• 제목/요약/키워드: Korean Medicine Hospital

검색결과 30,203건 처리시간 0.058초

Clinical Characteristics and Outcomes of the First Episode of Urinary Tract Infection in Neonates and Infants Younger than 2 Months of Age

  • Cheng, Jackie Ying-Wai
    • Childhood Kidney Diseases
    • /
    • 제21권2호
    • /
    • pp.94-100
    • /
    • 2017
  • Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.

CERAD-K의 단어목록기억검사를 통해 알아본 알츠하이머형 치매, 혈관성 치매, 노년기 우울, 정상 집단의 계열위치효과 비교 연구 (Comparison of the Serial Position Effect in Alzheimer's Disease, Vascular Dementia, Elderly Depression, and in Normal Group: Using the CERAD-K's Word List Memory Test)

  • 박정란;이석범
    • 동의신경정신과학회지
    • /
    • 제28권4호
    • /
    • pp.401-408
    • /
    • 2017
  • Objectives: The purpose of this study is to obtain the differential variable and learning effect of the serial position effect, targeting individuals aged 60 years and over. A total of 89 individuals were categorized into the following groups: Alzheimer's group, vascular dementia group, elderly depression group, and normal group. Methods: Considering the size of the groups used for comparison, of the total 89 participants, 28 were in the Alzheimer's group, 24 in the vascular dementia group, 16 in the elderly depression group, and 21 were randomly chosen for the normal group. In the CERAD-K word list memory test, 10 words were shown to the subjects. We then asked them to freely recall the words. After changing the order of the words three times, the same process was followed. Results: First, a significant difference was observed among the groups in terms of word recalling rate. The analysis conducted afterward showed that, as predicted, the depressed group showed significantly better performance in recalling the words. Second, the vascular dementia patients and the Alzheimer's patients showed, as predicted, better recall of the largest recency region of words shown. Third, the normal group and the elderly depressed group showed a high-performance rate, proving that the reiterative method can contribute to the recalling process. Thus, we demonstrated that the Alzheimer's group showed the deterioration of short memory recalling skills and the elderly depressed showed deteriorated output performance skill.

Analysis of Radiological and Clinical Results in Treatment of Open Segmented Tibia Fractures: A Comparison between Intramedullary Nailing and Minimal Invasive Plate Osteosynthesis

  • Kim, Ji Wan;Song, Hyung Keun
    • Journal of Trauma and Injury
    • /
    • 제29권3호
    • /
    • pp.76-81
    • /
    • 2016
  • Purpose: The purpose of this study was to compare the data comprehensively including not only the clinical and radiographic outcomes but some parameters related to operation between the minimally invasive plate osteosynthesis (MIPO) technique and intramedullary nailing (IMN) for treatment of segmental tibia shaft fractures. Methods: We conducted a retrospective study of 31 patients (mean age, 49.3 years, range, 27-74 years), with a mean follow-up of 14.1 months (range, 12-19 months) with acute segmental tibial fractures (AO 42-C2) who underwent either surgical treatment of MIPO or IMN. In accordance with the Gustilo-Anderson classification, 11 were type I, 5 were type II, and 15 were type III. Initial compartment syndrome was confirmed in 2 cases. Results: There were no statistically significant differences in terms of the patient demographic data between the two groups. The time to definitive fixation was longer in the MIPO group (mean $13.7{\pm}10.9days$; range, 2-27) than in the intramedullary group (mean $5.4{\pm}9.6days$; range, 0-35) with statistically significant difference (p=0.002). Bony union was observed in most of cases but except 5 cases of nonunion were diagnosed (3 in the MIPO vs 2 in IMN, p=0.188). The average bone healing time was 27.1 weeks (10 to 56 weeks) in MIPO group and 23.2 weeks (13 to 66 weeks) in IMN group, respectively (p=0.056). Overall complications were 5 cases in MIPO group and 2 cases in the IMN group. Difference in LEFS was not statistically significant between both groups (p=0.824). Conclusion: This study showed that segmental tibia shaft fractures treated with both MIPO and intramadullary nailing was challenging with relatively high complication rate. A well planned sequential strategy with keeping the soft tissue and personality of fracture in mind is utmost significant as much as the choice of surgical modalities.

