• The Korean journal of internal medicine
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• 제33권6호
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• pp.1203-1209
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• 2018

Background/Aims: Adverse drug reaction (ADR) is an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product. The present study was conducted in order to monitor the frequency and severity of ADR during antimicrobial therapy of septicemia. Methods: A prospective, observational, and noncomparative study was conducted over a period of 6 months on patients of septicemia admitted at a university hospital. Naranjo algorithm scale was used for causality assessment. Severity assessment was done by Hartwig severity scale. Results: ADRs in selected hospitalized patients of septicemia was found to be in 26.5% of the study population. During the study period, 12 ADRs were confirmed occurring in 9, out of 34 admitted patients. Pediatric patients experienced maximum ADRs, 44.4%. Females experienced a significantly higher incidence of ADRs, 66.7%. According to Naranjo's probability scale, 8.3% of ADRs were found to be definite, 58.3% as probable, and 33.3% as possible. A higher proportion of these ADRs, 66.7% were preventable in nature. Severity assessment showed that more than half of ADRs were moderate. Teicoplanin was found to be the commonest antimicrobial agent associated with ADRs, followed by gemifloxacin and ofloxacin. Conclusions: The incidence and severity of ADRs observed in the present study was substantially high indicating the need of extra vigilant during the antimicrobial therapy of septicemia.

• 한국임상약학회지
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• 제30권4호
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• pp.264-269
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• 2020

Background: Inflammatory diseases can increase the prevalence of anemia. Recent studies confirmed that the prevalence of anemia is increased by atopic dermatitis (AD), a chronic inflammatory disease. Therefore, we aimed to elucidate the correlation between AD severity and prevalence of anemia. Methods: We used data of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2016). We included pediatric patients (<18 years) with AD diagnosis who were prescribed medications for AD. We applied a propensity score method with inverse probability of treatment weighting (IPTW) adjusting for differences in prevalence of confounders and performed IPTW logistic regression to evaluate associations between the anemia and severity of AD. Results: In total, 91,501 patients (mild AD: 47,054 patients; moderate-to-severe AD: 44,447 patients) <18 years who were prescribed drugs for AD were analyzed. Analysis of the probability of patients with mild AD and prevalence of anemia as a reference revealed an odds ratio (OR) of 1.159 (95% CI, 1.109-1.212; p<0.001) in moderate-to-severe AD patients, indicating a correlation between anemia prevalence and AD severity. Subgroup analysis according to gender, age group, and type of health insurance revealed there was an association between AD severity and anemia except in patients equal or older than 7 years. Conclusion: The prevalence of anemia increased with AD severity despite adjusting for confounding factors. Our results support the hypothesis that AD can cause anemia, and anemia prevalence could be increased in severe AD patients. Further studies are needed to establish a pathological basis.

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2012년도 춘계학술논문집 1부
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• pp.22-24
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2012년도 춘계학술발표회 초록집
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• pp.190-193
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권6호
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• pp.405-417
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• 2022

Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

• The Journal of Advanced Prosthodontics
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• 제3권1호
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• pp.25-32
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• 2011

PURPOSE. The purpose of this study was to assess the prevalence and extent of clinical attachment loss of periodontal tissue and to find out variables related to clinical attachment loss (CAL) in Korean adults older than 40 years of age. MATERIALS AND METHODS. Data were collected from 2,519 subjects who were part of a cohort study conducted in Ansan city by Korea University Medical School for Korean Genome project. Age, sex, smoking, drinking, fast glucose, blood pressure, obesity and total cholesterol levels were examined. The oral examination included probing pocket depth, gingival recession and CAL of Ramford's teeth. The severity of periodontitis was classified based on the mean value of CAL. The relationship between each risk factor and the severity of CAL was independently estimated using the chi-square test, the test or one-way ANOVA. Multiple regression analysis was used to determine the significance of each factor in the periodontal disease. RESULTS. The prevalences of clinical attachment between 1 and 3 mm, between 3 and < 5 mm, and ${\geq}$ 5 mm were 80.27%, 16.75% and < 1%, respectively. Although the univariate analysis showed age, gender, smoking, fasting glucose, blood pressure and total cholesterol levels were significantly related to the severity of CAL, multiple regression analysis indicated that age (P < .0001), gender (P < .0001) and smoking (P < .05) were only significantly related. CONCLUSION. Older age, male gender and smoking were significant risk factor for the increase of CAL, and these may be useful indicators of periodontitis high-risk groups.

