• Kosin Medical Journal
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• v.33 no.3
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• pp.337-346
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• 2018

Objectives: Serum procalcitonin (PCT) is a specific biomarker that rises after bacterial infection, and levels of PCT are known to correlate with the severity and mortality of patients with pneumonia and sepsis. However, the usefulness of PCT levels in acute pyelonephritis is unknown. This study aimed to evaluate the effectiveness of using the PCT level as a predictive test for bacteremia in acute pyelonephritis. Methods: Between January 2012 and June 2013, 140 patients diagnosed with acute pyelonephritis were admitted to Haeundae Paik Hospital. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) levels at pre- and post- treatment were measured. Blood and urine cultures were obtained from all patients. The levels of PCT, CRP, and WBCs were each compared between the blood culture-positive and blood culture-negative groups to assess their effectiveness in predicting bacteremia. Results: Pre-treatment PCT level was 0.77 ng/mL (95% CI: 0.42-1.60 ng/mL) in the blood culture-negative group and 4.89 ng/mL (95% CI: 2.88-9.04 ng/mL) in the blood culture-positive group, and the increase between the two groups was statistically significant. The area under the receiver operating characteristic curve of PCT level for prediction of bacteremia was 0.728. A cut-off value of 1.23 ng/mL indicated a sensitivity of 79.0 % and specificity of 60.0 % for PCT level. Conclusions: Serum PCT level is a useful predictive test for bacteremia in acute pyelonephritis. Through the early detection of bacteremia, serum PCT level can help estimate the prognosis and predict complications such as sepsis.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.125-134
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• 2021

Purpose: The purposes of this study were to determine the changes in the pattern of patients who were transferred to the emergency room through inter-hospital private institutions and to determine how long transport takes following the COVID-19 outbreak. Methods: This retrospective observational study analyzed the emergency medical services reports of private institutions following the COVID-19 outbreak in South Korea. The study was conducted in Busan between January 19, 2019 and January 18, 2020, and between January 19, 2020 and January 18, 2021. Results: Upon comparing the patient transport times during the "Pre-COVID-19 period" and "COVID-19 period," a significant delay was noticed in the preparation for transfer of patients during the "COVID-19 period" (p<.05). There were significantly more patients with respiratory infections and patients who complained of general symptoms during the "COVID-19 period." Moreover, there was a higher frequency of patients who were transferred to a 'Level I' emergency room during the "COVID-19 period" compared to during the "Pre-COVID-19 period" (p<.05). Conclusion: Following the COVID-19 outbreak, there is a delay in patient transport to the emergency room through private institution inter-hospital transport and an increase in the number of patients complaining of respiratory infection symptoms. Thus, emergency medical services need additional administrative and economic support to transport infected patients.

• The Korean journal of internal medicine
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• v.39 no.4
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• pp.625-639
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• 2024

Background/Aims: Intensive care unit (ICU) quality is largely determined by the mortality rate. Therefore, we aimed to develop and validate a novel prognostic model for predicting mortality in Korean ICUs, using national insurance claims data. Methods: Data were obtained from the health insurance claims database maintained by the Health Insurance Review and Assessment Service of South Korea. From patients who underwent the third ICU adequacy evaluation, 42,489 cases were enrolled and randomly divided into the derivation and validation cohorts. Using the models derived from the derivation cohort, we analyzed whether they accurately predicted death in the validation cohort. The models were verified using data from one general and two tertiary hospitals. Results: Two severity correction models were created from the derivation cohort data, by applying variables selected through statistical analysis, through clinical consensus, and from performing multiple logistic regression analysis. Model 1 included six categorical variables (age, sex, Charlson comorbidity index, ventilator use, hemodialysis or continuous renal replacement therapy, and vasopressor use). Model 2 additionally included presence/absence of ICU specialists and nursing grades. In external validation, the performance of models 1 and 2 for predicting in-hospital and ICU mortality was not inferior to that of pre-existing scoring systems. Conclusions: The novel and simple models could predict in-hospital and ICU mortality and were not inferior compared to the pre-existing scoring systems.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.98-105
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• 2018

