.1
/
pp.46-52
/
2022
Background: The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19. Methods: This single-center study was conducted at Kyungpook National University Children's Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined. Results: HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036). Conclusion: Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.
Kim, Pill-Young;Choi, Jung-Gyu;Hyun, Myong-Su;Lee, Young-Hyun;Chung, Jae-Chun;Kim, Chong-Suhl
Journal of Yeungnam Medical Science
/
v.3
no.1
/
pp.201-207
/
1986
159 histologically proved cases of lung cancer have been reviewed at the Department of Internal Medicine, Yeungnam University Medical School for the past two years and six months from January, 1984 to July 1986. 1. The age distribution ranged from 27 to 87 years and 69.2% of the patient were distributed between the ages of 51 and 70. 2. The ratio of male and female was 4.6 : 1(131 males, 28 females) 3. Chief complains were in order of dyspnea, chest pain, cough, hemoptysis and weight loss. 4. Localization on chest film, right was more than left(right 58.6%, left 36.2%) and the most frequent site is right upper lung field (33 case, 21.7%) 5. Histologically squamous cell type(54.7%) was most common and next was small cell type(19.5%), adenocarcinoma(9.4%) large cell(6.4%). 6. 76.8% of case was diagnosed histologically under the bronchoscopic biopsy. 7. Pulmonary tuberculosis was the most common associated disease on admission time. 8. The most common treatment was conservative therapy In general. However chemotherapy was most common treatment of the small cell type carcinoma.
For a systematic analysis of the characteristics according to the counseling type, this study was about what type of counseling is the largest number of cases that three researchers participated. The main types of counseling for paid/leaved students were identified, and the characteristics of counseling types by admission type were analyzed. A total of 185 counseling cases conducted in 2018 and 2019 were analyzed by technical statistics and analysis by seven types of counseling(emotional and personality, academic motivation, learning method/strategy, family relationship, career and major choice, self-growth motivation) and analyzed to confirm the counseling needs for each student characteristic(entrance type, grade, gender, and academic changes(paid, leave of absence experience)) according to the characteristics of the students. Through this study, it was confirmed that the number of counseling was the highest in the order of "learning methods and strategies," "emotion and personality," and "self-growth motivation," and in particular, it was confirmed that the counseling rate of freshman and sophomore students was high. Most of the students who experienced paid/leave of absence were counseling on "emotional and personality" and "learning methods/ strategies." Through this study, academic-related programs are required for freshman and sophomore students, and the necessity of improving and establishing a counseling system was confirmed in consideration of the characteristics of each type of student counseling. In addition, this study proposed the necessity of institutional support such as the group mentoring system for students with academic fluctuations.
Seo, Jee-Young;Park, Mee-Ran;Kim, Chang-Sun;Son, Hyung-Dae;Cho, Dong-Il;Rhu, Nam-Soo
Tuberculosis and Respiratory Diseases
/
v.45
no.1
/
pp.45-56
/
1998
Background: Lung cancer continues to increase worldwide. Also, the proportion of female patients incease and adenocarcinoma is the predominant histological type among lung cancer in many western countries. So, we studied these current trends of lung cancer by clinical approach of recent patients from our department Method: We conducted a retrospective analysis on 212 subjects who were diagnosed with lung cancer at the department of chest medicine in National Medical Center between January 1990 and July 1996. The contents of analysis were patient's profile, clinical manifestation, smoking habits, accuracy of diagnostic methods, histological cell type, staging and treatment, etc. Results: The results were as follows. 1) The ratio of male to female was 5.2 : 1. The peak incidence of age was 7th decade(35.4%). 2) Chief complaints were cough, dyspnea and chest pain, etc. The most common duration of symptoms before the first admission was less than 3 months(57.7%). On the other side, duration more than 1 year represented 6.5%. The early diagnosed patients has been increased from the 1980s. 3) Smokers among the total patients were 77.2%. The proportion of smokers in sqamous cell carcinoma, small cell carcinoma and adenocarcinoma were 88.4%, 85.7% and 55.7%, respectively. Smoking history and histological cell type were correlated in squamous and small cell carcinoma. 4) Squamous cell carcinoma is still the predominant histological type (44.8%), but, adenocarcinoma increased more than the previous study(30.7%). The other histological types were small cell carcinoma(17.0%) and large cell carcinoma(3.8%) in order of their proportions. 5) The accuracy of diagnostic methods were as follows: sputum cytology 75.3%, bronchoscopic biopsy 65.7%, lymph node aspiration cytology 95.8%, percutaneous lung aspiration cytology 94.6% and open lung biopsy 100%. The general accuracies of diagnostic methods were improved than previous studies. 6) Performance status scales on admission were relatively good. After diagnosis, chemotherapy and/or radiotherapy were undertaken in 69.3% of the patients, and only 7.5% of the patients were operated. Conclusion: In our study, squamous cell carcinoma is still the predominant histological cell type, but, adenocarcinoma continues to increase. Because adenocarcinoma is less correlated with smoking habits, further evaluation of other carcinogens than smoking is requested. Screening and early diagnosis of lung cancer is important for good performance status scales in spite of advanced stages. But, we think that the prevention, for example, stop smokings is more important as because of no perfect treatment for lung cancer.
