• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.347-355
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• 2018

Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.124-128
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• 2016

Purpose: Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of trauma patients; however, the risk factors for contrast-induced nephropathy (CIN) in these patients remain unclear. This study determined the rate of CIN in trauma patients at a regional trauma center in Korea and identified the risk factors for developing CIN. Methods: We retrospectively reviewed the medical records of 138 patients for the patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast. Results: Of the patients, 7.2% developed CIN during their admission after receiving IV contrast for CT. In the multivariate analysis, only the creatinine level at presentation (Adjusted odds ratio [aOR], 5.944; 95% confidence interval [CI], 1.486-23.733; p=0.012) and an injury severity score (ISS) greater than 22 (aOR, 1.096; 95% CI, 1.021-1.176; p=0.011) were independently associated with the risk of CIN. Conclusion: CIN is uncommon in trauma patients following CT with IV contrast. The creatinine level at presentation and ISS were independent risk factors for developing CIN in trauma patients.

• Journal of Preventive Medicine and Public Health
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• 제53권5호
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• pp.381-386
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• 2020

Objectives: Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes. Methods: This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence. Results: A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis. Conclusions: In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient's motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.

• 산업진흥연구
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• 제2권2호
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• pp.15-22
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• 2017

본 연구는 한국폴리텍대학의 입학 홍보방식이 입시 경쟁률에 미치는 영향을 분석하였다. 한국폴리텍대학 신입생 및 재학생을 대상으로 설문지 총 66부를 분석하였다. 연구결과 첫째, 지면홍보(p<.01, ${\beta}=.363$)가 경쟁률에 영향을 미치는 것으로 나타났고, 지면홍보가 경쟁률에 17.3%의 설명력을 나타내고 있어 경쟁률에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 둘째, 지면홍보와 등록률은 .406으로 p<.01 수준의 상관관계가 나타났고, 미디어홍보와 등록률은 .297로 p<.05 수준의 상관관계가 있는 것으로 분석되었다. 셋째, 고등학교계열, 한국폴리텍대학을 알게 된 동기에는 등록률에 유의한 영향을 미치지 않았으나, 입학형태에서는 수시가 정시보다 더 높게 나타나 집단 간 차이가 있는 것으로 나타났다. 본 연구는 한국폴리텍대학의 입학 홍보방식이 입시 경쟁률에 미치는 영향을 분석함으로써 지면홍보, 미디어홍보가 경쟁률과 등록률에 대한 특성 요인의 중요도를 파악하고 특성요인의 효과성을 검증한 데 연구의 의의가 있다.

• 대한응급의학회지
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• 제29권6호
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• pp.679-686
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• 2018

Objective: The aim of this study was to identify the clinical characteristics and risk factors associated with the admission of patients in the emergency department (ED) within 30 days after discharge. Methods: A retrospective, observational study was conducted on adult patients presenting with abdominal pain to the ED of a single, urban, university hospital, between January 2014 and December 2015, who revisited the ED within 30 days after discharge. Data was collected on the emergency severity index level, time to contact doctors, physical examination, laboratory tests, use of computed tomography (CT), and patient disposition on revisitation. The primary outcome was hospital admission following an ED revisit in the 30-day period after the first visit. Results: During the study period, 19,480 patients visited the ED with the chief complaint of abdominal pain, and 13,577 were discharged. A total of 251 patients (1.29%) revisited the ED within 30 days, of which 89 were eligible for the study. The primary outcome was associated with not performing a CT scan on the initial visit and an increased C-reactive protein (CRP) value. Receiver operating characteristic curve analysis showed that a cut-off baseline CRP value of >0.35 mg/dL can predict the primary outcome with a sensitivity and specificity of 75% and 62.1%, respectively (area under the curve, 0.701; 95% confidence interval, 0.569-0.833; P=0.007). Conclusion: An increased CRP value and not performing abdominal CT were associated with a higher rate of admission following ED revisits of patients with abdominal pain. Future prospective studies on the role of abdominal CT imaging in patients presenting to the ED with abdominal pain will be needed.

• Clinical and Experimental Pediatrics
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• 제59권9호
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• pp.368-373
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• 2016

Purpose: This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. Methods: This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis. Results: Among 712 patients, 105 patients (14.7%) were classified in the delayed diagnosis group; 92 patients (12.9%) were diagnosed using ultrasonography (US), and both US and computed tomography were performed in 38 patients (5.3%). More patients in the delayed diagnosis group underwent US (P=0.03). Spring season and prior local clinic visit were significantly associated with a delayed diagnosis. Fever and diarrhea were more common in the delayed diagnosis group (fever: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.05-1.81; diarrhea: OR, 1.94; 95% CI, 1.08-3.46; P<0.05). These patients showed symptoms for a longer duration (OR, 2.59; 95% CI, 1.78-3.78; P<0.05), and the admission course (OR, 1.26; 95% CI, 1.11-1.44; P<0.05) and C-reactive protein (CRP) levels (OR, 1.47; 95% CI, 1.19-1.82; P<0.05) were associated with the delayed diagnosis. Conclusion: To decrease the rate of delayed diagnoses of acute appendicitis, symptoms such as fever and diarrhea, seasonal variations, admission course, and CRP levels should be considered and children with a longer duration of symptoms should be closely monitored.

• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.52-55
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• 2007

목 적 : 고빌리루빈혈증과 황달, 담낭수종 등은 가와사끼병의 일부에서 발생한다. 이 경우에 복통과 식욕부진, 복부팽만 등이 나타나 입원 기간이 길어질 수도 있다. 가와사끼병 급성기의 임상과정에서 고빌리루빈혈증의 관련인자가 있는가를 알아보고자 본 연구를 시행하였다. 방 법 : 1997년 1월부터 2004년 12월까지 만 8년간 원광대학병원 소아과에 입원하여 가와사끼병으로 치료받았던 282명의 환자를 대상으로 후향적으로 조사하였다. 나이와 성별, 발열-입원 기간, 치료-해열 기간, 입원 당시의 백혈구수, 혈소판수, ESR, CRP, AST, ALT치와 무균성 농뇨 등을 정상빌리루빈군(A)(n=269)과 고빌리루빈혈증군(B)(n=13)으로 나누어 비교 분석하였다. 통계처리는 Mann-Whitney test와 Fisher's exact test, logistic 회귀분석으로 하였다. 결 과 : 13 례(4.6%)에서 고빌리루빈혈증을 보였고 B군에서 나이와 ALT치가 높았다(P값 각각 0.003, 0.018). 백혈구 증가증이 있었던 경우와 AST/ALT치가 동시에 상승한 경우에는 고빌리루빈혈증의 발현 빈도가 더 높았다(P값 각각 0.007, 0.042). 짧은 발열-입원 기간과 고연령층이 고빌리루빈혈증에 영향을 주는 요인으로 분석되었다(P값 각각 0.007, 0.003). 반면에 ESR, CRP, 혈소판수, AST, ALT, 무균성 농뇨, 치료-해열 기간 등은 영향을 주지 않았다. 결 론 : 소아기의 가와사끼병에서 짧은 발열-입원 기간과 고연령층 환자군이 고빌리루빈혈증의 발현에 영향을 주는 인자로 분석되었다.

• 대한응급의학회지
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• 제29권5호
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• pp.408-414
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• 2018

Objective: Patients with low acuity who need hospitalization may be at risk if they do not receive proper treatment in overcrowded emergency rooms. This study was conducted to investigate factors affecting the hospitalization of patients with low acuity of Korean Triage and Acuity Scale (KTAS). Methods: This study was a retrospective chart review analysis of patients aged 15 years or older who had triaged as KTAS 4 and 5 grades when visiting a local emergency medical center from January 1, 2016 to December 31, 2017. Multivariate logistic analysis was performed to analyze the effects of age, sex, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission. Results: A total of 10,540 patients were enrolled and the odds ratio (OR) increased with age from those aged over 34 years (P<0.001). Patients that triaged as KTAS grade 5 (adjusted OR, 1.57; 95% confidence interval [CI], 1.36-1.82), had a condition caused by disease (adjusted OR, 2.31; 95% CI, 2.00-2.68), and visited by using an ambulance (public: adjusted OR, 1.05; 95% CI, 0.91-1.22; private: adjusted OR, 4.60; 95% CI, 3.85-5.49) were more likely to be hospitalized. Individuals in the "general" major category were more likely to be hospitalized than those falling into other major categories (P<0.001). Conclusion: The factors influencing the hospitalization of patients with low acuity were age, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission.

• 한국치위생학회지
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• 제13권4호
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• pp.659-668
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• 2013

Objectives : The purpose of this study is to analyze the causes of stress driven by the national examination and to find out correlation between stress factors and students' general characteristics. Methods : Data were collected from self-reported questionnaires by dental hygiene students in D university in February, 2012. Results : Those having good high school GPAs (p<.05) and high preliminary test scores (p<.01) towards dental hygienist (p<.05). National license examination was the most stressful factor for 54.2% of the students. Much more stressful pressure goes to students of non-scheduled admission (p<.01), students who graduated from vocational high schools(p<.01), students with good high school GPAs (p<.05), and having high preliminary test scores(p<.05). Most of the students tended to bear the burden on national written examination with an average of 4.17. The most difficult subject was oral biology introduction (average 4.52). Oral biology introduction was more stressful to students of early admission, students graduating from vocational high schools (p<.05), students with good high school GPAs (p<.05), and students who had relatively low preliminary test scores (p<.001). Conclusions : It is crucial to reduce stress factors and to develop related programs.

• 보건교육건강증진학회지
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• 제25권3호
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• pp.111-124
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• 2008

Objectives: The purpose of this study was to suggest effective methods for not only preventing college students from being exposed to smoking but also helping them stop smoking, by examining and analysing a variety of factors related to their smoking behavior. Methods: To accomplish the purpose, this study was carried out using 1,553 valid questionnaires selected from 1,584 questionnaires completed and returned by 1,800 randomly chosen students of 2 colleges and 3 universities in Gyeongsangbuk-do Province and Daegu City during the period of April 3 through April 21, 2006. Results: It was turned out that while the total smoking rate of whole students was 52.4% in male students and 9.1% in female students, the smoking rate after their admission to the college was 27.1% in males and 1.5% in females. It was also shown that both the perceived susceptibility and barrier factors of Health Belief Model were statistically significant, and that the perceived seriousness factors were entirely significant in all other variables except the body seriousness. The perceived benefit factors were significant in only the variable that there would not be any improvement in academic performance even after stopping smoking. A relation between smoking and stop smoking program or smoking prevention program showed that the non-smoking rate was significantly high among the college students who participated in such programs while in middle school. When variables having a significant effect on smoking students after their admission were analysed, it was shown that the smoking rate was higher among males than females students, and that the more the number of smoking friends is and the more the number of students thinking that stop smoking would make it difficult to release stress and make friends is, the higher the smoking rate is among students. It is required, therefore, to encourage students to continuously participate in more smoking prevention programs from middle school, and to put an emphasis on a variety of smoking-related illnesses and advantages from non-smoking. Conclusions: Since the current smoking rate among college students is relatively high but most of the smoking students surveyed are ready to actually try to stop smoking, it will be possible to significantly reduce the smoking rate among college students if proper methods are suggested to eliminate barrier factors they face while participating in the stop smoking programs.