• Title/Summary/Keyword: Medical therapy

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The Factors Affecting the Use of Empirical Antibiotics in Febrile Infants from 1 Month to Less than 3 Months (30일 이상 90일 미만의 발열 영아에서 경험적 항생제 사용에 영향을 미치는 요소)

  • Byun, Joung-Hee;Song, Bo Kyung;Kim, Young A;Ko, Hoon;Yoo, Suk dong;Lim, Taek Jin;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.91-100
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    • 2018
  • Purpose: This study investigated the factors affecting the use of empirical antibiotics in febrile infants from 1 month to less than 3 months. Methods: We retrospectively reviewed the medical records of hospitalized previously healthy infants with fever in Pusan National University Children's Hospital from January 2010 to December 2016. Clinical features, laboratory findings and antibiotic therapy were analyzed. Respiratory viruses were identified by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) and were reported after 1-3 days. Enterovirus were identified by real time polymerase chain reaction (PCR) and were reported in several hours. Results: The 129 of 366 subjects used empirical antibiotics and 237 patients didn't used empirical antibiotics. Empirical antibiotics were used more frequently when the fever was longer before admission, respiratory symptoms and ill being appearances were present and C-reactive protein was elevated. The rate of readmission was low in the group not used empirical antibiotics. Most of the patients detected by enterovirus PCR in cerebrospinal fluid didn't used empirical antibiotics. The results of respiratory virus multiplex RT-PCR showed no difference in the use of empirical antibiotics. Conclusions: In our study, empirical antibiotic prescriptions were affected not respiratory virus multiplex RT-PCR but enterovirus PCR. If multiplex RT-PCR were reported more rapid turn around time, it will affect antibiotic use.

Fatigue Subjective Symptoms and Risk Factors in Bank Workers with VDT (VDT작업 은행원들의 피로자각증상 조사)

  • Lee, Kyung-Jae;Kim, Joo-Ja
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.45-52
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    • 2005
  • Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

  • Woo, Eun-Kyung;Lee, Jong Wook;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.510-516
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    • 2013
  • Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

The Effects of Cynanchi wilfordii Radix Ethanol Extracts upon Irradiated Rat's Blood and Organ (백하수오 에탄올추출물이 방사선조사에 따른 흰쥐의 혈구 및 장기에 미치는 영향)

  • Kim, Jang-Oh;Choi, Jun-Hyeok;Shin, Ji-Hye;Jung, Do-Young;Min, Byung-In
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.451-459
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    • 2016
  • The development of radioprotector is being actively conducted in order to reduce the damage from over radiation exposure at radiation accident or radiation therapy. So this study was confirmed for radiation protective effects using the Cynanchi wilfordii Radix that has been known to be effective for antioxidant activity, anti-cancer, immune enhancing effects. The method of this study was administered orally Cynanchi wilfordii Radix ethanol extracts to Sprague Dawley Rat(SD Rat) for 14 days once a day, while measuring changed blood cell, spleen index, liver and uterus tissue along the change in time of 1, 4, 7 and 21 days after X-ray beam of 7 Gy irradiation. As the result of the experiment, the experimental group's rats which are administered with Cynanchi Wilfordii Radix ethanol extracts showed a rapid recovery in white blood cell count(p < 0.05) and spleen index(p < 0.05). In addition, condensation of nuclei, cytoplasmic swelling, and inflammatory cell infiltration in experimental group's liver cell was decreased more than in irradiation group's component. Further, experimental group's Uterine gland decreased the apoptosis more than irradiation group's components did. It is expected that Cynanchi Wilfordii Radix extracts will be useful as a new radioprotector. With above in mind, this paper may provide appropriate implications with the field of emergency management such as radiation accident.

Carcinoma of the Uterine Cervix Treated with External Beam Irradiation Alone (자궁경부암의 외부방사선 치료 성적)

  • Kim, Mi-Sook;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.363-367
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    • 1993
  • A retrospective analysis was peformed on 42 patients with carcinoma of the uterine cervix who were treated with external beam (EB) radiation therapy alone at the Department of Therapeutic Radiology, Seoul National University Hospital from March 1979 to December 1988. After whole pelvic field irradiation of 50Gy, all the patients received additional booster dose of 12-22Gy to the primary tumor Thirty one received EB radiotherapy alone because of poor geometry for intracavitary application,5 because of medical problems and 6 because of other reasons. Five year locoregional control rate and five year survival rate were $34.5\%\;and\;35.4\%,$ respectively. Five year survivals were $66.7\%,\;36.4%,\;32.8\%\;and\;25.0\%$ for stage IIA, IIB, IIIB and IVA, respectively. The response one month after treatment well correlated with prognosis. The incidence of grade 2 and 3 complication was $12\%\;and\;10\%,$ respectively. There was tendency of increased complication with advanced stage.

