• Title/Summary/Keyword: Severity of illness

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A Design for Evaluation of the Trauma Apportionment in Cerebral Infarction after Trauma

  • Kim, Tae-Hoon;Lee, Kyeong-Seok;Park, Hae-Ran;Shim, Jae-Joon;Yoon, Seok-Mann;Doh, Jae-Won
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.19-22
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    • 2015
  • Objective : Posttraumatic cerebral infarction (CI) is a well-known complication of traumatic brain injury (TBI). However, the causation and apportionment of trauma in patients with CI after TBI is not easy. There is a scoring method, so-called trauma apportionment score (TAS) for CI, consisted with the age, the interval, and the severity of the TBI. We evaluated the reliability of this score. Methods : We selected two typical cases of traumatic CI. We also selected consecutive 50 patients due to spontaneous CI. We calculated TAS in both patients with traumatic and spontaneous CI. To enhance the reliability, we revised TAS (rTAS) adding three more items, such as systemic illness, bad health habits, and doctor's opinion. We also calculated rTAS in the same patients. Results : Even in 50 patients with spontaneous CI, the TAS was 4 in 44 patients, and 5 in 6 patients. TAS could not assess the apportionment of trauma efficiently. We recalculated the rTAS in the same patients. The rTAS was not more than 11 in more than 70% of the spontaneous CI. Compared to TAS, rTAS definitely enhanced the discriminating ability. However, there were still significant overlapping areas. Conclusion : TAS alone is insufficient to differentiate the cause or apportionment of trauma in some obscure cases of CI. Although the rTAS may enhance the reliability, it also should be used with cautions.

A Study on Mental Health Analysis of Atopic Children and Awareness Improvement through Atopic Education (아토피 피부염 환아의 정신 건강 분석 및 아토피 피부염 교육을 통한 인식, 인지도 개선에 대한 고찰)

  • Park, Sung-Gu;Noh, Hyeon-Min;Jo, Eun-Hee;Park, Min-Cheol
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.2
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    • pp.51-85
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    • 2017
  • Objectives : This study aimed to investigate the awareness improvement of atopic dermatitis(AD) for AD children's parents and to evaluate the mental health condition of AD children and QoL of their parents. Methods : We conducted elementary school visit education(the first education) and recruited children and parents who wanted to participate the hospital visit education(the Second education). In the first education, we lectured about AD, performed survey about QoL and awareness about AD and obtained 48 valid results. In the second education, we performed an education for AD again, skin condition evaluation, mental health analysis survey and obtained 29 valid results. We compared the AD and non-AD groups of each education in the first and second education. We assessed atopic awareness, FDLQI, DFI, CDI, BAI, and KISE scores by gender, age, duration of disease, onset, and severity of AD. Results : Despite children with AD, the survey showed their parents lacked knowledge about AD. However, they acquired the necessary knowledge in AD education. There was a significant difference in the total score of Atopic awareness between the AD group in the first education and the AD group in the second education. (p=0.042) In addition, the CDI and BAI scores of all patients were divided by the duration of disease, and it was estimated that depression and anxiety disorders may be aggravated by longer term illness. Conclusions and Discussions : This study confirmed duration of AD affects AD children's mental health, and verified positive changes in atopic awareness after AD education.

Supraventricular Arrhythmias in the Surgical Intensive Care Unit (외과계 중환자실에서 발생한 상심실성 부정맥)

  • Yang, Song-Soo;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.85-90
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    • 2008
  • Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.

Comparative genome characterization of Leptospira interrogans from mild and severe leptospirosis patients

  • Anuntakarun, Songtham;Sawaswong, Vorthon;Jitvaropas, Rungrat;Praianantathavorn, Kesmanee;Poomipak, Witthaya;Suputtamongkol, Yupin;Chirathaworn, Chintana;Payungporn, Sunchai
    • Genomics & Informatics
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    • v.19 no.3
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    • pp.31.1-31.9
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    • 2021
  • Leptospirosis is a zoonotic disease caused by spirochetes from the genus Leptospira. In Thailand, Leptospira interrogans is a major cause of leptospirosis. Leptospirosis patients present with a wide range of clinical manifestations from asymptomatic, mild infections to severe illness involving organ failure. For better understanding the difference between Leptospira isolates causing mild and severe leptospirosis, illumina sequencing was used to sequence genomic DNA in both serotypes. DNA of Leptospira isolated from two patients, one with mild and another with severe symptoms, were included in this study. The paired-end reads were removed adapters and trimmed with Q30 score using Trimmomatic. Trimmed reads were constructed to contigs and scaffolds using SPAdes. Cross-contamination of scaffolds was evaluated by ContEst16s. Prokka tool for bacterial annotation was used to annotate sequences from both Leptospira isolates. Predicted amino acid sequences from Prokka were searched in EggNOG and David gene ontology database to characterize gene ontology. In addition, Leptospira from mild and severe patients, that passed the criteria e-value < 10e-5 from blastP against virulence factor database, were used to analyze with Venn diagram. From this study, we found 13 and 12 genes that were unique in the isolates from mild and severe patients, respectively. The 12 genes in the severe isolate might be virulence factor genes that affect disease severity. However, these genes should be validated in further study.

