• Title/Summary/Keyword: Admission control

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A Case of Miliary Tuberculosis Associated with Multiple Intracranial Tuberculoma (다발성 뇌결핵종을 동반한 속립결핵 1례)

  • Park, Sun Yung;Lee, Jung Hyun;Chung, Nak Gyun;Kim, Jin Tack;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.250-256
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    • 2000
  • The incidence of tuberculosis has been decreased, and especially the incidence of severe complicated tuberculosis has been markedly decreased as the result of widely used BCG vaccines. But tuberculosis is still an important community accquired infectiouse disease in the world despite continued worldwide efforts to control the disease. Miliary tuberculosis, the most serious complicated tuberculosis, can be occurred by lymphohematogenous dissemination of tuberculosis, and intracranial tuberculoma with or without tuberculosis meningitis can be developed in case of miliary tuberculosis. In general, serious tuberculosis infections such as miliary tuberculosis and CNS tuberculosis are developed especially in young infants and children in cases of delayed diagnosis and treatment despite receiving BCG vaccination, and usually those patients have contact sources. Intrcranial tuberculoma in children are usually found near infratentorial site at the base of cerebellum, and clinically symptoms and signs of increased intracranial pressure developed before treatment. Serial brain CT or MRI is a good non-invasive diagnostic modality of intracranial tuberculoma. Although surgical intervention was initially advocated as the mainstay of intracranial tuberculoma therapy, but many recent clinical studies indicate that intracranial tuberculoma can be cured with medical treatment alone. We experienced a case of 3 months old male patient, who was diagnosed as having miliary tuberculosis associated with multiple intracranial tuberculoma. He received BCG vaccination at 4 weeks after birth, and his father was confirmed as active pulmonary tuberculosis patient after this patient's admission. We report this case with a review of related literatures.

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The Analysis of Nursing Research in Korea in relation to the Evaluation of Quality of Nursing (간호의 질 평가에 관한 국내 간호연구 분석)

  • Kim, Nam-Young;Jang, Keum-Seong;Ryu, Se-Ang;Kim, Yun-Min
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.337-352
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    • 2003
  • Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

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A Study on Efficient Cell Queueing and Scheduling Algorithms for Multimedia Support in ATM Switches (ATM 교환기에서 멀티미디어 트래픽 지원을 위한 효율적인 셀 큐잉 및 스케줄링 알고리즘에 관한 연구)

  • Park, Jin-Su;Lee, Sung-Won;Kim, Young-Beom
    • Journal of IKEEE
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    • v.5 no.1 s.8
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    • pp.100-110
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    • 2001
  • In this paper, we investigated several buffer management schemes for the design of shared-memory type ATM switches, which can enhance the utilization of switch resources and can support quality-of-service (QoS) functionalities. Our results show that dynamic threshold (DT) scheme demonstrate a moderate degree of robustness close to pushout(PO) scheme, which is known to be impractical in the perspective of hardware implementation, under various traffic conditions such as traffic loads, burstyness of incoming traffic, and load non-uniformity across output ports. Next, we considered buffer management strategies to support QoS functions, which utilize parameter values obtained via connection admission control (CAC) procedures to set tile threshold values. Through simulations, we showed that the buffer management schemes adopted behave well in the sense that they can protect regulated traffic from unregulated cell traffic in allocating buffer space. In particular, it was observed that dynamic partitioning is superior in terms of QoS support than virtual partitioning.

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Interference-Prediction based Online Routing Aglorithm for MPLS Traffic Engineering (MPLS 트래픽 엔지니어링을 위한 간섭 예측 기반의 online 라우팅 알고리듬)

  • Lee, Dong-Hoon;Lee, Sung-Chang;Ye, Byung-Ho
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.42 no.12
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    • pp.9-16
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    • 2005
  • A new online routing algerian is proposed in this paper, which use the interference-prediction to solve the network congestion originated from extension of Internet scope and increasing amount of traffic. The end-to-end QoS has to be guaranteed in order to satisfy service level agreements (SLAs) in the integrated networks of next generation. For this purpose, bandwidth is allocated dynamically and effectively, moreover the path selection algorithm is required while considering the network performance. The proposed algorithm predicts the level of how much the amount of current demand interferes the future potential traffic, and then minimizes it. The proposed algorithm considers the bandwidth on demand, link state, and the information about ingress-egress pairs to maximize the network performance and to prevent the waste of the limited resources. In addition, the interference-prediction supports the bandwidth guarantee in dynamic network to accept more requests. In the result, the proposed algorithm performs the effective admission control and QoS routing. In this paper, we analyze the required conditions of routing algorithms, the aspect of recent research, and the representative algorithms to propose the optimized path selection algorithm adequate to Internet franc engineering. Based on these results, we analyze the problems of existing algorithms and propose our algorithm. The simulation shows improved performance by comparing with other algorithms and analyzing them.