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A Case Report on Panic Disorder Patient Using the 'MRM (Mentalizing the Rooms of Mind)' and Korean Medicine Therapy (한의치료와 '마음의 방 그리기'를 활용한 공황장애 치험 1례 보고)

  • Kim, Jeesu;Cheong, Moon Joo;Lee, Ga-Won;Lyu, Yeoung-Su;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.197-211
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    • 2020
  • Objectives: The purpose of this study was to introduce the progress of treatment and improve clinical use after conducting Mentalizing the Rooms of Mind, the main technique of Mindfulness & Loving Beingness psychotherapy, for a patient with panic disorder. Methods: We conducted a Mentalizing the Rooms of Mind for 10 sessions on an age 23 female diagnosed with panic disorder based on the DSM-5 diagnostic criteria. After receiving consent from the subject, through chart review, the progress of treatment was observed focusing on the MMPI-2 and CSEI-s (The Core Seven Emotions Inventory-short form) conducted pre- and post-treatment. This study was approved by the Institutional Review Board of Wonkwang University Sanbon Hospital (WMCSB202007-55). Results: 1. The MMPI-2 clinical scales of an age 23 female with panic disorder showed a 7 (Pt)-1 (Hs)-3 (Hy) profile pre-treatment, but for post-treatment, the scale showed 1 (Hs)-3 (Hy) profile, and the 7 (Pt) scale showed significant decline. In the MMPI-2 reconstructed clinical scales, RC7 (Dysfunctional Negative Emotions) and RC8 (Aberrant Experiences) showed significant decline. 2. In the pre- and post-treatment MMPI-2 content scales, Anxiety, Fears, Obsessiveness, Social Discomfort, and Work Interference scores decreased, showing overall positive stability. On the MMPI-2 supplementary scales, the Anxiety and Post-Traumatic Stress Disorder scores decreased, and the Ego Strength increased, resulting in improved overall psychological adaptation. 3. Pre- and post-treatment of an age 23 female with panic disorder, CSEI-s showed significant decline of 恐, 驚, 悲, and 思. So it seems that the emotions caused by Chiljeongsang (七情傷) were more stable than before treatment. Conclusions: As shown above, the treatment of panic disorder through Mentalizing the Rooms of Mind, a major technique of Mindfulness & Loving Beingness psychotherapy, showed positive changes in MMPI-2 as well as improvement of the subjective symptoms. Thus, Mentalizing the Rooms of Mind has high clinical use, and it seems that it is necessary to create a manual for this in the future.

Case Report on Dysphagia Related to The Wallenberg's Syndrome Improved by Acupuncture Therapy (침구치료를 통한 Wallenberg's syndrome 환자의 연하장애 치험례)

  • Yun Jone-Min;Park Sae-Wook;Lee Sun-Woo;Son Ji-Woo;Kim Yong-Jeong;Lee Seung-Eon;Cho Chang-Hyun;Cho Yoon-Soong;Lee In;Moon Byung-Soon;Lee Min-Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1701-1705
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    • 2005
  • Dysphagia is Swallowing disorder characterized by difficulty in oral preparation for the swallow or in moving material from the mouth to the stomach. Dysphagia is the one of the most symptom of CVA and predisposes to medical complications such as aspiration pneumonia in poststroke patients. This study was designed to report the clinical effects of acupuncture for dysphagia on a patient with Wallenberg's syndrome. 8 acupoint were used and videofluoroscopic evaluation were performed. According to the above evaluation, 'Oral transit time' decreased within 1.5 sec and 'Coating of pharyngeal wall after swallow' were disappeared. The above results suggest that acupuncture is beneficial for dysphagia.

Effect of Gamiondam-tang (GMODT), a Polyherbal Formula on the Pharmacokinetics Profiles of Tamoxifen in Male SD Rats (2) - Single Oral Combination Treatment of Tamoxifen 50 mg/kg with GMODT 100 mg/kg with 2.5 hr-intervals -