Objective: To evaluate whether the increase of the amplitude of motor evoked potentials (MEPs) during surgery can imply favorable prognosis postoperatively in spinal cord tumor surgery. Method: MEPs were monitored in patients who underwent spinal cord tumor surgery between March 2016 and March 2018. Amplitude changes at the end of monitoring compared to the baselines in limb muscle were analyzed. Minimum and maximum changes were set to $MEP_{min}$ (%) and $MEP_{max}$ (%). Strengths of bilateral 10 key muscles which were documented a day before ($Motor_{pre}$), 48 h ($Motor_{48h}$) and 4 weeks ($Motor_{4wk}$) after the surgery were reviewed. Results: Difference of $Motor_{48h}$ from $Motor_{pre}$ ($Motor_{48h-pre}$) and $Motor_{4wk}$ from $Motor_{pre}$ ($Motor_{4wk-pre}$) positively correlated with $MEP_{min}$, suggesting that smaller the difference of MEPs amplitude, less recovery of muscle strength. There was a negative correlation between the amount of bleeding and $MEP_{min}$, indicating that the greater the amount of bleeding, the smaller the $MEP_{min}$, implying that MEPs amplitude is less likely to improve when the amount of bleeding is large. It also showed significant difference between patients with improved or no change of motor status and patients with motor deterioration after surgery according to anatomical tumor types. Conclusion: Improve of muscle strength was less when the increase of MEPs amplitude was small, and improvement of MEPs amplitude was less when the amount of bleeding was large. Correlation between changes of status of muscle strength after surgery and tumor types was observed. With amplitude increase in MEPs monitoring, restoration of muscle strength can be expected.

• Korean Journal of Health Education and Promotion
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• v.11 no.2
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• pp.18-32
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• 1994

The purpose of this study was to analyze the effectiveness of injury prevention education on elementary school students. We are selected two elementary school in Tejeon, one was intervention school, the other was control school. Surveys were completed before the begining of the interventions in February in 1994 and again after their completion in July 1994. Intervention group was 284 students in pre-test and 218 students in post-test. And control group was 253 students in pre-test and 208 students in post-test. The results of this study was followed. 1. In the general characteristics of subjects studied, sex, mother education, father education, economic status, number of household, and traffic environment were not significant difference between intervention and control group(p>0.05). 2. The contents of injury prevention education that subjects wished to learn, were not significant difference between intervention and control group(p>0.05). Also the mothods of that were significant difference between intervention and control group in pre-test(p<0.05) but not in post-test(p>0.05). 3. Education in knowledge, attitude and practice of injury prevention was slightly effectiveness. Change in attitude of injury prevention was higher than in knowledge and attitude of that we guess that they require a lot of education in the pedestrian prevention. 4. Reative risk between intervention and control group in injury incidence was 1.53 in hospital-care students, and 1.43 in home-care children. Also relative risk of total injury incidence was 1.38, therefore we knew that injury incidence after education was reduced. 5. In the analysis of injury causes, pedestrain injury was remarkably reduced at hospital-care students in two group. At home-care students, two groups were high proportion in play injury. 6. In the analysis of injury places, intervention group was high proportion at near-the house in pre-test(35.4%) and at school in post-test(36.4%). And control group was high at inside-the house in pre-test(31.5%) and at near-the house in post-test(28.2%).

• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.505-514
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• 2015

Purpose: The purpose of this study was to examine their levels of knowledge of the kidney, self-efficacy, and kidney function in pre-dialysis patients with chronic renal insufficiency. Methods: A total of 142 pre-dialysis patients with chronic renal insufficiency were recruited from a nephrology clinic of a hospital in Korea. Participants' knowledge of the kidney, self-efficacy, and kidney function were measured, and the correlations between these factors were computed. Results: The levels of knowledge of the kidney were moderate, with a mean score of $12.30{\pm}5.35$. Knowledge level was significantly correlated with age, education level, occupation, income, physical symptoms, and information resources (p<.05). The mean score for self-efficacy was $6.06{\pm}2.00$. Self-efficacy was significantly associated with patients' age, education level, occupation, income, cigarette use, and information resources (p<.05). The mean score for kidney function was $35.66{\pm}18.68mL/min/1.73m^2$. Kidney function was significantly correlated with use of medications and drinking behavior (p<.05). Knowledge of the kidney was significantly correlated with self-efficacy (r=.31, p<.001), but not with kidney function. There was a significant correlation between self-efficacy and kidney function (r=.30, p<.001). Multiple regression analysis revealed that self-efficacy and drinking behavior accounted for 11% of the variance in kidney function of pre-dialysis patients with chronic renal insufficiency. Conclusion: Nursing interventions are necessary to increase self-efficacy among pre-dialysis patients with chronic renal insufficiency in order to maintain their kidney function.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.38-46
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• 2003