A Clinical Study on the Effects of Pain control of Dong-Si acupunture therapy for the patients with lumbago (요각통환자(腰脚痛患者)의 동씨침(董氏鍼) 병행시술(竝行施術)이 통증감소(痛症減少)에 미치는 영향(影響)에 대한 임상고찰(臨床考察))

  • Ha, Chi-Hong;Han, Sang-Gyun;Park, Chun-Ha;Cho, Myung-Rae;Bae, Eun-Jeong;Shin, Young-Il;Yang, Ki-Young;Hwang, Kyu-Jung;Lee, Hyun;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.92-100
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    • 2002
  • Objective : I planned to write this paper to use more Dong-Si acupunture treatment clinically by comparing Dong-Si acupunture with common acupunture for lumbago. Methods : This study was carried out on 56 patients with lumbago who were hospitalized in Dongshin Univ. Oriental Hospital from 1st, April, 2001 to 31st, Octover, 2001. Group A of 28 patients were taken both common acupunture and Dong-Si acupunture. And Group B of 28 patients were only taken common acupunture. And after 10 days of admission, I checked and compared VAS(Visual Analogue Scale) and improvement index out of these two groups. Results : In improvement index, Group A is $0.3932{\pm}0.1073$ and Group B is $0.2793{\pm}0.1080$. So Group A is thought to be significant(P=0.000). In VAS(Visual Analogue Scale), Group A is $6.9286{\pm}1.4889$ and Group B is $5.0000{\pm}1.4142$. So Group A is also thought to be significant(P=0.0000). Conclusion : The group with both Dong-Si acupunture and common acupunture treatment is more effective than the group with common acupunture treatment.

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A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY VISITING SANG-GYE PAIK HOSPITAL EMERGENCY ROOM. (상계백병원 응급실에 내원한 구강악안면외과 응급환자에 대한 임상적 연구)

  • Baik, Jee-Seon;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Choi, Min-Hye;Kwon, Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.561-566
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    • 2008
  • This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.

Comparison of the National Early Warning Score+Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleeding

  • Kim, Daejin;Jo, Sion;Lee, Jae Baek;Jin, Youngho;Jeong, Taeoh;Yoon, Jaechol;Park, Boyoung
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.219-229
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    • 2018
  • Objective We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB). Methods We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ${\geq}5$ packs of red blood cell transfusion within 24 hours. Results Among 530 included patients, the composite outcome occurred in 59 patients (19 inhospital deaths, 13 intensive care unit admissions, and 40 transfusions of ${\geq}5$ packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59-0.73, P=0.004), but not to GBS (0.70, 0.64-0.77, P=0.141) and AIMS65 (0.76, 0.70-0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%. Conclusion The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.

Factors Affecting Emotional Status and Suicidal Risk in Hospitalized Medical Patients (일 종합병원 입원 환자의 자살 위험도 및 정서 상태에 영향을 미치는 요인 연구)

  • Lee, Jeon-Ho;Lee, Jong-Ha;Mok, Young-Eun;Lee, Ho-Jun;Jung, Hyun-Gang;Kim, Seung-Hyun;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.127-134
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    • 2018
  • Objectives : This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. Methods : The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. Results : Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. Conclusions : Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.

Characteristics of poisoning patients visiting emergency departments before and after the COVID-19 pandemic (코로나바이러스감염증-19 대유행 전, 후의 응급실로 내원한 중독 환자의 특성)

  • Seung Jae Kee;Yongil Cho;Hyunggoo Kang;Tae Ho Lim;Jaehoon Oh;Byuk Sung Ko;Juncheol Lee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.2
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    • pp.66-74
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    • 2022
  • Purpose: This study investigates the characteristics and prognosis of acute poisoning patients visiting nationwide emergency departments before and after the Coronavirus disease 2019 (COVID-19) pandemic. Data were obtained from the National Emergency Department Information System (NEDIS). Methods: This nationwide retrospective observational study included acute poisoning patients who visited the emergency departments between February 1 to December 31, 2020, which has been determined as the pandemic period. The same periods in 2018 and 2019 were designated as the control periods. The primary outcome assessed was the length of stay in emergency departments (EDLOS). The secondary outcomes examined were intensive care unit admission rate and in-hospital mortality rate before and after the pandemic. A subgroup analysis was performed for inpatients and intentional poisoning patients. Results: A total of 163,560 patients were included in the study. During the pandemic, the proportion of women increased from 50.0% in 2018 and 50.3% in 2019 to 52.5% in 2020. Patients aged 20-29 years increased from 13.4% in 2018 and 13.9% in 2019 to 16.6% in 2020. A rise in cases of intentional poisoning was also noted - from 33.9% in 2018 and 34.0% in 2019 to 38.4% in 2020. Evaluating the hospitalized poisoned patients revealed that the EDLOS increased from 3.8 hours in 2018 and 3.7 hours in 2019 to 4.2 hours in 2020. ICU admissions were also markedly increased (2018, 48.2%; 2019, 51.8%; 2020, 53.2%) among hospitalized patients. Conclusion: The COVID-19 pandemic has changed the epidemiology, clinical characteristics, and prognosis of acute poisoning patients visiting nationwide emergency departments in Korea. The proportion of young adults, women, and intentional poisoning patients has increased after the COVID-19 pandemic. Prolonged length of stay at the emergency department and an increased rate of intensive care unit admissions were determined in hospitalized acute poisoning patients.

A Case of Psychogenic Tremor Improved by Complex Korean Medicine Treatment Including Cheongshimondam-tang-gamibang and Acupuncture Treatment - A Case Report (청심온담탕가미방과 침구치료를 포함한 복합한의치료로 호전된 심인성 떨림 환자 1례 - 증례보고)

  • Jihyun Lee;Seokyeong Yoon;Hyoenjun Cheon;Sungjun Joo;Jisu Lee;Jungtae Leem;Yanghee Han
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1186-1197
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    • 2022
  • Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.