• Title/Summary/Keyword: Medical Examination Result

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Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Health Behavior and Attitude of Residents toward the National Health Promotion Law in Kyungsan City (지역주민과 건강행태와 국민건강증진법에 대한 인식과 태도)

  • 이관희;박재용;한창현;윤석옥
    • Korean Journal of Health Education and Promotion
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    • v.16 no.2
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    • pp.19-40
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    • 1999
  • In order to ascertain the attitudes of residents to their health and the National Health Promotion Law, surveyors interviewed 1,220 subjects, 1% of men and women in Kyungsan city, who were twenty-year-old or more. The major findings are as follows: Men and women were 48.2% and 51.8%, respectively. The recognition rate of enacting and enforcing this law is 59.2% of men and 51.3% of women. With regard to the behavioral attitude to the health in the distinction of sex and age, current smokers are 31.2% of the interviewees, 61.6% of the men and 3.3% of the women. Current drinkers are 35.1%, 59.5% of the men and 12.3% of the women, but on the other hand there is little significance in the distinction of age. The acknowledgement proportion of enacting and enforcing this law is 59.2% of male and 51.3% of female. In terms of the recognition rate of the contents according to the general characteristics of interviewees, it appears that the indication of a warning expression on a packing paper of cigarette case and a liquor bottle is 92.4% and also the designation of a smoking free area in public facilities is 94.8%. Prohibition of cigarette-sale to the teenagers who are under 19, is 96.0%. Considering these facts, the recognition rate is high. On the contrary, 48.8% is accounted for encouraging a medical check-up before marriage which is in a low position. As a result of multiple behavior as a independent educational level, marital significant variables. In case of having undergone a periodic medical examination the recognition rate was high whereas frequent exercise led to the low recognition rate. Concerning the details of the undertaking in accordance with each factor of general characteristics, the greater part of them have been appraised successfully whether it is recognized or not. On the other side, no effect got answered about the result of the undertaking subjects to general and peculiar behavior attitude towards health was in effect or not. A great majority approved of more reinforcement of legal regulation about smoking and drinking regardless of whether they perceived the details of the law of promotion of National Health Promotion Law or not. Additionally there was significant difference in reinforcing legal regulation of smoking and drinking in compliance with the attitude of the substance of this law. With regard to education, public relations and evaluation about national health through public health centers by our government, the younger and the higher in education they are, the more deficient they feel. First of all, those who were aware of the enforcement of this law as well as plenty of scarcity answered that better service of disease prevention had to be expanded than ever. In consideration of the above-stated results, the education to public health and the business of public relations should be reinforced and a practical campaign for health life should also spread out for the purpose of encouraging to practise healthy life-style.

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The Study on Acute Subacute Toxicity and Anti-cancer Effect of K-herbal-acupuncture (K-약침(藥鍼)의 급성(急性) 아급성(亞急性) 독성실험(毒性實驗) 및 항암효과(항암효과)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Kim, Kwang-Ho;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.76-94
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    • 2003
  • Objectives : The purpose of this study was to investigate Acute$\cdot$Subacute Toxicity and Anti-cancer Effect of K-Herbal-acupuncture in mice and rats. Methods : Balb/c mice were injected intraperitoneally with K-herbal-acupuncture for $LD_{50}$ and acute toxicity test. Sprague-Dawley rats were injected intraperitoneally with K-herbal-acupuncture for subacute toxicity test. K-Herbal-acupuncture was injected on abdomen of mice with S-180 cancer cell line. Result : 1. $LD_{50}$ of K-Herbal-acupuncture was limited $4{\times}10^{-3}$ml/kg~$2{\times}10^{-3}$ml/kg by the test. 2. In acute toxicity test, all of mice were down to the moving reflex, but the weight of mice was increased in treatment group, compared with the normal group. (P<0.05) 3. In acute toxicity test of serum biochemical values of mice, glucose was increased in treatment II group, total cholesterol was increased both treatments.(P<0.05) 4. In subacute toxicity test, the clinical signs of toxication was down to the moving reflex, but it is not severe like acute toxicity test, and observed weight loss at the treatments. 5. In subacute toxicity test, liver weight was decreased compared with the normal group. (P<0.05) 6. In subacute toxicity test of complete blood count test (CBC) of rat, HCT was decreased in treatments, compared with the normal group.(P<0.05) 7. In subacute toxicity test of serum biochemical values of rat, uric acid and triglyceride were decreased, and glucose was increased in treatment groups compared with the control group. (P<0.05) 8. Median survival time was increased about $45\%$ in treatment groups compared with the control group.(P<0.05) 9. Natural killer cell activity was increased in B16F10 lung cancer model, but it was not in sarcoma-180 abdomen cancer. 10. In interleukin-2 productivity test, treatment groups didn't show significant change in lung cancer and abdomen cancer, compared with the normal group.(P<0.005) 11. In making an examination of metastatic cancer with the naked eye, melanoma metastasized in the Lung of C57BL/6 mice. The treated group showed more Melanoma than the control in the numbers and volume. Conclusion : According to the result, K-herbal-acupuncture need further study to know the function and effect in cancer.