Since the current tendencies show us the increasing number of cerebral palsy children and the standard longevity, we need to find out more research about the following various problems. Therefore I have tried to figure out the difference of oxygen saturation and heart rate between before ambulation and after. Objects chosen are 17 C.P children on the process of treatment those who were able to walk and 8 normal children in Ah-San hospital, Gang-Nung. They haven't had either any operation or suffered heart disease and I measured their oxygen saturation and heart rate by using pulse-oximeter and are analyzed by SPSS (10.07 version). Results are the followings; 1. There was no difference of oxygen saturation and heart rate between pre-ambulation and post-ambulation of normal and spastic hemiplegia children. 2. There showed the significant statistic difference of oxygen saturation, heart rate between pre-ambulates and post-ambulation of normal and spastic diplegia(p<.05). 3. There was no difference of oxygen saturation, heart rate in C.P between(p>.05), but shows the significant statistic difference in heart rate(p<.05). As I compared the oxygen saturation and heart rate of spastic and normal children on between pre-ambulation and post-ambulation, theres is significant statistic difference on both items (p<.05). However there was no difference of oxygen saturation among hemiplegia, normal and diplegia children while the pulse rate showed the significant difference(p<.05). According to this clinical research, CP children's oxygen saturation and heart rate had no change between pre and post compared to normal children. But there was difference in diplegia. This is why we need to invest time to study these kinds of research about various analysis and comparison of oxygen saturation and heart rate, and furthermore making use of pulse-oxymetry in physical therapy room for the children involved would be beneficial to calculate in accuracy without any discomfort for the patient as well.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.86-94
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• 1996

Coronary angiography should be performed to verify the patency of bypass graft if coronary artery disease is said to be surgically corrected. Rest/stress myocardial SPECT could be used as a noninvasive alternative to prove patency of bypass graft and functional significance of graft patency by showing improvement of rest perfusion and perfusion reserve after operation. We evaluated the outcome of coronary artery bypass graft surgery by comparing rest/dipyridamole-stress myocardial SPECT before and after operation. Myocardial SPECT were performed $19{\pm}23$ days before and $108{\pm}19$ days after operation in 44 patients(M:F=25:19). Segmental perfusion were scored with 0(normal) to 3(defect) independently for each image set of rest and stress. Perfusion scores were compared between pre and postoperative images. Rest/stress images of pre and post-operative SPECT were compared in paired sets. Postoperative change of perfusion was determined as no change, improvement or aggravation for each artery territory. Postoperative outcome of patients were analyzed. Overall, 74%(158 segments) of 215 segments which had perfusion decrease before operation showed improvement. Among 60 artery territories, 37 territories(62%) improved. Among 42 patients with perfusion decrease in preoperative SPECT, 21 patients(47%) improved after operation. Severe persistent defects improved in 43%(6/14). We concluded that bypass surgery improved myocardial perfusion in dipyridamole stress induced or persistent decrease and that rest/stress myocardial SPECT could be used as a guide for which artery should be operated.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.855-860
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• 2014

Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.27-33
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• 1998

Purpose : To improve the therapeutic results of postoperative recurrent disease and inoperable disease of stomach cancer, we used the thermoradiotherapy. We conducted a retrospective analysis of the results and compared the results of hyperthermia before radiotherapy and those of hyperthermia after radiotherapy Materials and Methods : From July 1994 to November 1996, we treated twenty patients with locally advanced stomach cancer and recurrent stomach cancer with thermoradiotherapy. We divided those patients into two groups : hyperthermia before radiotherapy group (PreRT group : 13 Patients) and hyperthermia after radiotherapy group (PostRT group : 7 patients). We performed radiation therapy with the total tumor dose of 3000-5040cGy in a traction of 180-300cGy and 5 fractions per week. Hyperthermia was performed with 8 MHz radiofrequency apparatus. PreRT group patients were treated daily for 30 minutes before the radiation therapy within the interval of ten minutes. And PostRT group patients were treated with 1-2 sessions Per week for 40-60 minutes after the radiation therapy within the interval of 10 minutes. Results : Overall response rate was $33.3\%$. This response rate appeared the same in both groups. Mean survival and 1 rear survival rate were 10.3 months and $16.5\%$. In PreRT group, mean survival and 1 year survival rate were 6.8 months and $9.0\%$, and in PostRT group, mean survival and 1 year survival rate were 7.7 months and $34\%$. There were no statistically significant difference between the prognostic factors and therapeutic results. Conclusion : The thermoradiotherapy was a safe treatment method in advanced and recurrent gastric cancer when compared with other treatment. Because the number of patients we treated was small and the follow up period was short. we were not able to draw any conclusions about the therapeutic efficacy of the sequence of radiation therapy and hyperthermia. Therefore, further clinical trials of thermoradiotherauy for stomach cancer appear to be warranted.