• Title/Summary/Keyword: Korean Medical Institution

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Antimicrobial Resistance Patterns of Salmonella Enteritidis and Salmonella Typhimurium Isolated from Diarrhea Patients in Incheon between 2008 and 2012 (최근 5년간 인천지역 설사환자에서 분리한 Salmonella Enteritidis와 Salmonella Typhimurium의 항생제 내성 양상)

  • Jang, Jae-Seon;Lee, Jea-Man;Gong, Young-Woo;Lee, Mi-Yeon
    • Journal of Environmental Health Sciences
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    • v.39 no.3
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    • pp.239-246
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    • 2013
  • Objectives: Antimicrobial resistance and multidrug resistance patterns have been studied with a total of 189 samples of Salmonella Enteritidis and Salmonella Typhimurium isolated from diarrhea patients in Incheon from 2008 to 2012. Methods: Antimicrobial resistance tests were determined by Disc Diffusion method. Results: The serological distribution of Salmonella spp. showed 108 strains (30.1%) of S. Enteritidis, 81 strains (22.6%) of S. Typhimirium, eight strains (8.0%) of S. Typhi, 11 strains ( 3.1% ) of S. Paratyphi, and the 151 other strains (42.1%). The separation rate of Salmonella spp. by year showed 14.5% (52 strains) in 2008, 13.6% (49 strains) in 2009, 22.8% (82 strains) in 2010, 25.3% (91 strains) in 2011, and 23.7% (85 strains) in 2012. Additionally, the separation rate of S. Enteritidis and S. Typhimirium in 2010 was the highest. The Salmonella spp. isolated from diarrhea patients showed significant differences according to age (p<0.05), gender (p<0.01) and medical institution (p<0.05). The highest resistance was found to the following antimicrobial agents: imipenem 77 strains, ampicillin 47 strains, ciprofloxacin 34 strains, nalidixic acid 29 strains for S. Enteritidis, and ampicillin 45 strains, nalidixic acid 45 strains for S. Typhimurium. Separated S. Enteritidis and S. Typhimurium resistance to the antibiotics by the year showed significant differences (p<0.05). The patterns of multidrug resistance rates were 43.1% (47 strains) for one drug, 8.3% (9 strains) for two drugs, 11.0% (12 strains) for three drugs, 15.62% (17 strains) for four drugs, and 13.7% (15 strains) for five or more drugs for S. Enteritidis. For S. Tyhpimurium, the rates were 15.0% (12 strains) for one drug, 10.0% (8 strains) for two drugs, 6.3% (five strains) for three drugs, 18.7% (15 strains) for four drugs, and 23.8% (19 strains) for five or more drugs. Conclusion: The antibiotic resistance issue is directly related to people's lives. Thus, the usage of antibiotics should be reduced in order to manage antibiotic resistance.

Resuscitative Endovascular Balloon Occlusion of the Aorta in Impending Traumatic Arrest: Is It Effective?

  • Chung, Jae Sik;Kim, Oh Hyun;Kim, Seongyup;Jang, Ji Young;An, Gyo Jin;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.23-30
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    • 2020
  • Purpose: Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations. Methods: This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups. Results: We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%. Conclusions: Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.

Clinical and Laboratory Findings of the 2012 Winter Seasonal Influenza A and B Outbreak at a Single Institution (계절 인플루엔자: 단일기관 연구)

  • Choi, Jae Won;Cho, Hyun Jun;Kim, Hwang Min;Hahn, Seok
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.1-8
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    • 2014
  • Purpose: The aim for this study was to investigate clinical manifestation of seasonal influenza A and B during the 2012 winter season in Wonju, South Korea. Their clinical and laboratorial characteristics and effect of oseltamivir were compared and analyzed. Methods: Children under the age of 18 years who visited the Wonju Severance Christian Hospital with fever or acute respiratory symptoms and who were diagnosed with influenza A or B by rapid antigen test from nasopharyngeal swab were selected for the study. The medical records of patients were retrospectively reviewed. Results: Influenza A was detected in 374 patients (83.7%), and influenza B in 72 (16.6%). The incidence of influenza A was highest in February (n=186), while that of influenza B was highest in March (n=36). The most common symptoms were fever (n=434, 97.1%) and cough (n=362, 81.0%). No significant differences were observed between influenza A and B in symptoms and laboratory data. Patients who had used oseltamivir within 2 days showed statistically lower admission rate, shorter admission duration, and lower incidence of pneumonia. Conclusion: This study found no statistical difference between influenza A and B, in symptoms, progression, and laboratory test, but those who were treated with oseltamivir given within 2 days of the onset of fever experienced more positive outcomes.