Analysis of Endcap Effect for MRI Birdcage RF Coil by FDTD Method (FDTD 방법을 이용한 MRI Birdcage RF Coil의 Endcap 효과 분석)

  • Chung Sung-Taek;Park Bu-Sik;Shin Yoon-Mi;Kwak June-Sik;Cho Jong-Woon;Kim Kyoung-Nam
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.137-143
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    • 2003
  • Purpose : B1 field of birdcage RF (radiofrequency) coil that is used most for brain imaging in magnetic resonance imaging (MRI) decreases toward endring from the coil center. We investigated how much RE B1 homogeneity effect the endcap shield brings form the coil center as it towards to endcap region. Materials and Methods : We compared RF B1 field distribution by each finite difference time domain (EDTD) simulations for lowpass, highpass and hybrid birdcage RF coils. We selected the highpass birdcage RF coil that was the highest RF B1 field condition as simulation result, and studied how much RF B1 homogeneity effect was occurred when endcap shield was applied to endring area. Results : B1 field of the highpass birdcage RF coil was higher than other birdcage RF coil types as simulation result. However, the RF B1 homogeneity was lower than other coil types. RE B1 field of highpass birdcage RF coil with endcap shield is similar with RF B1 field of hybrid birdcage RF coil and the overall RE B1 homogeneity in sagittal direction was better. Conclusion In this paper, proposed method can apply improving RF B1 homogeneity of RF coil in clinical examination.

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Usefulness of "Volumetrix Suite" with SPECT/CT (SPECT/CT 영상에서 Volumetrix Suite의 유용성)

  • Cho, Seung-Wook;Shin, Byeong-Ho;Kim, Jong-Pil;Yoon, Seok-Hwan;Kim, Tae-Yeub;Seung, Yong-Joon;Moon, Il-Sang;Woo, Jae-Ryong;Lee, Ho-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.166-171
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    • 2010
  • Purpose: The SPECT/CT is able to acquire diagnostic information resolved the difficult problems that discriminate regions of focals by intergrating functional images and anatomical images. We introduce the usefulness of "Volumetrix Suite" which can describe 3D images by the convergence of the SPECT/CT images and reference CT images. Materials and Methods: We applied Volumetrix Suite program (Volumetrix IR, Volumetrix 3D) to patients, Bone, Venography, Parathyroid, WBC, taken diagnostic CT examination which have same regions of focal in Seoul Metropolitan Government Seoul National University Boramae Medical Center. After acquiring SPECT/CT images and reference CT images, we fused a couple of scans applying for this programs. The CT scan of Infinia Hawkeye 4 shows limitation of anatomical information. For this reason, we tried to transfer CT images that have lots of diagnostic informations as the form of Dicom file in PACS, and changed from 2D images to 3D images after image registering in Xeleris Workstaion of Hawkeye 4. Results & Conclusion: By using Volumetrix Suite program, we're able to acquire more accurate anatomical informations with 3D rendering which can distinguish both location and range of focals in Infinia Hawkeye 4. Thus, the result of utilizing this program indicate that nuclear medicine anatomical images can be improved by providing more diagnostic imformations produced by its program.

