• Tuberculosis and Respiratory Diseases
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• 제76권2호
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• pp.66-74
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• 2014

Background: The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality. Methods: A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality. Results: A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167). Conclusion: HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

• 대한치과마취과학회지
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• 제8권1호
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• pp.1-9
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• 2008

Common dental procedures (local anesthesia and dental treatment) are potentially stress-inducing in many patients, especially medically compromised patients. The body response to dental stress involves the cardiovascular system (an increase in cardiovascular workload), the respiratory organ and the endocrine system (change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given. This protocol is predicated on the belief that the prevention of or reduction of stress ought to begin before the start of an appointment, continue throughout treatment, and, if indicated, into the postoperative period. The authors used the stress reduction protocol in the care of local anesthesia infected teeth in medically compromised patients. The final prognosis was comfortable without any complications.

• 융합신호처리학회논문지
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• 제20권1호
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• pp.1-8
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• 2019

멀미(Motion Sickness)란 전정기관에서 감지된 움직임과 시각적으로 감지된 움직임이 서로 충돌하는 경우에 발생하는 어지럼증 증상이다. 어지럼증이 발생할 경우 사용자는 메스꺼움 및 구토감, 방향 감각 이상과 피로 등의 증세를 호소한다. 이러한 어지럼증 원인이 다양하여 증상에 대한 감별과 치료가 어려운 질환이다. 특히 어지럼증의 유형 중 시각 정보로 인해 유발되는 어지럼증(Visually Induced Motion Sickness)은 발전하는 VR산업에서 해결해야 할 고질적인 숙제로 남아있다. 이러한 VIMS에 대한 분석은 사용자의 활력 징후 측정 및 특징 분석과 EEG 특성 분석을 통하여 가능하다. 이에 본 논문에서는 EEG 신호를 기반으로 시각 정보로 인해 유발되는 어지럼증(VIMS)의 최소화 방안에 대해 고찰하며, 그와 관련된 연구 동향들을 분석한다.

• Journal of Chest Surgery
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• 제40권1호
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• pp.66-68
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• 2007

외상성 심장 손상은 매우 위중한 의학적인 상황이다. 흉벽의 외상이 없는 경우 심장의 손상은 간과될 수 있다. 저자들은 자동차 추돌사고를 입고 우심방 파열이 발생한 47세 여자 환자를 보고한다. 감속손상으로부터 발생하는 비틀림의 힘은 고정점에서 심장의 파열을 일으킬 수 있다. 심장의 심각한 손상을 의심할 수 있는 가장 흔한 증상은 활력증후의 변화이다. 그러므로 감속손상을 입은 환자에서 흉벽의 외상이 없더라도, 이유가 설명되지 않는 저혈압이 관찰될 때 심장의 손상을 의심하여야겠다.

• Journal of Trauma and Injury
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• 제27권3호
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• pp.84-88
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• 2014

The severity of blunt hepatic injury correlates with internal organ damage. We experienced a patient, who had an extensive crushed liver injury. The patient was a 28-year-old man, who was involved in a traffic accident in which a wheel ran over his right upper abdomen. A grade V severe hepatic laceration was diagnosed with computed tomography. His vital signs were stable, so we could wait for times with conservative management. Bile leakage led to biloma and bile spillage into the peritoneal space. Selective percutaneous drainage was needed to control the several biloma. After four months of conservative management, could the patient was discharged in good condition.

• 동의생리병리학회지
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• 제20권1호
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• pp.224-228
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• 2006

The pattern identification of exterior-interior syndrome and cold-heat syndrome is one of the diagnostic methods using most frequently in Oriental medicine. There was no systematic studies analyzing the characteristics of the 'exterior-interior and cold-heat' between healthy and disease group. In this study, cold-heat pattern, blood pressure, pulse rate, height and weight are recorded from 100 healthy subjects and 196 disease subjects with age ranging from 30 to 59 years. To analyze the differences between healthy and disease group, we used the descriptive statistics. And linear regression function, linear support vector machine and bayesian classifier were used for distinguishing healthy group from disease group. The score of both exterior-heat and interior-cold in healthy group is higher than the score in disease group. This means that if one belongs to the disease group, his(or her) exterior gets cold and his interior gets hot. And also, these result have no relevance to age. But, the attempt to classify healthy group from disease group with a exterior-interior and cold-heat and other vital signs did not have good performance. It mean that even though they have a different trend each other, only these kinds of information couldn't classify healthy group and disease group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.76-81
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• 2016

Carnitine palmitoyltransferase 1A (CPT1A) is an enzyme functioning in mitochondrial fatty acid oxidation (FAO) of the liver. Patients with CPT1A deficiency have impaired mitochondrial FAO and display hypoketotic hypoglycemia and hepatic encephalopathy as typical manifestations. In this report, we present a case of CPT1A deficiency presenting jaundice as the first manifestation. A 1.9 years old boy showed jaundice and elevated levels of free and total carnitine were observed. From direct sequencing analysis of CPT1A, two novel mutations, c.1163+1G>A and c.1393G>A (p.Gly465Arg), were identified. At the age of 2.2 years, hypoglycemia, tachycardia, and altered mental status developed just after cranioplasty for craniosynostosis. High glucose infusion rate was required for recovery of his vital signs and mentality. Diet rich in high carbohydrate, low fat and inclusion of medium chain triglyceride oil resulted in improvement in cholestatic hepatitis and since then the boy has shown normal growth velocity and developmental milestones to date.

• Korean Journal of Acupuncture
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• 제35권2호
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• pp.82-90
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• 2018

Objectives : The purpose of this study is to investigate the effect of acupoint and meridian muscle massage given by automatic massage chair. Methods : We recruited 30 patients with back pain who met inclusion criteria. Two weeks were given as a waiting period, and the massage intervention was applied 12 times for 4 weeks. The programmed automatic massage chair was used to provide effective stimulus on acupoints and meridians for 20 minutes. We used Visual analog scale(VAS) and Korean Oswestry Disability Index(KODI) to quantify pain and function. We also recorded patients' all of vital signs and abnormal reactions during the trial to asses to assess safety. Results : Two participants dropped out due to personal reasons and 28 participants completed the clinical trial. We found that the degree of back pain (VAS, KODI) decreased significantly after the trial. As a result, VAS score decreased from $6.44{\pm}0.85$(Visit 2) to $4.59{\pm}1.52$ (Visit 14)(p<0.001), and KODI score was also reduced from $14.79{\pm}5.13$(Visit 14) to $9.04{\pm}4.52$ (Visit 2) (p<0.001). Also, we did not find any adverse effects in this study. Conclusions : We found that the acupoint and meridian muscle massage can effectively decrease back pain. This proves that the massage program designed by Korean medicine can be a good option to patients with back pain. However, further study with controlled design is still needed to verify its effectiveness.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.113-116
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• 2014

A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

• 대한임상독성학회지
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• 제6권2호
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• pp.130-133
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• 2008

In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1 g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.