• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• Pediatric Infection and Vaccine
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• v.21 no.1
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• pp.43-52
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• 2014

Purpose: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. Method: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. Results: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. Conclusions: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.

• Journal of Trauma and Injury
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• v.26 no.2
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• pp.47-52
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• 2013

Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.8-16
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• 2018

Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.220-224
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• 1997

Background: The incidence of pain on injection of propofol varies between 30 and 100%. A variety of pretreatments have been tried to alleviate this problem such as a local anesthetics, cooling and opioids. However, none of these pharmacological maneuvers were satisfactory yet. In a recent study, subhypnotic doses of both thiopental sodium and propofol decrease the acute pain. We report a comparison of thiopental sodium, lidocaine and placebo on the incidence and severity of pain on injection of propofol. Method: A controlled, double-blind study was performed to compare the prior administration of intravenous saline 2 ml(n=30, group S), lidocaine 20 mg(n=30, group L) and thiopental sodium 50 mg(n=30, group T) in alleviating the pain by propofol. Injection pain was assessed with the four-point verbal categorical scoring system. Result: The incidence of injection pain during induction was lower in group L(30%) and T(17%) than group S(77%). The incidence of injection pain was lower in group T(17%) than group L(30%), but not significant statistically. The pain scores for recall of pain in the recovery room was simlar to those pain during propofol induction. Conclusion: The pretreatment of thiopental sodium can be effective in reducing both incidence and severity of propofol injection pain and has similar effect to lidocaine to prevent propofol injection pain.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.15 no.1
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• pp.140-150
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• 2002

Introduction: Atopic dermatitis is chronic eczematous dermatosis which is related strongly to a family history of atopic disease and hereditary disposition. Its threshold of itching is low so that severe itching occurs and causes secondary eczema. Adult atopic dermatitis has mostly severe symptoms and progresses to chronic relapsing. Objective: The purpose of this study was to estimate the efficacy of oriental medical treatment and management on chronic adult atopic dermatitis. Subject: We studied 3 patients who visited Dongguk University Gangnam Oriental Hospital Dept. of Dermatol. with chronic adult atopic dermatitis from August 2001 to April 2002 and were observed for over 4 months. Methods: We treated them with herb-medication, acupuncture, negative therapy, aroma therapy, full spectrum visible ray therapy(by carbon arc) and external application(Jaun-go). We used the SCORAD index to assess the severity of atopic dermatitis. Results: There were 3 patients with chronic adult atopic dermatitis we could check for over 4 months by clinical scoring using the SCORAD system. 1. The grades of the severity of atopic dermatitis were lower only by the oriental medical treatments and management. 2. Intensities of relapse cases were lower then before the oriental medical treatments. 3. The secondary treatment term for relapse cases was shorter then the first treatment term after oriental remedies were used. Conclusion: Considering the above results, more study is needed on the chronic relapse cases with adult atopic dermatitis, the factors of increasing seventy of adult atopic dermatitis, the prognostic factors of adult atopic dermatitis, and the clinical interchange of chronic adult atopic dermatitis between oriental medicine and western medicine.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.177-188
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• 2001

Background : Atopic Dermatitis is thought to be a common and chronic relapsing inflammatory skin disease that probably results from allergic reaction. Because it make some serious problems in children, it is needed to treat and at least subside symptoms. Objective : The aim of this study was to evaluate the efficacy of GamiYeoldahansotang(加味熱多寒少湯) for treating Atopic Dermatitis and survey the general characteristics in children with Atopic Dermatitis. Method : Atopic Dermatitis with typical clinical symptoms were included in this study. Forty two patients were treated with hot water extract of GamiYeoldahansotang(加味熱多寒少湯) for four weeks. Clinical evaluation were made by Jacob T scoring system before and after treatment. Total Serum IgE, Eosinophil count were also conducted. Results : Reduction in body surface area was not observed. But significant reductions of severity scores before and after adminstration of GamiYeoldahansotang(加味熱多寒少湯) were observed in all of three groups: mind, moderate, severe. specially severe intensity group was very statistically significant.(p<0.05) Conclusion : We speculate that GamiYeoldahansotang(加味熱多寒少湯) has some therapeutic effects in mitigating the symptoms of Atopic Dermatitis.

• The Korean Journal of Nuclear Medicine
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• v.3 no.1
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• pp.59-67
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• 1969

Correlation between the blood clearance half time and findings of liver scan using the colloidal radiogold in patients of liver cirrhosis is observed through the scoring system, in which the more changes in size, shape and density in the liver scan, the more points are given (table 1). Results: 1) Within the increase in severity of hepatocellular dysfunction in liver cirrhosis, the degree and frequency of following changes in liver scan (done with colloidal radiogold) were increased in order. a) generalized hepatomegaly b) enlargement of the left lobe & reduction of the right lobe c) relatively increased radiodensity in the left lobe and 4) visualization of spleen. 2) Frequency of the normal scan in liver cirrhosis was $12{\pm}3.56%$, frequency of normal value in blood clearance half time of the radiogold was $5.0{\pm}2.34%$ and frequency of normal scan & normal blood clearance rate in liver cirrhosis was $3.6{\pm}2.06%$.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.1
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• pp.219-236
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• 2009

Background : Recently the number of atopic dermatitis patients has increased, but the treatment of atopic dermatitis is not effective, and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. A new standard treatment system is needed. Objective : This study investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : 6 patients were admitted for short term hospitalization program. The program includes Acupuncture, herbal medicine, examination, education, cupping therapy, herbal dressing, exercise and etc. Everyday we evaluated the patients by Severity Scoring Atopic Dermatitis(SCORAD) index and took the photos of lesions, and the patients evaluated themselves by atopic dermatitis diary which consists of emotion, pruritus, sleep loss. Results : Admission duration was 7 to 14 days. The SCORAD scores of them were decreased. Most symptoms of 6 patients were improved. Especially herbal dressing was effective for severe oozing. Subjective scores of atopic dermatitis diary were reduced. Conclusion : We expect that the short term hospitalization program could be helpful for uncontrollable atopic dermatitis patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.56-78
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• 1998

Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.