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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.

Factors associated with effectiveness of and rash occurrence by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in patients with non-small cell lung cancer (비소세포폐암 환자에 있어서 Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors의 약효 및 rash 발생과 관련한 인자에 대한 연구)

  • Bae, Na-Rae;Choi, Hye-Jin;Lee, Byung-Koo;Gwak, Hye-Sun
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.75-83
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    • 2008
  • Purpose: Currently lung cancer ranks second in cancer for incidence rate and is a disease that ranks first for a death rate by cancerous growth because it is already advanced at the time of diagnosis. The purpose of this paper was to analyze the factors that affect the effectiveness of and rash occurrence by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR TKI) in patients with non-small cell lung cancer. Methods: A retrospective chart review of 100 patients, who took EGFR TKI (erlotinib, gefitinib) among patients who were diagnosed with non-small cell lung cancer in a Hospital in Korea between May 2005 and February 2008, was conducted. The drug effectiveness was evaluated by Response Evaluation Criteria In Solid Tumor. Results: EGFR mutation was the only factor associated with drug response (complete response and partial response). When stable disease was added to drug response as the evaluation parameter, ECOG and rash as well as EGFR mutation were found to be important factors. Survival, however, was not affected by EGFR mutation. The factors influenced on survival were older age (${\geq}65$), low ECOG ($1{\sim}2$), adenocarcinoma and rash. In the case of rash, group with EGFR mutation or low ECOG showed significantly higher chance of occurrence. There was no significant difference in rash occurrence between gefitinib and erlotinib groups. Conclusions: Based on the results, EGFR mutation positive and low ECOG ($1{\sim}2$) were significantly important factors for both effectiveness of EGFR TKI and rash occurrence. Also, rash itself was found to be an independently significant factor for the disease control and survival. Therefore, while administering EGFR TKI, patients who have the factors associated with rash occurrence should be closely monitored for effective and safe drug therapy.

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A Clinical Report on 39 Urticaria Patients Treated With The Ko-Bang(古方) (고방(古方)으로 치료한 두드러기 환자 39례의 임상보고(臨床報告))

  • Tark, Myoung-Rim;Kim, Mi-Bo;Byun, Seok-Mi;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.22 no.3
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    • pp.196-207
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    • 2009
  • Objectives : This study was designed to investigate the chronical features of urticaria and the effects of urticaria treatment with Ko-Bang(古方). Methods : We treated 39 patients for urticaria with Ko-Bang(古方), who visited to care urticaria at the Dept. of Dermatology Oriental medical hospital Dong-eui university from Jan, 2008 to Sep, 2009. This study was assessed using the chart analysis and the follow-up survey by telephone. Results & Conclusions : 1. 39 outpatients were surveyed, who were 20 males and 19 females. And patients who were ages 21-30 were the largest group, 11(28.21%). Among the 39 patients, acute urticaria patients were 8(20.5%), chronic urticaria patients were 31(79.5%), and contraction of a disease period between 6 weeks with 3 months was 17.9%. 2. The causes of urticaria were measured unknown 37.5%, foods 37.5%, drugs 25% in acute and unknown 35.5%, a change of temperature 29%, foods 16% in chronic. And suspected provocation factors were measured unknown and foods each 12 cases. The most of accompanied symptoms was itching sign(34 cases), the second most was self-conscious fever(10 cases). 3. Out of treat prescription(Ko-Bang,古方), Injinho-Tang(茵蔯蒿湯) was used most in 5 cases, Daehwanghwangryunsasim-Tang(大黃黃連瀉心湯), Hwangryun-Tang(黃連湯), Daesiho-Tang(大柴胡湯) were used in each 4 cases, Galgeun-Tang(葛根湯), Chijadaehwangsi-Tang(梔子大黃豉湯), Sosiho-Tang(小柴胡湯) were used in each 3 cases, Gaemagakban-Tang(桂麻各半湯), Chijasi-Tang(梔子豉湯),Oryeongsan(五笭散) were used in each 2 cases. 4. When the processes of treatment were classified by one poison(一毒), there were the 19 cases (48.7%) which was caused by Bun(煩), the 12 cases(30.8%) by Water(水) and the 4 cases(10.3%) by Gyur(結).

