• Title/Summary/Keyword: Frequent Episode

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Prognostic Factors of Renal Defects on the Initial DMSA Scan in Children with Acute Pyelonephritis (급성신우신염 환아에서 DMSA 스캔상 발견된 신결손의 예후 인자)

  • Seon, Yeong-Seon;Kwon, Duck-Geun;Shin, Yun-Hyea;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.195-202
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    • 2010
  • Purpose : The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. Methods : This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by $^{99m}Tc$-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. Results : Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the followup DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. Conclusion : The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.

Air Pollutant Variations Observed at Deokjeok Island in the Yellow Sea During April 1999 to June 2000 (1999년 4월부터 2000년 6월까지 황해 덕적도에서 관찰된 대기오염물질 변화 특성)

  • 김영성;이승복;김진영;배귀남;문길주;원재광;윤순창
    • Journal of Korean Society for Atmospheric Environment
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    • v.19 no.4
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    • pp.347-361
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    • 2003
  • Sulfur dioxide (SO$_2$), ozone, total suspended particulates (TSP) and PM$_{2.5}$ were measured at Deokjeok Island in the Yellow Sea during April 1999 to June 2000. Although the emission amount of air pollutants is quite low in this small island of 36 km$^2$ with 1.4 thousand inhabitants, there are pollutant sources such as an oil -firing power plant and a wharf for ferryboat. The island is also influenced from the emissions from the greater Seoul area in the east and from China in the west. In order to characterize the pollutant variations due to interactions between transport and local emissions. the correlation between variations of SO$_2$ and ozone was investigated. Mass and ion concentrations of TSP and PM$_{2.5}$ were examined on selected episode days of positive and negative correlations between the two gaseous species in spring and winter. The effects of transport were pronounced on the days of positive correlation in spring with higher concentrations of ozone and PM$_{2.5}$. TSP concentrations were also high on these days because of high wind speeds. On the days of negative correlation in spring, frequent fog associated with low wind speeds facilitated SO$_2$ oxidation and increased sulfate accompanied with decrease in nitrate in PM$_{2.5}$ and chloride in TSP. This latter phenomena was noticeable since it showed that chemical composition of fine particles could be significantly altered not only during the transport but also by local environment.ronment.

Nonsteroidal Anti-inflammatory Drugs Utilization Patterns among the Elderly with Osteoarthritis at Primary Ambulatory Care Units in Busan Metropolitan City, Korea (부산지역 의원급 외래 노인 골관절염환자의 비스테로이드소염제 사용양상평가)

  • Choi, Nam-Kyong;Kim, Yoon-I;Lee, Seung-Mi;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.150-156
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    • 2004
  • Objectives : To investigate the utilization patterns of non-steroidal anti-inflammatory drugs (NSAIDs) among the elderly with osteoarthritis (OA) undergoing primary ambulatory care in Busan metropolitan city, Korea. Methods : OA patients, aged 65 years and over, were identified from the Korean National Health Insurance Review Agency drug prescription database. The subjects had at least one episode of claim for OA (ICD-10-CM: M15-M19) between August 1, 2000 and February 28, 2002. Trends in the determinations of NSAIDs utilization were identified using chi-squared tests for trend. Results : There were 47,711 osteoarthritic patients. The total number of visits by these patients was 177,443, with a total frequency for NSAID prescriptions of 214,952. Seventy-nine percent of the OA patients were female. NSAIDs were prescribed on 133,284 visits (75.1%) and the proportion of prescriptions was significantly increased with age. Only the proportion of visit when NSAIDs were prescribed decreased, from 65.1 to 43.5%, during the study period (p<0.001). However, the proportion of combined treatments with anti-ulcer drugs was increased. The use of NSAIDs injections was decreased. Of the individual NSAIDs, diclofenac (28.7% of total frequency of NSAID prescriptions), piroxicam (15.0%) and talniflumate (8.7%), were the most frequently prescribed. Among the NSAIDs prescribed OA visits, 45.7% used two or more NSAIDs. Conclusion : The total proportion of NSAIDs prescribed to the osteoarthritic patients was higher than in other studies. The decline in the use of NSAIDs during the study period, and the frequent selection of safer medications, such as combination therapy with anti-ulcer drug, may reflect the risk awareness of the use of NSAIDs.

Analysis of Verbal Interaction in Small Group Discussion (소집단 토론 과정에서의 언어적 상호작용 분석)

  • Kang, Suk-Jin;Kim, Chang-Min;Noh, Tae-Hee
    • Journal of The Korean Association For Science Education
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    • v.20 no.3
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    • pp.353-363
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    • 2000
  • In this study, discourse patterns of four peer small groups in learning science concepts were examined. Verbal interactions during small group discussions were audio- and video-taped, transcribed, and analyzed. Three coding frameworks for the levels of turns, interaction units, and episodes were developed. In the analyses of turns, no clear relationships between students' prior achievements and contributions to knowledge building processes were found. Partly participating modes and symmetrical interaction modes were dominant in the analyses of interaction units to suggest that some students did not participate actively in small group discussions and that students' verbal interactions were superficial. The analyses of episodes also indicated that agreeing and/or partial elaborating on group members' ideas were the most frequent patterns and dialectical exchanges were rare in small group discussion.