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Recovery Rate and Characteristics of Nontuberculous Mycobacterial Isolates in a University Hospital in Korea (한 대학병원에서 비결핵항산균의 분리 및 동정 실태)

  • Lee, Jung Yeon;Choi, Hee Jin;Lee, Hyeyoung;Joung, Eun Young;Huh, Jin Won;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.385-391
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    • 2005
  • Background : The incidence of nontuberculous mycobacterium (NTM) infections in Korea is increasing. This retrospective study was performed to examine the recovery rate of NTM from respiratory specimens as well as the isolated NTM colony characteristics, and to assess the clinical significance of a NTM isolation. Methods : The results of the respiratory specimens requested for an acid-fast bacilli (AFB) examination during 2002 at Asan Medical Center, along with the patients clinical characteristics were analyzed. Results : A total 26,820 respiratory specimens were requested for the acid-fast bacilli (AFB) smear and culture during the study period. The proportion of M. tuberculosis and NTM isolation was 5.7% and 2.2%, respectively. Among the AFB smear and culture positive specimens, 12.2% were found to be NTM. The scotochromogen showing a low colony count < 20, which appeared to be contaminants, were isolated in 31.8% of the 584 NTM isolates. Excluding the low-colony scotochromogens, the M. avium-intracellulare complex was the most common NTM isolates (42.1%), and was also the most common causative organism for NTM pulmonary diseases. 8.4% (23/275) and 17.8% (49/275) of patients with NTM isolates met the American and British Thoracic Society diagnostic criteria for NTM pulmonary disease, respectively. Conclusion : In case of a positive AFB-smear or culture result, the possibility of NTM being a causative organism should always be considered, even in Korea, which has an intermediate incidence of tuberculosis.

The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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Factors Influencing in the Bone Mineral Density and the Incidence of the Osteoporosis among Male Older than 40 Years Old (40세 이후 남성의 골밀도 관련 요인과 골다공증의 유병률)

  • Mo, Eun-Hee;Cho, Jung-Keun;Lee, Sang-Ho;Lim, Cheong-Hwan;Choi, JI-Won
    • The Journal of the Korea Contents Association
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    • v.8 no.10
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    • pp.241-250
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    • 2008
  • The interest in male osteoporosis is increasing as the incidence of osteoporotic fractures has increased not only in female but also in male due to the increase of old age population thanks to the development of medical science and science in general. Therefore, this study is to find factors related to bone mineral density of male older than 40 years old, to investigate the incidence of the male osteoporosis and to provide a basic result for prevention and medical treatment for the male osteoporosis. The incidence of the osteopenia and the osteoporosis at L-spine was 45% and 12.9% respectively and the incidence of them at femur was 51.9% and 7.63% respectively, among male older than 40 years old who took a medical examination. It was higher than the existing study results conducted to male older than 50 years old in USA and Europe. The incidence of them at both of L-spine and femur showed a significant difference depending the age groups. As the age increases, the average bone mineral density decreases at both of L-spine and femur. And as the weight increases and the body mass index is higher, the incidence of the osteoporosis decreases. There was no significant relation with the incidence of the osteoporosis depending on the exercise, the smoking and the drinking, but the number of exercise, smoking and drinking changes the quantity of bone and are factors influencing the bone mineral density of male person.

