• Title/Summary/Keyword: Hospital Treatment

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Comparison of Success Rates after Silicone Tube Intubation with or without Lacrimal Endoscopy for Epiphora (눈물흘림 환자에서 눈물길미세내시경의 사용 여부에 따른 실리콘관삽입술의 성공률 비교)

  • Choi, Min Gyu;Lee, Jeong Kyu
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1001-1008
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    • 2018
  • Purpose: To compare the success rates between silicone tube intubation using a lacrimal endoscope and using a conventional nasal endoscope alone in adult patients suffering from epiphora. Methods: We conducted a retrospective chart review of 80 eyes of 55 patients who underwent silicone tube intubation from January 2014 to June 2017. Patients were preoperatively diagnosed with syringing and dacryocystography. The silicone tube was removed 3 months after surgery and success rates were evaluated at 4 and 12 months. Success rates were analyzed by dividing the patients into two groups, according to lacrimal endoscope use. Results: A lacrimal endoscope was used in 40 eyes. In the group using a lacrimal endoscope, preoperative diagnoses were partial obstruction in 26 eyes and complete obstruction in 14 eyes. In the group without lacrimal endoscope use, preoperative diagnoses were partial obstruction in 35 eyes and complete obstruction in 5 eyes (p = 0.018). The success rates at 4 and 12 months after surgery in the two groups (with and without lacrimal endoscope use) were 87.5% and 80.0% and 72.0% and 62.1% (p = 0.546 and p = 0.565), respectively. The success rates of patients with partial obstruction in the two groups were 92.3% and 82.9% at 4 months and 71.4% and 69.2% at 12 months (p = 0.448 and p = 1.000), respectively. The success rates of patients with complete obstruction in the two groups were 78.6% and 60.0% at 4 months and 72.7% and 33.3% at 12 months (p = 0.570 and p = 0.505), respectively. Site differences, the degree of obstruction, and lacrimal endoscope use had a significant impact on the success rate at 4 and 12 months (p = 0.001 and p = 0.022, respectively). Conclusions: Although silicone tube intubation using a lacrimal endoscope cannot guarantee a significant success rate, it is possible to observe the anatomical structure of the nasolacrimal pathway in real time, such that the appropriate diagnosis and treatment can be performed simultaneously. Because patients diagnosed as having a complete obstruction had a good success rate, we can extend indication of silicone tube intubation as a less invasive approach.

Simultaneous Detection of Seven Phosphoproteins in a Single Lysate Sample during Oocyte Maturation Process (난자성숙 과정의 단일 시료에서 일곱 가지 인산화 단백질의 동시 분석 방법)

  • Yoon, Se-Jin;Kim, Yun-Sun;Kim, Kyeoung-Hwa;Yoon, Tae-Ki;Lee, Woo-Sik;Lee, Kyung-Ah
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.3
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    • pp.187-197
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    • 2009
  • Objective: Phosphorylation and dephosphorylation of proteins are important in regulating cellular signaling pathways. Bead-based multiplex phosphorylation assay was conducted to detect the phosphorylation of seven proteins to maximize the information obtained from a single lysate of stage-specific mouse oocytes at a time. Methods: Cumulus-oocyte complexes (COCs) were cultured for 2 h, 8 h, and 16 h, respectively to address phosphorylation status of seven target proteins during oocyte maturation process. We analyzed the changes in phosphorylation at germinal vesicle (GV, 0 h), germinal vesicle breakdown (GVBD, 2 h), metaphase I (MI, 8 h), and metaphase II (MII, 16 h in vitro or in vivo) mouse oocytes by using Bio-Plex phosphoprotein assay system. We chose seven target proteins, namely, three mitogen-activated protein kinases (MAPKs), ERK1/2, JNK, and p38 MAPK, and other 4 well known signaling molecules, Akt, GSK-$3{\alpha}/{\beta}$, $I{\kappa}B{\alpha}$, and STAT3 to measure their phosphorylation status. Western blot analysis and kinase inhibitor treatment for ERK1/2, JNK, and Akt during in vitro maturation of oocytes were conducted for the confirmation. Results: Phosphorylation of ERK1/2, JNK, p38 MAPK and STAT3 was increased over 3 folds up to 20 folds, while phosphorylation of the other three signal molecules, Akt, GSK-$3{\alpha}/{\beta}$, and $I{\kapa}B{\alpha}$ was less than 3 folds. All of these results except for Akt were statistically significant (p<0.05). Conclusion: This is the first report on the new and valuable method measuring many phosphoproteins simultaneously in one minute sample such as oocyte lysates. All of the three MAPKs, ERK1/2, JNK, and p38 MAPK are involved in the process of mouse oocyte maturation. In addition, STAT3 might be important regulator of oocyte maturation, while Akt phosphorylation at Serine 473 may not be involved in the regulation of oocyte maturation.

Full mouth rehabilitation for a patient with vertical dimension loss using digital diagnostic analysis: A clinical report (수직고경이 감소된 환자의 디지털 진단 분석을 이용한 완전 구강 회복 증례)

  • Choi, Yeawon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.487-496
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    • 2021
  • Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

The effects of out of hospital ACLS simulation training on the paramedic's duty ability (구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향)

  • Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.99-106
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    • 2019
  • The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.

Clinical Characteristics in Panic Disorder Patients in Emergency Department (공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징)

  • Lee, Chang-Ju;Nam, Beom-Woo;Sohn, In-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.26-33
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    • 2021
  • Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

Administration of Yijung-tang, Pyeongwi-san, and Shihosogan-tang for Standardization of Korean Medicine Pattern Identification for Functional Dyspepsia: A Study Protocol of a Randomized, Assessor-blind, 3-Arm, Parallel, Open-label, Multicenter Clinical Trial (기능성 소화불량 한의 변증 표준화를 위한 이중탕, 평위산 및 시호소간탕 투여 : 무작위 배정, 평가자 눈가림, 3군 비교, 평행 설계, 공개, 다기관 임상시험 프로토콜)

  • Boram Lee;Min-Jin Cho;Young-Eun Choi;Ojin Kwon;Mi Young Lim;Seok-Jae Ko;So-yeon Kim;Yongjoo Kim;Donghyun Nam;Dong-Jun Choi;Jun-Hwan Lee;Jae-Woo Park;Hojun Kim
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1105-1121
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    • 2022
  • Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder (섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구)

  • Seong min Lee;Seung-Ho Ryu;Jee Hyun Ha;Hong Jun Jeon;Doo-Heum Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.10-18
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    • 2023
  • Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

Economic evaluation of a weekly administration of a sustained-release injection of recombinant human growth hormone for the treatment of children with growth hormone deficiency (소아 성장호르몬결핍증 치료에 사용되는 성장호르몬 서방형 주사제의 경제성 평가)

  • Kang, Hye-Young;Kim, Duk Hee;Yang, Sei-Won;Kim, Yoon-Nam;Kim, Miseon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1249-1259
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    • 2009
  • Purpose:From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. Methods:Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. Results:Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. Conclusion:The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.

Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants (미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험)

  • Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1216-1220
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    • 2009
  • Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.