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Two Cases of Surgically Created Aneurysms of the Sinus of Valsalva (Valsalva 동의 선천성 동맥류 파열: 2례 수술 경험)

  • 이성행
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.133-139
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    • 1977
  • Two cases of congenital aneurysm of sinus of Valsalva, ruptured into the right ventricle, and associated with ventricular septal defects, were undergone intracardiac repair with the aid of extracorporeal circulation using Bentley bubble oxygenator and moderate hypothermia. Case 1. A 20 year old male, with the chief complaints of palpitation and dyspnea, was admitted to Kyungpook National University Hospital on Dec. 16, 1976. Continuous machinery murmur was heard best at left 3rd. intercostal space along the sternal border. Retrograde aortography disclosed aneurysm of the right coronary cusp, which ruptured into the right ventricle. Utilizing cardiac bypass and moderate hypothermia, the right ventricle was opened and aneurysm was closed by direct sutures. Associated ventricuar septal defect was directly ,closed and suture line was reinforced by Dacron patch. Total bypass time was 112 minutes and total aortic cross clamping time was 37 minutes. Assist ventilation was carried out for 28 hours postoperatively. His postoperative course was smooth except removal o1 substernal hematoma and he was .discharged on 24th postoperative day. Case 2. A 28 year old man was admitted to our Hospital on June 9, 1976. two weeks prior to this admission, suddenly he had collapsed while he was walking on the street. Following `this episode, palpitation, dyspnea on exertion and frequent respiratory infection developed. Grade IV systolic murmur was heard best at 3rd intercostal space along the sternal border. Retrograde aortography confirmed the diagnosis of rupture of aneurysm of the sinus Valsalva ruptured into the right ventricle. Under the cardiopulmonary bypass the right ventricle was opened and ruptured aneurysm and infracristal ventricular septal defect were directly closed and reinforced with Dacron patch. Postoperative course was uneventful and he was discharged on 14th postoperative day. The pathogenesis of aneurysm of the sinus Valsalva and mode of diagnosis were discussed. Principle of surgical repair was presented.

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Epilepsy in children with a history of febrile seizures

  • Lee, Sang Hyun;Byeon, Jung Hye;Kim, Gun Ha;Eun, Baik-Lin;Eun, So-Hee
    • Clinical and Experimental Pediatrics
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    • v.59 no.2
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    • pp.74-79
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    • 2016
  • Purpose: Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures. Methods: The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between the subsequent occurrence of epilepsy and clinical factors including seizure and fever-related variables were analyzed by multivariate analysis. Results: Twenty-five patients (10.0%) had additional afebrile seizures later and were diagnosed with epilepsy. The subsequent occurrence of epilepsy in patients with a history of febrile seizures was associated with a seizure frequency of more than 10 times during the first 2 years after seizure onset (P<0.001). Factors that were associated with subsequent occurrence of epilepsy were developmental delay (P<0.001), preterm birth (P =0.001), multiple seizures during a febrile seizure attack (P =0.005), and epileptiform discharges on electroencephalography (EEG) (P =0.008). Other factors such as the age at onset of first seizure, seizure duration, and family history of epilepsy were not associated with subsequent occurrence of epilepsy in this study. Conclusion: Febrile seizures are common and mostly benign. However, careful observation is needed, particularly for prediction of subsequent epileptic episodes in patients with frequent febrile seizures with known risk factors, such as developmental delay, history of preterm birth, several attacks during a febrile episode, and epileptiform discharges on EEG.

Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care Center

  • Jansaka, Natpat;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10837-10840
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    • 2015
  • To assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were divided into three groups according to the platinum free interval as follows: platinum refractory that included the patients with tumor progression during treatment; platinum resistant and platinum sensitive that included the patients with tumor progression less than or more than six months, respectively. Clinical data for tumor progression in epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 and December, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in the platinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration of neoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean total number of chemotherapy regimens, the early stage patients, the patients with complete surgery and the surviving patients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment after tumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the median overall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant and platinum sensitive groups, respectively (p<0.001). In addition, when the platinum sensitive patients developed the next episode of tumor progression, the median progression free interval time was only three to four months. In conclusion, the outcomes for platinum refractory the and platinum resistant groups was poorer than the platinum sensitive group. However, subsequent progression in the platinum sensitive group was also associated with a poor outcome.

