• Journal of Korean Neurosurgical Society
• /
• v.30 no.1
• /
• pp.73-77
• /
• 2001

Object : To determine whether to use surgical or medical therapy in treatment of infectious intracranial aneurysms, we reviewed two recent cases of infectious intracranial aneurysms and others known previous reports of aforementioned cases. Hence, we attempted to compare the validity and effectiveness of surgical and medical treatment. Method : Recently, we treated two cases of ruptured infectious intracranial aneurysms. In former case, the aneurysm was located distal to the middle cerebral artery in a patient with mild mitral regurgitation of the heart. In latter case, the aneurysm was multiple with varying hemorrhage. The hemorrhage was located bilaterally and a moderate mitral regurgitation and infective endocarditis were accompanied in this patient. Result : Due to the large size of the intracranial hematoma, stable medical condition, and easy resectability, we treated the former patient surgically. And, because of successive hemorrhage by multiple aneurysmal rupture, and the risk of heart failure, we treated the latter patient medically with serial follow-up angiography. Both patients are at present in good health. Conclusion : Because of the variability in associated factors, such as the patient's health, the number of lesions, location, anatomy of the aneurysms and the causative organism, each patient's care must be individualized and tailored to the patient's particular clinical situation.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.18 no.1
• /
• pp.34-41
• /
• 2020

Purpose: This study evaluated aggressive hyperbaric oxygen therapy (HBOT) by understanding various exposure routes of acute carbon monoxide (CO) poisoning, the risk factors causing acute cardiovascular, and neurological toxicity caused by poisoning. Methods: A retrospective study was conducted based on the medical records of 417 acute CO poisoning patients who visited the emergency care unit from March 2017 to August 2019. The exposure routes, HBOT performance, age, sex, medical history (hypertension, diabetes mellitus, ischemic heart disease, heart failure), intentionality, loss of consciousness (LOC), intake with alcohol or sedatives, and initial test results (carboxyhemoglobin (COHb), troponin-I, electrocardiography, echocardiography, brain MRI) were examined. Comparative analysis of the clinical information was conducted between the groups that showed acute cardiovascular toxicity and neurological toxicity, and groups that did not. Results: Among 417 patients diagnosed with acute CO poisoning, 201 cases (48.2%) were intentional, and charcoal briquette was the most common route (169 patients (40.5%)). Two hundred sixteen cases (51.8%) were accidental, and fire was the most common route (135 patients (32.4%)). The exposure route was more diverse with accidental poisoning. Three hundred ninety-nine patients were studied for acute cardiovascular toxicity, and 62 patients (15.5%) were confirmed to be positive. The result was statistically significant in intentionality, LOC, combined sedatives, initial COHb, HTN, and IHD. One hundred two patients were studied for acute neurological toxicity, which was observed in 26 patients (25.5%). The result was statistically significant in age and LOC. Conclusion: Active HBOT should be performed to minimize damage to the major organs by identifying the various exposure routes of CO poisoning, risk factors for acute cardiovascular toxicity (intentionality, LOC, combined sedatives, initial COHb, HTN, IHD), and the risk factors for acute neurological toxicity (age, LOC).

• Journal of Chest Surgery
• /
• v.49 no.5
• /
• pp.350-355
• /
• 2016

Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

• Journal of Convergence for Information Technology
• /
• v.10 no.10
• /
• pp.253-258
• /
• 2020

This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.7 no.2
• /
• pp.264-267
• /
• 2004

Beriberi, which is caused by thiamin deficiency, is a rare disease in recent years. But it has been described in the Eastern literature as far back as the 17th century. Early symptoms are fatigue, apathy, irritability, drowsiness, anorexia, nausea, vomiting and abdominal pain. Signs and symptoms of progression are peripheral neuritis, paresthesia, decreased tendon reflex and congestive heart failure. Thiamin deficiency remains as an important health care issue in many world population, specially in AIDS, pregnancy women and TPN associated patients. The best diagnostic test is assessing clinical response to administration of thiamin. We have experienced a case of Beriberi caused by continuous rice-soup feeding during one and half years in a 7-year-old boy.

• International Journal of Advanced Culture Technology
• /
• v.5 no.2
• /
• pp.26-43
• /
• 2017

This study investigated the effects of TBL nursing education(for the care of congestive heart failure patients) on self identity and self efficacy among nursing students. A one-group, pre-post design was utilized with 28 nursing students as the participants. The scenario of TBL nursing education was created based on PBL, and consisted of four states(1) Present a problem, (2) Problem Follow-Up Steps,(3) Present the results including presentation, and(4) Problem Conclusion and after resolution. And then In-depth interviews were conducted with volunteers on program experiences. The data were analyzed using descriptive statistics, Pearson's correlation coefficients and paired t-tests and Giorgi phenomenology analysis method was performed. The TBL program was effective in self - efficacy and self - identity (p<0.01) increased significantly after the education intervention and The meaning of the TBL experience is four (meaning that the learners embarrassed TBL, aggressive learning attitude change, effective collaboration for problem solving in a free learning environment, university classes imagined in high school), and 67 sub-components appeared as an element. The TBL program is an effective teaching method for nursing education and it can be used as basic data for the development of nursing education based on this research.

• The Journal of Pediatrics of Korean Medicine
• /
• v.19 no.2
• /
• pp.137-152
• /
• 2005

Objective : As the meaning of collective medical examination, the purpose of this study is to investigate distribution of weak children by measurement according to the five group of weakness (Lung, Heart, Pancreas, Liver, Kidney), and the relationship between the five group of weakness and the Growth failure on primary school children. Methods : This study is composed of 1078 children who attend A primary school in ${\bigcirc}{\bigcirc}$ city. They are divided into 6 groups by grade and for the purpose of effective comparison, The five weak symptoms are studied to determine the association with growth stature among children and we standardize the weak children's height into percent according to age. Results: When each weak children controled grade, sex, body-weight, existence or nonexistence of personal history, physical exercise so on, relatively group of weakness for kidney is statistically less then opposite group and the rest of the people statistically have no significant difference. Conclusions: From the above result, it is suggested that the statistical relationship between the weakness for kidney and growth(p<0.001). It looks forward to have contributed to collective medical examination and children's health care by oriental medical treatment.

• Perspectives in Nursing Science
• /
• v.9 no.2
• /
• pp.111-118
• /
• 2012

Purpose: This study investigated the effects of simulation-based nursing education (for the care of congestive heart failure patients) on self-directed learning competency, clinical knowledge and problem-solving ability among nursing students. Methods: A one-group, pre-post design was utilized with 87 nursing students as the subjects. The scenario of simulation-based nursing education was created using a high-fidelity patient stimulator, and consisted of four states ((1) assessment, (2) reviewing laboratory data and administering medications and treatments, (3) managing increased dyspnea and decreased urine output, and (4) handling the "getting better" state). The simulation-based nursing education included orientation, team-based learning, team-based practice, and debriefing. The data were analyzed using descriptive statistics, Pearson's correlation coefficients and paired t-tests. Results: The scores on the factors for self-directed learning competency (t=-2.57, p= .011), clinical knowledge (t=-6.85, p<.001), and problem-solving ability (t=-3.01, p= .003) increased significantly after the education intervention. Conclusion: Simulation-based nursing education is useful in improving self-directed learning competency, clinical knowledge, and problem-solving ability in nursing students.

• Journal of Chest Surgery
• /
• v.48 no.4
• /
• pp.289-293
• /
• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.5
• /
• pp.781-786
• /
• 1995

Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.