심에코를 이용한 승모판막이식환자의 예후결정요소에 관한 임상적 고찰 (The echocardiographic analysis of the prognostic factors in mitral valvular replacement)

  • 안재호;서경필
    • Journal of Chest Surgery
    • /
    • 제16권1호
    • /
    • pp.55-64
    • /
    • 1983
  • A hundred and eleven patients of mitral valvular heart disease, who were operated at Seoul National University Hospital, were analysed with echocardiogram before and after operation during the period from November 1979 to February 1982. Twenty-eight patients had mitral stenosis and eighty-three mitral regurgitation. In patients with mitral stenosis, right ventricular end-diastolic volume was in normal range at preoperative and postoperative period. But the left ventricular end-systolic volume was slightly increased preoperatively to 35.4mm and decreased to 33.5mm on immediate postoperative period and 32.5mm after a year later. The left ventricular end-diastolic volume was 50.5mm preoperatively and fell to 46.8mm postoperatively. Ejection fraction was normal preoperatively and postoperatively without changes. Left atrial size fell significantly from 50ram to 37.6mm at the time of late follow-up study. With mitral regurgitation, right ventricular end-diastolic volume was also normal preoperatively and postoperatively. The left ventricular end-systolic volume was increased to 41.9mm and decreased to 31.6mm postoperatively with statistic significance. Left ventricular end-diastolic volume fell from 58.5mm to 45.7mm significantly at the time of late follow-up period. Ejection fraction was also within normal range and had no changes postoperatively. Left atrial size fell from 54.8mm to 45.5mm on a year later [ p value less than 0.01 ]. When atrial fibrillation, the left atrial dimension was increased as 54.9mm compared with 46.8mm of no atrial fibrillation patients.

  • PDF

교정형 대혈관전위증동반된 심혈관기형의 수술요 (Corrected transposition of the great arteries: surgical treatment of associated anomalies)

  • 김기봉;노준량;서경필
    • Journal of Chest Surgery
    • /
    • 제17권3호
    • /
    • pp.371-380
    • /
    • 1984
  • Corrected transposition of the great arteries [C-TGA] is one of the rare congenital heart disease in which there is both a discordant atrioventricular relationship and transposition of the great vessels. With this arrangement, systemic venous blood passes through the right atrium into the morphologic left ventricle and out the pulmonary artery. Pulmonary venous blood returns to the left atrium, flows into the morphologic right ventricle and out the aorta. Thus, in the rare case when no additional cardiac anomaly is present, a hemodynamically normal heart exists. But more often they are symptomatic as a result of one or several of the commonly associated defects. This paper describes 13 patients who underwent repair of one or more cardiac anomalies associated with corrected transposition at SN UH, from June 1976 through June 1984. 1.8 were males and 5 females, with ages ranging from 3 years to 27 years. 2. Segmental anatomy was {S,L,L} in 12, or {I,D,D} in 1. 3.Associated anomalies were ventricular septal defect in 10, pulmonary outflow tract obstruction in 6, tricuspid insufficiency in. 4, atrial septal defect in 3, subaortic stenosis in 1, mitral insufficiency in 1, and patent ductus arteriosus in 1. 4.None had complete heart block preoperatively, and 3 developed complete heart block intraoperatively. But one of them recovered sinus rhythm on the postoperative 7th day spontaneously. 5.There were 3 cases of hospital morality. But there was no morality since Dec. 1980. 6.Patients with single ventricle, hypoplastic ventricle or those who had palliative surgery alone are not included in this review.

  • PDF

선삼 투여가 고에너지 X-선을 조사한 마우스에서 소장움 재생에 미치는 효과 (Effects of Sun Ginseng on the Crypt Cell Survival in Mice Irradiated with High-energy X-ray)

  • 신정섭;박정일;김성호;김현정;김영철
    • Environmental Analysis Health and Toxicology
    • /
    • 제22권1호
    • /
    • pp.73-82
    • /
    • 2007
  • Six week-old ICR mite which were divided into four groups including NC, RC, RR and RS were injected with sun ginseng (RS), red ginseng (RR) and saline (RC) intraperitonedlly as an amount of 60 mg/g body weight at 1 hour, 12 hours and 36 hours before the irradiation of high-energy X-ray and the mire were sacrificed at three and a half days after the irradiation. The RS group were significant increase in the weight of spleen (p<0.01) and the numbers of jejunal crypt cells (P<0.01), WBC (p<0.05), lymphocytes (p<0.05) and neutrophils (p<0.05) in comparison with the RC group. The RR group were significant increase in the numbers of jejunal crypt cells (p<0.001), WBC (p<0.05) and neutrophils (p<0.05) in comparison with the RC group. The RS group exhibited a more increase in the weights of spleen and thymus and the numbers of jejunal crypt cells and all items of hematological examination than the RR group. The values of ALT (alanine transaminase) and AST (aspartate transaminase) were significantly elevated (p<0.05) by radiation and they were significantly decreased (p<0.05) in the RS group to the values of the NC group. Taken together the above results, sun ginseng demonstrated a jejunal crypt survival effect, the protective effects on hepatocytes and immune and hematopoietic cells in mice irradiated with high-energy X-ray, and those radiation protective effects were a little higher in comparison with red ginseng.