Park, Young Hee;Kim, Won Jung;Son, Byeong Hee;Kim, Sung Won
Pediatric Infection and Vaccine
/
v.5
no.1
/
pp.115-120
/
1998
Purpose : In the summer 1997, there was an outbreak of aseptic meningitis in Pusan area. We report the clinical features and viral studies of aseptic meningitis in Pusan area in 1997. Methods : 265 children with aseptic meningitis who had been admitted to Department of Pediatrics, St. Benedict Hospital between April to October 1997 were included. Results : 1) Male-to-female ratio was 1.7:1. 2) Mean age was $6.2{\pm}3.29$ years. 3) It occured mostly April to October. 4) Clinical manifestations were fever 99.6%, vomiting 99.2%, headache 99.2%, rash 6.0%. 5) The duration of fever was $3.34{\pm}2.21$ days. 6) The duration of admission was $5.3{\pm}3.21$ days. 7) WBC count in peripheral blood were $11,200{\pm}4,163/mm^3$. 8) WBC count in CSF were $156.1{\pm}394.7/mm^3$. 9) Causative agents were coxsackievirus B5, echovius 6, 30, type nonspecific enterovirus. Conclusion : Aseptic meningitis in 1997 compared with that in 1996 had clinical feature of increase in age, decrease in duration of fever and incidende of rash. It occurred mostly April to October in 1997 and May to October in 1996. Causative agents were coxackievirus B5, echovirus 6, 30, type nonespecific enterovirus in 1997, and echovirus 9, coxsackievirus A24, type nonespecific enterovirus in 1996.
Kwon, O Sung;Lee, Jong Bin;Kim, Ki Sik;Jung, Dong Woo;Park, Ga Hyun
Journal of Trauma and Injury
/
v.18
no.2
/
pp.179-183
/
2005
Whiplash injury commonly seen in automobile accident. This type of acceleration-deceleration injury may rarely lead to unfavorable outcomes as in the case of retropharyngeal hematoma. Because this lesion has the possibility of compressing the potential airway acutely or gradually, not only the rapid assessment and treatment but also closed observation are needed. We report a case of a 20-year-old man, who sustained a whiplash injury from contact with the headrest of his seat after his car was involved in a rollover. He had no symptom except posterior neck pain initially, but complained odynophagia and acute dyspnea after 10 hours of admission. The diagnostic work-up comprising lateral radiograph, CT imaging disclosed the rare constellation of a retropharyngeal hematoma with cervical spine fractures. Medical treatment and close observation were sufficient for the patient because he had no progressive dyspnea or major dysphagia.
This is one case report of surgically treated ventricular septal defect [VSD] with aortic insufficiency [AI] at department of thoracic and cardiovascular surgery, Hanyang university hospital. He had had progressive dyspnea on exertion and palpitation for 3 years prior to admission to our hospital. On examination, the blood pressure was 120/0 mmHg and the pulse rate 88 times/min. Bobbing motion of the head, Water hammer pulse, Corringan`s pulse, Quincke`s pulse and to and fro murmur were present. The heart murmur was consistent with .VSD and AI. Cardiomegaly was seen in chest X-ray. EKG, echocardiogram, aortogram and right heart catheterization was performed. On Sep. 9, 1980, open heart surgery was performed under the impression of VSD with AI. Infracrystal type VSD measuring 2 x 1.5 cm in diameter was closed with Teflon patch graft through the transverse ventriculotomy. AI was due to prolapsed, elongated right coronary and noncoronary cusp, especially noncoronary cusp. The prolapsed, elongated aortic leaflets were plicated by placing three 8-figure sutures between the free edge and the base of the leaflet [Frater`s method] through a transverse aortotomy. Postoperatively, he made an uneventful recovery, his blood pressure was 120/70 mmHg and showed no signs AI or residual shunt at discharge.
Journal of Korean Academy of Fundamentals of Nursing
/
v.19
no.2
/
pp.168-178
/
2012
Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.
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