• Tuberculosis and Respiratory Diseases
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• 제60권2호
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• pp.215-220
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• 2006

연구 배경: 폐활량측정법 정상예측식이 한국인을 대상으로 개발되었다. 한국인 정상예측식을 실제 진료에 사용하기 위해서 그 동안 많이 사용하던 정상 예측식 중 하나인 Morris 예측식을 적용하였을 때와 한국인 예측식을 적용하였을 때 장애 양상 해석 및 질병 중증도 평가가 어떻게 달라지나 비교하고자 하였다. 방 법: 서울아산병원의 호흡기검사실에서 2004년도 11월 한 달간 폐활량측정법을 시행한 남자 926명과 여자 694명을 대상으로 하였다. 나이, 성, 키, 몸무게, 그리고 폐활량측정법으로 $FEV_1$ [forced expiratory volume in one second], FVC [forced vital capacity], $FEV_1/FVC$ 등을 구하였다. 한국인 예측식과 Morris 예측식을 사용하여 장애 양상 해석과 질병 중증도 평가를 하였고 그 차이를 비교하였다. 폐활량측정법 장애 양상은 $FEV_1/FVC$과 FVC 값에 따라서 정상, 제한성, 폐쇄성, 양상 미정 등으로 정의하였고 질병 중증도는 기류제한이 있는 환자는 $FEV_1$ 값에 따라서 기류제한이 없는 환자는 FVC값에 따라서 정의하였다. 결 과: Morris 예측식에서 한국인 예측식으로 바꾸어 적용하면 장애 양상 해석이 남자 환자의 경우 22.5% (208/926) 달라졌고 여자의 경우 24.8% (172/694) 달라졌다. 한국인 예측식을 적용하였을 때, 기류제한이 있는 환자의 경우 질병의 중증도가 남자에서 30.2% (114/378) 바뀌었고 여자에서 39.4% (37/94) 바뀌었다. 기류제한이 없는 환자의 경우는 질병의 중증도가 남자에서 27.9% (153/548) 바뀌었고 여자에서 30.2% (181/600) 바뀌었다. 결 론: 폐활량측정법 정상예측식이 바뀌면 장애 양상 해석과 질병 중증도 평가에 유의한 영향을 미칠 수 있다.

• 한국병원경영학회지
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• 제19권4호
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.115-124
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• 2001

연구목적：본 연구는 일과성 틱 장애(Transient tic disorder：TTD), 만성 틱 장애(chronic tic disoder：CTD), 뚜렛 장애(Tourette's disorder：TD) 아동의 임상 양상을 비교하고, 틱 장애의 질환 심각도와 연관된 변인을 알아보기 위해 시행되었다. 방 법：DSM-Ⅳ 진단분류에 따라 틱 장애로 진단된 69명의 아동과 대조군 43명을 대상으로 인구학적 변인 및 틱과 관련된 임상적 변인을 조사하였다. 틱 증상의 심각도를 알아보기 위해 예일 틱 증상 평가 척도(Yale Global Tic Severity Scale)을 시행하였으며 연구 대상 모두에게 동반된 정서/행동 문제를 평가하기 위해 아동 행동조사표(Child Behavior Checklist)를 시행하였다. 결 과：TTD군은 CTD 및 TD군과 비교할 때 틱 증상의 지속 기간이 짧을 뿐 아니라 틱 증상의 심각도와 장해 정도도 미약하였다. TTD군의 동반된 정서/행동 문제 역시 CTD, TD군에 비해 유의하게 적었으며 공격성 소척도 점수를 제외하고는 정상대조군과 차이가 없었다. CTD군과 TD군간에는 틱 증상의 종류, 개수와 CBCL의 사회성 문제 소척도 점수외에는 통계적으로 유의한 차이를 나타내는 변인이 없었다. 틱 증상으로 인한 장해 정도를 가장 잘 예측해 주는 변인은 운동틱의 강도와 방해도, 틱 증상의 지속기간이었으며, CBCL 총 문제행동 점수와 가장 높은 연관성이 있는 변인은 주의력결핍/과잉운동장애(Attention deficit hyperactivity disorder：ADHD)의 존재여부였다. 결 론：본 연구의 결과는 틱 증상의 심각도 외에 증상의 지속 기간이 틱 장애 아동들의 틱으로 인한 장해도에 큰 영향을 미치며, 동반된 ADHD의 존재가 이들의 임상상을 결정하는 데 있어 중요한 역할을 한다는 점을 시사한다. 또한 위와 같은 임상 변인들이 틱 장애의 진단적 분류보다도 틱 장애 아동의 질환 심각도를 판단하고 치료방침을 결정하는데 있어 더욱 중요함을 시사한다.

• 말소리와 음성과학
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• 제5권1호
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• pp.39-46
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• 2013

This study examined the effects of phonetic complexity and articulatory severity on Percentage of Correct Consonant (PCC) and speech intelligibility in adults with dysarthria. Speech samples of thirty-two words from APAC (Assessment of Phonology and Articulation of Children) were collected from 38 dysarthric speakers with one of two different levels of articulatory severities (mild or mild-moderate). A PCC and speech intelligibility score was calculated by the 4 levels of phonetic complexity. Two-way mixed ANOVA analysis revealed: (1) the group with mild severity showed significantly higher PCC and speech intelligibility scores than the mild-moderate articulatory severity group, (2) PCC at the phonetic complexity level 4 was significantly lower than those at the other levels and (3) an interaction effect of articulatory severity and phonetic complexity was observed only on the PCC. Pearson correlation analysis demonstrated the degree of correlation between PCC and speech intelligibility varied depending on the level of articulatory severity and phonetic complexity. The clinical implications of the findings were discussed.