Dumping Syndrome in a Child with Gastrojejunal Tube Feeding (위공장 경관식이(Gastrojejunal Tube Feeding) 환아에서 동반된 덤핑 증후군(Dumping Syndrome) 1례)

  • Lee, Sung Hyuk;Byun, Jun Chul;Choi, Won Joung;Choi, Soon-Ok;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.96-101
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    • 2005
  • Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.

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Sports injuries: a 5-year review of admissions at a major trauma center in the United Kingdom

  • Ahmad Hammad Hassan;Aref-Ali Gharooni;Harry Mee;James Geffner;Fahim Anwar
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.39-48
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    • 2023
  • Purpose: Sports offer several health benefits but are not free of injury risk. Activity dynamics vary across sports, impacting the injury profile and thereby influencing healthcare resource utilization and health outcomes. The purpose of this study was to investigate sports-related major trauma cases and compare differences across sports and activity groups. Methods: A retrospective case notes review of sports-related major traumas over a 5-year period was conducted. Demographic, hospital episode-related, and health outcome-related data were analyzed, and differences were compared across sports and activity groups. The Glasgow Outcome Scale (GOS) at discharge was used as the primary outcome measure and the length of hospital stay as the secondary outcome measure. Results: In total, 76% of cases had good recovery at discharge (GOS, 5), 19% had moderate disability (GOS, 4), and 5% had severe disability (GOS, 3). The mean length of hospital stay was 11.2 days (range, 1-121 days). The most severely injured body region was the limbs (29.1%) and vertebral/spinal injuries were most common (33%) in terms of location. A significant difference (P<0.05) existed in GOS across sports groups, with motor sports having the lowest GOS. However, no significant differences (P>0.05) were found in other health-outcome variables or injury patterns across sports or activity groups, although more competitive sports cases (67%) required admission than recreational sports cases (33%). Conclusions: Spinal injuries are the most frequent sports injuries, bear the worst health outcomes, and warrant better preventive measures. Head injuries previously dominated the worst outcomes; this change is likely due to better preventive and management modalities. Competitive sports had a higher injury frequency than recreational sports, but no difference in health outcomes or injury patterns.

The Changes of Arterial Oxygen Saturation During Sleep in Chronic Obstructive Pulmonary Disease Patients (만성 폐쇄성 폐질환 환자에서 수면중 동맥혈 산소 포화도의 변화)

  • Jeong, Ki-Ho;Choi, Hyung-Seok;Hyun, In-Gyu;Choi, Dong-Chull;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.255-261
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    • 1991
  • Frequently patients with chronic obstructive pulmonary disease have lowered arterial oxygen saturation in daytime. During sleep, they are apt to experience additional hypoxemia. These episode of nocturnal hypoxemia are usually associated with periods of relative hypoventilation. Noctunal hypoxemia may be associated with cardiac arrhythmia and with acute increase in pulmonary arterial pressure and may be implicated in the development of chronic pulmonary hypertension and cor pulmonale. We selected 14 patients with chronic obstructive pulmonary disease, 9 with emphysema dominant type and 5 with chronic bronchitis dominant type, to examine the frequency and severity of nocturnal hypoxemia and the effect of oxygen in prevention of nocturnal hypoxemia. The results were as follows; 1) On PFT, FVC, $FEV_1$, and $FEV_1$/FVC showed no significant difference between the emphysema dominant type (pink puffers, PP) and the chronic bronchitis dominant type (blue bloaters, BB). But DLCO/VA for the PP group was $45.7{\pm}15.1%$ which was significantly different from BB group, $82.4{\pm}5.6%$. 2) The daytime arterial oxygen saturation ($SaO_2$) and the lowest $SaO_2$, during sleep for the BB group were significantly lower than for the PP group. 3) The hypoxemic episodes during sleep were more frequent in BB group and the duration of hypoxemic episode was longer in BB group. 4) In both group studied, although there was a tendency for a lower L-$SaO_2$ (the lowest $SaO_2$, during sleep), an increase in hypoxemic episodes and duration as the daytime $SaO_2$, fell lower, the only parameter which showed significant correlation was daytime $SaO_2$, and the frequency of hypoxemic episodes in the PP group (r=-0.68, P<0.05). 5) In PP group, with oxygen supplementation, L-$SaO_2$, during sleep showed significant increase, and there was a tendency for the frequency of hypoxemic episodes and duration to fall but it was not significant. 6) In BB group, oxygen supplementation significantly increased the L-$SaO_2$ during sleep and also significantly decreased the frequency and duration of hypoxemic episode. From these results, we can see that oxygen supplementation during sleep can prevent the decrease in $SaO_2$ to some extent and that this effect of oxygen can be seen more prominently in the BB group.

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