Treatment outcome of localized prostate cancer by 70 Gy hypofractionated intensity-modulated radiotherapy with a customized rectal balloon

  • Kim, Hyunjung;Kim, Jun Won;Hong, Sung Joon;Rha, Koon Ho;Lee, Chang-Geol;Yang, Seung Choul;Choi, Young Deuk;Suh, Chang-Ok;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.187-197
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    • 2014
  • Purpose: We aimed to analyze the treatment outcome and long-term toxicity of 70 Gy hypofractionated intensity-modulated radiotherapy (IMRT) for localized prostate cancer using a customized rectal balloon. Materials and Methods: We reviewed medical records of 86 prostate cancer patients who received curative radiotherapy between January 2004 and December 2011 at our institution. Patients were designated as low (12.8%), intermediate (20.9%), or high risk (66.3%). Thirty patients received a total dose of 70 Gy in 28 fractions over 5 weeks via IMRT (the Hypo-IMRT group); 56 received 70.2 Gy in 39 fractions over 7 weeks via 3-dimensional conformal radiotherapy (the CF-3DRT group, which served as a reference for comparison). A customized rectal balloon was placed in Hypo-IMRT group throughout the entire radiotherapy course. Androgen deprivation therapy was administered to 47 patients (Hypo-IMRT group, 17; CF-3DRT group, 30). Late genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated according to the Radiation Therapy Oncology Group criteria. Results: The median follow-up period was 74.4 months (range, 18.8 to 125.9 months). The 5-year actuarial biochemical relapse-free survival rates for low-, intermediate-, and high-risk patients were 100%, 100%, and 88.5%, respectively, for the Hypo-IMRT group and 80%, 77.8%, and 63.6%, respectively, for the CF-3DRT group (p < 0.046). No patient presented with acute or late GU toxicity ${\geq}$grade 3. Late grade 3 GI toxicity occurred in 2 patients (3.6%) in the CF-3DRT group and 1 patient (3.3%) in the Hypo-IMRT group. Conclusion: Hypo-IMRT with a customized rectal balloon resulted in excellent biochemical control rates with minimal toxicity in localized prostate cancer patients.

Results of Surgical Treatment for Primary Gastric Adenocarcinoma - Single Institute Experience for 14 Years - (위선암에서 외과적 치료 결과 - 단일병원의 14년간 경험 -)

  • Cho, Jun-Min;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.193-199
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    • 2009
  • Purpose: The aim of this study was to evaluate the clinicopathologic features, treatment outcomes, and prognostic factors of gastric cancer based on 14 years' experience in a single medical center, and to compare treatment outcomes with a previous study. Materials and Methods: We retrospectively studied 2,327 patients who were operated on for gastric cancer between 1993 and 2006 at Korea University Hospital. Results: The resection rate was 92.8% and curative resection was achieved for 1,960 (90.8%) patients. The 5-year survival rate was 70.0% for all patients undergoing resection and 79.2% for patients undergoing curative resection. The 5-year survival rate was 1.5% for unresected cases. Age, tumor size, location of the tumor, gross tumor type, depth of tumor invasion, lymph node involvement, distant metastasis, tumor stage, combined resection, complications, histology, and type of operation each had prognostic significance on univariate analysis. On multivariate analysis, lymph node involvement, depth of invasion, venous invasion, and age were independent prognostic factors. Conclusion: The 5-year survival rate for patients who underwent curative resection was 79.2%. Depth of invasion, lymph node involvement, venous invasion, and age were independent prognostic factors. The fact that tumor stage is the most important prognostic factor after curative resection, increases the importance of early detection.

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The Effects on Satisfaction and Recommendation according to Orthodontic Patients' Perception of Treatment (치열교정환자의 진료인식에 따른 만족과 추천에 미치는 영향)

  • Chun, Jong Ae
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.105-114
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    • 2013
  • The purpose of this study was to offer information to medical institution of specializing in orthodontic patients by surveying the influence of orthodontic patients' perception of treatment according to orthodontic treatment upon satisfaction and recommendation with orthodontic treatment, targeting patients with completion of orthodontics who have experience of having received orthodontic treatment. As a result of SAS ver. 9.1 analysis on what was surveyed from February 2010 to August, the following conclusions were obtained. In comparing perception of treatment on orthodontic treatment according to general characteristics, women compared to men were indicated to be higher (p<0.05) in inconvenience recognition (p<0.05) on orthodontic device and in inconvenience during orthodontic treatment (p<0.05). In perception of treatment on orthodontic treatment, the inconvenience of orthodontic device accounted for 79.3%, thereby having been recognized by the majority of subjects. Even the inconvenience during orthodontic treatment was being recognized by 69.8%. The orthodontic treatment expenses appeared enough to be expected by 61.6%. The frequency of visiting hospital during orthodontic treatment was indicated as saying of having been proper by 72.8%. The period of orthodontic treatment was indicated to be proper as well by 61.2%. Even understanding about treatment contents during orthodontic treatment was indicated to be understood by 62.6%. In the results of correlation among subjects' cooperation with dental treatment, satisfaction with treatment service, recommendation of this clinic, and satisfaction with the convenient facilities, the significantly positive correlation was shown (p<0.05) in all among items in each.

Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

  • Choi, Sang Kyu;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Jee Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.539-544
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    • 2017
  • Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

An Exploratory Research for Development of Design of Sensor-based Smart Clothing - Focused on the Healthcare Clothing Based on Bio-monitoring Technology - (센서 기반형 스마트 의류의 디자인 개발을 위한 탐색적 연구 - 생체 신호 센서 기술에 기반한 건강관리용 의류를 중심으로 -)

  • Cho Ha-Kyung;Lee Joo-Hyeon;Lee Chung-Keun;Lee Myoung-Ho
    • Science of Emotion and Sensibility
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    • v.9 no.2
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    • pp.141-150
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    • 2006
  • Since the late 1990s, 'smart clothing' has been developed in a various way to meet the need of users and to help people more friendly interact with computers through its various designs. Recently, various applications of smart clothing concept have been presented by researchers. Among the various applications, smart clothing with a health care system is most likely to gain the highest demand rate in the market. Among them, smart clothing for check-up of health status with its sensors is expected to sell better than other types of smart clothing on the market. Under this circumstance, research and development for this field have been accelerated furthermore. This research institution has invented biometric sensors suitable for the smart clothing, and has developed a design to diagnose various diseases such as cardiac disorder and respiratory diseases. The newly developed smart clothing in this study looks similar to the previous inventions, but people can feel more comfortable in it with its fabric interaction built in it. When people wear it, the health status of the wearers is diagnosed and its signals are transmitted to the connected computer so the result can be easily monitored in real time. This smart clothing is a new kind of clothing as a supporting system for preventing various cardiac disorder and respiratory diseases using its biometric sensor built-in, and is also an archetype to show how smart clothing can work on the market.

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The Predisposing Factors in Recurrenct Inguinal Hernias in Infants and Children (영아 및 소아에서의 서혜부 탈장의 재발에 관여하는 인자)

  • Doh, Jae-Tae;Kim, Hyun-Young;Choi, Seung-Eun;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.126-132
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    • 2002
  • Inguinal hernia is a major surgical disease in pediatric surgery, occurring in 3.5% to 5% of all mature newborns and 9% to 11% of all premature babies. The objective of this study is to analyze the predisposing factors in association with recurrences of inguinal hernias in infants and children. In the period from January 1995 to September 2001, 1,575 infants and children who had primary inguinal hernias or recurrent inguinal hernias operated on at the Department of Pediatric Surgery at Seoul National University Hospital were evaluated retrospectively. We evaluated the data by medical records and by telephone interview. The sex, age, location of hernia, comorbidity, prematurity, incarceration, interval to operation after incarceration, postoperative complications were analyzed as predisposing factors in associated with hernia recurrence. Operative findings of recurrent inguinal hernia were reviewed. The data were statistically analyzed with Pearson Chi-Square test and Fisher-exact test. A total of eighteen (1.14%) out of 1,575 patients underwent an operation due to recurrent inguinal hernia. In 5 (27.8%) out of 18 recurred patients, institution of the primary herniorrhaphy was our hospital and in the other 13 (72.2%) was outside hospital. No impact on the development of recurrences was seen for sex, age, interval to operation after incarceration, and postoperative complications. The significant predisposing factors of recurrent inguinal hernias were left inguinal hernias (p=0.002), comorbidity (p=0.002), prematurity (p=0.006), incarceration (p=0.017) and technical error of first herniorrhaphy. We expect that knowledge for predisposing factors of recurrent inguinal hernias and experienced skill of pediatric surgeons will decrease recurrence rate in primary inguinal hernia.

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Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

  • Kuru, Pinar;Cakiroglu, Aylin;Er, Aynur;Ozbakir, Hincal;Cinel, Ali Emin;Cangut, Busra;Iris, Merve;Canbaz, Berkay;Picak, Ebru;Yuksel, Mustafa
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.29-34
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    • 2016
  • Background: Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients' family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods: This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution's ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results: The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was $14.52{\pm}0.51years$ and the age at the time of operation was $17.89{\pm}0.42years$; for PC patients, the corresponding ages were $15.23{\pm}0.55years$ and $16.77{\pm}0.55years$, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was $8.17{\pm}0.15$ for PE patients and $8.37{\pm}0.26$ for PC patients. The postoperative pain duration was $51.93{\pm}5.18days$ for PE patients and $38.5{\pm}6.88days$ for PC patients. Conclusion: In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care.