An Evaluative Study of a Subsidiary Program in Small Scale Industries (소규모사업장 보건관리지원사업에 대한 평가연구)

  • Lee Myung Sook;Choe Byung Soo;Kim Myung Soon
    • Journal of Korean Public Health Nursing
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    • v.11 no.2
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    • pp.12-37
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    • 1997
  • This study was performed to evaluate the subsidiary program on occupational health services in small scale industries. The survey of occupational health services was undertaken in 346 industries from July 1 to August 31. 1994. The major results were as follows ; 1. The subsidiary program on occupational health services The evaluation of working environments were conducted in 305 industries, $42.3\%$ of the industries had the harzardous agents exeeding TLV. Special medical examinations were done in 310 industries. the results were detected $C(33.3\%).\;D_1(0.8\%), D_2(5.4\%)$. Health management were done in 341 industries, the average visits for a industry were 3.8 times. The activities of health management were included to check of the workplace. health education, health counselling, etc. 2. The recognition of the employees and employers on occupational health services $91.5\%$ of employers and $87.0\%$ of workers felt healthy themselves. But $39.7\%$ of employers and $21.2\%$ of workers were under the stress from their jobs or home affairs. The workers perceived more harmful for the hazardous agents than the employers. $32.8\%$ of employers and $42.9\%$ of workers perceived that employer's efforts were the most important things to protect for the hazardous agents. The result of the evaluation of working environments were understood by $57.3\%$ of employers and $24.5\%$ of workers. The notification of medical examinations were recognized $83.9\%$ of employers and $50.3\%$ of workers. Many employers and workers felt the necessities of health management in small scale industries. The priorities of health manegement were different between employers and workers. Employers' priorities were as follows ; follow up care of medical examination$(97.3\%)$, health counselling$(93.7\%)$, planning of health$(93.5\%)$, health education of occupational diseases$(93.2\%)$, health education of chronic diseases$(93.5\%)$, etc. Workers' priorities were as follows ; follow up care$(93.4\%)$, health counselling$(94.3\%)$, health education of occupational diseases$(93.0\%)$. first aids$(92.0\%)$. etc.

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Amendment of the Inspection Standard for Diagnostic Radiation Equipment Applying IEC 60601-1-3: Medical Electrical Equipment - Part 1-3: General Requirements for Basic Safety and Essential Performance - Collateral Standard: Radiation Protection in Diagnostic X-ray Equipment (KS C IEC60601-1-3: 의료용 전기기기-제1-3부: 기본 안전 및 필수 성능에 관한 일반 요구사항-보조표준: 진단용 X선 장치의 방사선 방어를 적용한 진단용 방사선 발생장치의 검사기준 개선안)

  • Park, Hye-Min;Kim, Jung-Min;Kim, Jung-Su;Kim, Seong-Ok;Choi, Young-Min
    • Journal of radiological science and technology
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    • v.41 no.5
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    • pp.493-504
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    • 2018
  • The diagnostic radiation equipment is managed in accordance with the "Rules for Safety Management of Diagnostic Radiation Equipment" enacted in 1995. The equipments should be inspected before use and every three years after use in accordance with the [Appendix 1] of the same rule. The inspection standard has been maintained without particular revision since enacted. But, over the past two decades new types of equipments have been manufactured and used. So, it is necessary to revise [Appendix 1] by making inspection items and inspection standards. In this study, we revised the classification system of equipments and reviewed international standards of IEC 60601 series, IEC 61223 series and AAPM TG 18 On-line Report No.03. And identified the problem of current inspection standards. Through this, we revised, deleted and added the inspection items and inspection standard of each equipment to meet the domestic circumstances. As a result of the study, we reorganized the classification system of equipment which are current classified as 5 classes into 22 classes as X-ray system etc. (7 classes), CT system etc. (5 classes) and Dental X-ray system etc. (10 classes). And then, we developed 70 inspection items for 6 types of equipments according to the reorganized classification system of equipments. The inspection items and inspection standards derived from this study have been proposed to the KCDC and will be applied to the revision of the Rule's [Appendix 1]. Therefore, we expect to be used as reference materials for domestic medical center, inspection institutions, and equipment manufacturing import companies.