Unmet Healthcare Needs Status and Trend of Korea in 2016 (2016 미충족의료율과 추이)

  • Jang, Jieun;Yoon, Hyo Jung;Park, Eun-Cheol;Jang, Sung-In
    • Health Policy and Management
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    • v.28 no.1
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    • pp.91-94
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    • 2018
  • Unmet healthcare needs do not end with the phenomenon itself, but lead to possibilities of increased severity of illness. Missed opportunities for treatment at the right timing increase possibilities of complications, and affect prognosis of disease. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007-2016); the Community Health Survey (CHS '2008-2016); the Korea Health Panel Survey (KHP '2011-2014); and the Korean Welfare Panel Study (KOWEPS '2006-2016). The proportion of individual reporting unmet healthcare needs as of 2016 was 8.8% (KNHNES), 11.5% (CHS), and 12.8% (KHP, as of 2014). Annual percentage change which characterizes trend for the follow-up period was -9.9%, -3.1%, and -1.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost was 1.8% (KNHNES), 1.5% (CHS), and 3.0% (KHP). The proportion of households reporting unmet healthcare needs due to cost was 1.0% (KOWEPS). Annual percentage change was -10.0%, -15.2%, -5.4%, and -17.5%, respectively. Low income populations had more unmet healthcare needs than high income populations. Therefore, in order to improve unmet healthcare needs, it is necessary to focus on low income populations.

Efficacy of Lactobacillus fermentum Isolated from the Vagina of a Healthy Woman against Carbapenem-Resistant Klebsiella Infections In Vivo

  • Tajdozian, Hanieh;Seo, Hoonhee;Kim, Sukyung;Rahim, Md Abdur;Lee, Saebim;Song, Ho-Yeon
    • Journal of Microbiology and Biotechnology
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    • v.31 no.10
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    • pp.1383-1392
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    • 2021
  • Carbapenem-resistant Enterobacteriaceae (CRE) that produce Klebsiella pneumoniae carbapenemase are increasingly reported worldwide and have become more and more resistant to nearly all antibiotics during the past decade. The emergence of K. pneumoniae strains with decreased susceptibility to carbapenems, which are used as a last resort treatment option, is a significant threat to hospitalized patients worldwide as K. pneumoniae infection is responsible for a high mortality rate in the elderly and immunodeficient individuals. This study used Lactobacillus fermentum as a candidate probiotic for treating CRE-related infections and investigated its effectiveness. We treated mice with L. fermentum originating from the vaginal fluid of a healthy Korean woman and evaluated the Lactobacilli's efficacy in preventive, treatment, nonestablishment, and colonization mouse model experiments. Compared to the control, pre-treatment with L. fermentum significantly reduced body weight loss in the mouse models, and all mice survived until the end of the study. The oral administration of L. fermentum after carbapenem-resistant Klebsiella (CRK) infection decreased mortality and illness severity during a 2-week observation period and showed that it affects other strains of CRK bacteria. Also, the number of Klebsiella bacteria was decreased to below 5.5 log10 CFU/ml following oral administration of L. fermentum in the colonization model. These findings demonstrate L. fermentum's antibacterial activity and its potential to treat CRE infection in the future.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

A Qualitative Study on the Counseling Practice of Students with Majoring in Addiction (중독연계전공 학생들의 상담실습에 관한 질적 연구)

  • Park, Jong-Hwan
    • The Journal of the Korea Contents Association
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    • v.17 no.8
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    • pp.667-676
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    • 2017
  • The purpose of this study was to examine the experience of practitioners who completed the counseling practice in addiction organizations and to suggest the direction of effective counseling practice for students in interdisciplinary program of addiction majors. For this purpose, we provided the counseling training to two addiction treatment institutions and conducted the interviews with 16 students who participated the counseling practice at the institute and then analyzed the data qualitatively. The results of the study showed that the counseling practitioners experienced fear and prejudice against addicts, prejudice against addicts, change of illness, severity and risk of addiction, career expectation in addiction area, and reality of addiction. Also, the significance of the counseling practice was to give an important lesson in establishing the attitude of self - reflection and the identity of addiction counselor. In the discussion, a systematic management plan of counseling practice in the addiction field was suggested based on the derived topic.

Increased Interlenkin-2 Serum Level in Male Schizophrenic Patients (남자 정신분열증 환자에서 혈청 Interlenkin-2 농도의 증가)

  • Kim, Yong-Ku;Kim, Sa-Jun;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.109-114
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    • 1996
  • We have previously reported that Korean schizophrenic patients hove low production of IL-2 in vitro suggestive of autoimmunity to the pathogenesis of the disorder. In an attempt to further explore this issue, we measured in vivo serum levels of interleukins(IL-$1{\beta}$, IL-2, and IL-6) using a quantitative "sandwich" enzyme immunoassay(ELISA) in 26 male schizophrenic patients and in 26 age-matched normal controls. Patients met DSM-IV criteria for schizophrenia and were drug free for at least six months. The severity of symptoms was assessed by SANS and SAPS. We found a significant increase of IL-2 level(p<0.05) in schizophrenic patients as compared with normal controls. There were significant positive correlations between IL-2, IL-6 levels and negative symptom scores. There were no correlations between age, age at onset, duration of illness and interleukin levels. Our results may support the hypothesis of viral-autoimmune dysfunction in schizophrenia. IL-2 or IL-6 may be associated with specific clinical feature in schizophrenic syndrome, especially negative symptom.

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