  • Ryu, Eun-A;Kang, Su-Jin;Song, Chang-Hyun;Lee, Bong-Hyo;Choi, Seong-Hun;Han, Chang-Hyun;Lee, Young-Joon;Ku, Sae-Kwang
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.127-137
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    • 2017
  • Objectives : In our previous study, single co-administration GMODT within 5 min significantly inhibited the oral bioavailability of tamoxifen through variable influences on the absorption and excretion of tamoxifen. Therefore, the object of this study was to elucidate the possible effects on the pharmacokinetics of tamoxifen after single oral co-administration of GMODT with 2.5 hr-intervals. Methods : After 50 mg/kg of tamoxifen treatment, GMODT 100 mg/kg was administered with 2.5 hr-intervals. The plasma were collected at 30 min before administration, 30 min, 1, 2, 3, 4, 6, 8 and 24 hrs after end of GMODT treatment, and plasma concentrations of tamoxifen were analyzed using LC-MS/MS methods. PK parameters of tamoxifen (Tmax, Cmax, AUC, $t_{1/2}$ and $MRT_{inf}$) were analysis as compared with tamoxifen single administered rats. Results : Two-half hr-interval co-administration with GMODT induced variable changes on the plasma tamoxifen concentrations as compared with tamoxifen single treated rats, and especially significant (p<0.05) increases of plasma tamoxifen concentrations were demonstrated at 0.5 (199.61%) and 1 hr (101.06%) after end of co-administration with GMODT, and also related significant (p<0.05) decreases of $t_{1/2}$ (-39.54%) and $MRT_{inf}$ (-43.94%) as compared with tamoxifen single formula treated rats, at dosage levels of tamoxifen 50 mg/kg and GMODT 100 mg/kg with 2.5 hr-intervals, in this experiment. Conclusions : According to the results, GMODT critically decreased on the oral bioavailability of tamoxifen through variable influences on the absorption and excretion of tamoxifen. Hence, the co-administration of GMODT and tamoxifen should be avoided in the comprehensive and integrative medicine, combination therapy of tamoxifen with GMODT on the breast cancer.

The 10 Years Experience of Lung Transplantation (폐 이식 수술의 10년 치험)

  • Paik, Hyo-Chae;Hwang, Jung-Joo;Kim, Do-Hyung;Joung, Eun-Kyu;Kim, Hae-Kyoon;Lee, Doo-Yun
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.822-827
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    • 2006
  • Background: Lung transplantation is a definitive therapy for a variety of end stage lung diseases. Since 1996, we have performed thirteen cases of lung transplantation including two retransplantations, and we analyzed the outcomes, complications, and survivals of these patients. Material and Method: We retrospectively analyzed the medical records of thirteen cases from July, 1996 to July, 2005. Result: During the period, 11 patients had undergone 43 lung and heart-lung transplantations, and two patients had retransplantation due to allograft failure. Mean age of recipients were $45.2{\pm}10.7$ years(range, $25{\sim}59$). Early complications were bleeding, reperfusion injury, and infection and late complications were mainly infection and post-transplantation lymphoproliferative disease. Excluding the operative mortality, the mean survival period was 16.5 months($2{\sim}60$ months). Two retransplantations had been performed 2 weeks and 13 months after single lung transplantations. Conclusion: In order to achieve long term survival, early detection of complications and proper treatment in addition to surgical skills are necessary, and these efforts can promote better lung transplantation programs in the near future.

Absorbed Dose Measurement by the MIRD System in the $^{131}I$ Treated Thyroid Cancer Patients (갑상선 암 환자에서 $^{131}I$ 치료시 MIRD Schema에 의한 흡수선량의 평가)

  • Lim, Sang-Moo;Woo, Kwang-Sun;Chung, Wee-Sup;Hong, Sang-Woon;Kim, Jang-Hee;Kim, Ki-Sup
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.54-60
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    • 1995
  • Medical Internal Radiation Dose(MIRD) schema was developed for calculating the absorbed dose from the administered radiopharmaceuticals. With the biological distribution data and the physical properties of the radionuclide we can estimate the absorbed dose by the MIRD schema. For the thyroid cancer patients received $^{131}I$ therapy, the absorbed dose to the bone marrow is the limiting factor to the administered dose, and the duration of admission is deter-mined by the retained activity in the whole body. To monitor the whole body radioactivity, we used Eberline Smart 200 system using ionization chamber as a detector. With the time activity curve of the whole body, total body residence time was obtained. From the ICRP publication 53, the residence times of the source organs, such as kidney, urinary bladder content and stomach, were used to calculate the absorbed doses of the target organs, such as stomach, red marrow, bladder wall and remaineder total body. In 8 thyroid cancer patients with 175 mci of $^{131}I$ administered orally, the mean absorbed dose in the bladder wall was 375.1, in the stomach 285.1, red marrow 25.4 and total body 22.4 rad respectively. For the monitoring of the large administered activity, this method seemed to be quite useful.

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