• Journal of Trauma and Injury
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• v.22 no.1
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• pp.108-115
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• 2009

Purpose: We designed a retrospective study to measure the accuracy of the ICD-10 (International Classification of Disease-10) code for trauma patients. We also analyzed the error of the ICISS (International Classification of Disease based Injury Severity Score) due to a missing or an incorrect ICD-10 code. Methods: For the measuring the accuracy of the ICD-10 code for trauma patients in a tertiary teaching hospital's emergency department, two board certified emergency physician performed a retrospective chart review. The ICD-10 code was classified as a main code or a sub-code. The main code was defined as the code of the main department of treatment, and the sub-code was defined as a code other than the main code. We calculated and compared two ICISS for each patient one by using both the existing code and the other by using a corrected code. We compared the proportions of severe trauma (defined as an ICISS less than 0.9) between when the existing code and the corrected code was used respectively. Results: We reviewed the records of 4287 trauma patients who had been treated from July 2008 to November 2008. The accuracy of the main code, the sub-code of emergency department, main-code, the sub-code of hospitalized patients were 97.1%, 59.8%, 98.2% and 57.0%, respectively. Total accuracy of the main and sub-code of emergency department and of hospitalized patients were 91.4% and 58.6%. The number of severe trauma patients increased from 33 to 49 when the corrected code was used in emergency department and increased from 35 to 60 in hospitalized patients. Conclusion: The accuracy of the sub-code was lower than that of the main code. A missing or incorrect subcode could cause an error in the ICISS and in the number of patients with severe trauma.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.175-182
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• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• Anxiety and mood
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• v.4 no.1
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• pp.55-61
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• 2008

Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.1
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• pp.8-14
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• 2022

Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.55 no.8
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• pp.498-507
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• 2012

Background and Objectives We aimed to develop a Korean version of the velopharyngeal insufficiency (VPI) speech corpus system. Subjects and Method After developing a 3-channel simultaneous speech recording device capable of recording nasal/oral and normal compound speech separately, voice data were collected from VPI patients aged more than 10 years with/without the history of operation or prior speech therapy. This was compared to a control group for which VPI was simulated by using a french-3 nelaton tube inserted via both nostril through nasopharynx and pulling the soft palate anteriorly in varying degrees. The study consisted of three transcriptors: a speech therapist transcribed the voice file into text, a second transcriptor graded speech intelligibility and severity and the third tagged the types and onset times of misarticulation. The database were composed of three main tables regarding (1) speaker's demographics, (2) condition of the recording system and (3) transcripts. All of these were interfaced with the Praat voice analysis program, which enables the user to extract exact transcribed phrases for analysis. Results In the simulated VPI group, the higher the severity of VPI, the higher the nasalance score was obtained. In addition, we could verify the vocal energy that characterizes hypernasality and compensation in nasal/oral and compound sounds spoken by VPI patients as opposed to that characgerizes the normal control group. Conclusion With the Korean version of VPI speech corpus system, patients' common difficulties and speech tendencies in articulation can be objectively evaluated. Comparing these data with those of the normal voice, mispronunciation and dysarticulation of patients with VPI can be corrected.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.152-155
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• 2005

Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

• Research in Community and Public Health Nursing
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• v.10 no.2
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• pp.362-371
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• 1999

This study was conducted to explore the relationship between locus of control and health belief. the life style of gastric cancer patients. The subjects of this study were 40 of the early gastric cancer and 90 of the advanced gastric cancer who first visiting patient to general surgery out patient department of Chungnam University Hospital for operation. The data was collected with structured questionnaire from July. 1998 to Feb. 1999 The tool were Moon's Health Belief Scale and Multiple Locus of Control of Wallston. Wallston, DeVellis. The data was analysed by SAS program using frequency, $X^2$-test, Pearson's correlation coefficient, ANOVA. Scheffe-test, t-test. The results were as follows 1. 30.8% of subjects were early gastric cancer anf 69.2% were advanced gastric cancer. The subject knowing about diagnosis was 83.1%. 16.9% did'nt know about diagnosis. 2. The correlationship between Health belief and Locus of control of subjects was not supported. 3. There was statistically no difference of life style between early and advanced gastric cancer patients. 4. There were statistically significant differences in perceived sensitivity according to weight. educational level. and birth order, in perceived barrier according to educational level. and in perceived severity according to occupation among demographic characteristics of study subjects. From above results. health professional has to educate general population to detect gastric cancer early to improve survival rate because early gastric cancer is high in survival rate, and to prevent recurrence and to maintain continuing healthy status. In the future, gastroscopy also has to expand to detect early. For there was no difference in life style between early and advanced gastric cancer. carcinogen related to diet should be emphasized through education. The perceived benefit among health belief model was not supported in this study therefore further study and comparison between gastric cancer and normal population are needed.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.124-127
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• 2008

Injury to the inferior vena cava (IVC) is associated with a high mortality rate, and little progress has been made for improving the treatment for this since the 1970s. Injury to the retrohepatic IVC, in particular, has been associated with up to a 75% mortality rate due to the difficulty in gaining adequate exposure and controlling the bleeding. Both the severity of injury and anatomic accessibility has been directly correlated with survival in IVC injury. We have experienced a patient with retrohepatic IVC that was ruptured by a penetrating gunshot injury and we managed to save this patient's life.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.939-948
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• 2021

Objectives: This study considered the effectiveness of Korean medicine for the treatment of eyelid edema post craniotomy. Methods: The patient was diagnosed with Taeumin-one of the four constitution types in Korean medicine-and treated with herbal medicines: Cheongsimyeunja-tang, Chungpyesagan-tang, and Hwangryunhaedok-tang pharmacoacupuncture treatment. The severity of eyelid edema was assessed using Kara and Gokalan's scale, daily imaging of the patient's eyelids, and the ratio of the length of the left eye to that of the right. Results: Following treatment, the Kara and Gokalan score decreased from 3 to 0. The changes in the ratios were 29% and 50%, respectively. The visual field defect due to edema in the left eye was also repaired. Conclusion: This study suggests that Korean medical treatment could be an effective option for treating eyelid edema following craniotomy.

• Journal of Veterinary Clinics
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• v.39 no.5
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• pp.240-245
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• 2022

A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.