주파수 추적 방식에 의한 이식형 의료기기용 무선전력전달 장치 구현 (Implementation of a Transcutaneous Power Transmission System for Implantable Medical Devices by Resonant Frequency Tracking Method)

  • 임형규;이장우;김동욱;이정현;성기웅;김명남;조진호
    • 대한의용생체공학회:의공학회지
    • /
    • 제31권5호
    • /
    • pp.401-406
    • /
    • 2010
  • Recently, many implantable medical devices have been developed and manufactured in many countries. In these devices, generally, energy is supplied by a transcutaneous method to avoid the skin penetration due to the power wires. As the most transcutaneous power transmission methods, the electromagnetic coupling between two coils and resonance at a specific frequency has been used widely. However, in case of a transcutaneous power transmitter with a fixed switching frequency to drive an electromagnetic coil, inefficient power transmission and thermal damage by the undesirable current variation may occur, because the electromagnetic coupling state between a primary coil and a secondary coil is very sensitive to skin thickness of each applied position and by person. In order to overcome these defects, a transcutaneous power transmitter of which operating frequency can be automatically tracked into the resonance frequency at each environment has been designed and implemented. Through the results of experiments for different coil surroundings, we have been demonstrated that the implemented transcutaneous power transmitter can track automatically into a varied resonance frequency according to arbitrary skin thickness change.

항생제에 대한 세균학적 감수성시험방법에 관한 비교실험(Tetracycline, Neomycin 및 Colistin) (A Comparative Experiment on the Methods for Antibiotic Sensitivity Test In Vitro)

  • 박필원;김영자
    • 대한미생물학회지
    • /
    • 제9권1호
    • /
    • pp.25-31
    • /
    • 1974
  • A comparative study was performed with 176 cultures of Salmonella organisms on tetracyline, neomycin and colistin in order to find out the relationship between the results obtained from the Ericsson's single disk method and the tube dilution method of antibiotic sensitivity tests which may be carried out in many hospital laboratories. With tetracycline, thirty-three out of 163 cultures of Salmonella typhi were found to be either sensitive or moderate sensitive by means of the disk method and thirty one(ca 94%) out of the thirty three cultures showed less than 1.0 ${\mu}g$ of the Minimal Inhibitory Concentretions(MIC) in the tube-dilution tests, which mean that there were a quite good agreement between the two methods. With neomycin, a hundred and five out of 163 S.typhi were appeared to be either sensitive or moderate sensitive by means of Ericsson's single disk method, among which 103 cultures showed less than 10.0 ${\mu}g$ MIC in the tubedilution method. And also there was a quite correlative pat. terns observed in the result of testing with 13 salmonella cultures other than S. typhi. With colistin, it was hard to observe any particular tendency in the distribution of plotting for 148 cultures showing less the 18 mm in the inhibiting zone diameters between MIC and disk sensitivity patterns except the fifteen, cultures out of 176 salmonella, which appeared to be sensitive in the single disk method and showed less than 1.0 ${\mu}g$ MIC in the tube dilution method.

  • PDF

무의식 중환자의 비언어적 통증사정 도구의 신뢰도와 타당도 검증 (Reliability and Validity of Nonverbal Pain Assessment Scale for Patients who Stayed a Intensive Care Units)

  • 김정순;강인순;박규현
    • 보건의료산업학회지
    • /
    • 제9권2호
    • /
    • pp.89-102
    • /
    • 2015
  • Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

이화 영아 발달 선별 검사(Ewha Infant Development Screening Test)에 대한 연구 (The Ewha Infant Develomental Screening Test)

  • 이근
    • Clinical and Experimental Pediatrics
    • /
    • 제45권6호
    • /
    • pp.700-711
    • /
    • 2002
  • 대 상: 영아의 발달 장애를 조기에 발견하여 치료를 하기 위하여는 발달 장애의 가능성이 있는 영아뿐 아니라 모든 영아의 정기 검진에서 발달 선별 검사를 시행하는 것이 바람직하다. 본 연구에서는 이러한 발달 선별에 사용할 수 있고 결과를 점수화 할 수 있는 새로운 발달 선별 검사를 개발하고자 하였다. 방 법 : 1개월에서 4세의 아동에 사용할 수 있는 이화 영아 발달 선별 검사를 개발하고 이를 베일리 영아 발달 검사를 기본검사로 하여 동시에 104명의 영아에 시행하였다. 104명 중 건강한 아동은 94명, 발달 지연을 주소로 내원한 아동은 10명이였다. 이화 발달 선별 검사의 가상 합격선을 80, 85, 90점으로 하여 각각의 점수에서 민감도와 특이도, 예측가를 계산하였다. 결 과 : 이화 영아 발달 선별 검사의 합격선을 90점으로 하는 경우 민감도 83.3%, 특이도 93.5%, 예측가 62.5%로 비교적 안정된 결과를 나타내었다. 결 론 : 발달 선별 검사의 결과를 점수화 하는 데에는 문제가 있을 수 있지만 발달을 진단하기 위해서가 아니라 선별하기 위해서 사용한다면 이러한 위험을 피할 수 있을 것이며 앞으로 더 많은 수의 아동을 상대로 검사를 시행하여 보완할 필요가 있을 것이다.