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Driving State of the stroke patients after Cognitive Perceptual Assessment for Driving evaluation at the National Rehabilitation Center (국립재활원에서 운전인지평가를 받은 뇌졸중 환자의 운전 실태조사)

  • Lee, J.A.;Choi, H.;Lee, S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.2
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    • pp.117-124
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    • 2013
  • Objective : To investigate the actual driving state of the stroke patients who had assessed CPAD. Methods : We conducted a follow-up survey with 48 stroke patients who had assessed CPAD. First, we reviewed the medical chart and then carried out the telephone survey. Results : Of the 48 subjects, 12 were driving and 36 were not driving. Current drivers' CPAD score, it was 54.13, was higher than non-drivers' CPAD score(p<0.05). Those who passed the CPAD were driving more than who failed(OR=8.3, 95%CI=1.931-35.558). Conclusion : The pass group of CPAD have higher chance of driving than fail group and have lower chance of car accidence than fail group. Thus we can apply the CPAD for driving cognitive evaluation tests.

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Characteristics of First Visit Pediatric Patients with Suicidal Ideation and Behavior: An 8-Year Retrospective Chart Review

  • Song, Jungeun;Kweon, Yong-Sil;Hong, Sung Hee;Kim, Joonbeom;Chun, Ka Hye;Bahn, Geon Ho;Yook, Ki-Hwan;Shin, Dongwon;Hong, Hyun Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.185-192
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    • 2020
  • Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

Flumazenil administration in suspected patients with acute hypnotics and sedatives poisoning: risk-benefit re-evaluation (급성 진정제 중독 추정 환자에서 플루마제닐의 투여: 위험도/이익 재평가)

  • Huh, Jae Hong;Choi, Sang Chun;Lim, Yong Gyun;Lampotang, Samsun;Park, Eung Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.92-99
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    • 2016
  • Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

A retrospective study of changes in skin cancer characteristics over 11 years

  • Park, Young Ji;Kwon, Gyu Hyeon;Kim, Jun Oh;Kim, Nam Kyun;Ryu, Woo Sang;Lee, Kyung Suk
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.87-91
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    • 2020
  • Background: The incidence of skin cancer, which is primarily caused by exposure to ultraviolet radiation, has steadily increased in recent years. The authors of the present study sought to investigate changes in the epidemiology of skin cancer by conducting a retrospective review of patients diagnosed with skin cancer who received related care at a single medical institution. Methods: The present study included patients who were diagnosed with skin cancer and received treatment at Gyeongsang National University Hospital from 2008 to 2018. The site and type of skin cancer, the number of patients with skin cancer each year, the sex and sex ratio of the patients, and changes in patients' age at first diagnosis were examined through retrospective chart reviews. Results: The number of patients with skin cancer significantly increased, but statistically significant changes were not found in patients' sex, skin cancer sites, or the types of skin cancer. However, patients' age at the first diagnosis of skin cancer showed a statistically significant decrease starting in 2015. Conclusion: In this study, the number of patients with skin cancer increased over time. However, patients' age at first diagnosis has decreased since 2015. Therefore, younger patients should take care to prevent skin cancer, and further research on the causes of skin cancer in younger patients is needed.

Analysis of morbidity, mortality, and risk factors of tracheostomy-related complications in patients with oral and maxillofacial cancer

  • Lee, Seung Tae;Kim, Min Gyun;Jeon, Jae Ho;Jeong, Joo Hee;Min, Seung Ki;Park, Joo Yong;Choi, Sung Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.32.1-32.6
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    • 2016
  • Background: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. Methods: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. Results: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2 % (n = 18) and 0 % (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. Conclusions: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.

Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

  • Kim, Jee-Hwan;Shin, Soo-Yeon;Paek, Janghyun;Lee, Jong-Ho;Kwon, Ho-Beom
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.229-234
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    • 2016
  • PURPOSE. The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS. This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS. Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION. The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required.

Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial

  • Misra, Swati;Lairson, David R.;Chan, Wenyaw;Chang, Yu-Chia;Bartholomew, L. Kay;Greisinger, Anthony;Mcqueen, Amy;Vernon, Sally W.
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.3
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    • pp.101-110
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    • 2011
  • Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.