Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.
Lee, Mi Seon;Lee, Rosie;Ko, Cheol Woo;Moon, Jung Eun
Journal of Yeungnam Medical Science
/
v.39
no.1
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pp.46-52
/
2022
Background: The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19. Methods: This single-center study was conducted at Kyungpook National University Children's Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined. Results: HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036). Conclusion: Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.
Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
Tuberculosis and Respiratory Diseases
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v.80
no.2
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pp.169-178
/
2017
Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
Objectives : The purpose of this study was to evaluate the tooth whitening effect of 0.74% and 2.80% hydrogen peroxide toothpastes and safety on tooth and gingival tissue. Methods : Toothpastes containing 0.74% and 2.80% hydrogen peroxide were evaluated. In in-vitro test, some additives (sodium metaphosphate, sodium pyrophosphate and titanium dioxide) were added to the toothpastes. Hydroxyapatite specimens (HAPs) were made and stained using modified Stookey's methods. HAPs were treated for 1 hour at shaking incubator and brushed for 1,000 times as 250 gF with each diluted toothpaste. Before and after color was measured by colorimeter. Using double blind method, 99 Korean with natural maxillary anterior teeth were selected and the initial brightness (baseline) was measured by SHADEEYE-EX. Based on this measurement they were crossly distributed into control group (0% hydrogen peroxide), test 1 (0.74% hydrogen peroxide) and test 2 (2.80% hydrogen peroxide). After 2 weeks, people of each group were provided toothpaste and told to use 3 times a day right after every meal for 3 minutes. The brightness of teeth was measured 3 times for every one month. Results : ${\Delta}L$ was statistically significant among three groups in shaking test. ${\Delta}L$ of two test groups was statistically significant compared with control group but not between each test group in brushing test. After using toothpaste for 3 months, test 1 group and test 2 group were 15.89% and 31.23% more whitened compared with control group respectively (p<0.05). Rate of more whitened person of each test group was 24.2% and 40.5% more than control group respectively (p<0.05). There was no difference in the hypersensitivity during 3 months using toothpastes and no side effect on teeth or gums. Conclusions : Toothpastes containing 0.74% and 2.80% hydrogen peroxide showed tooth whitening effect and both were safe enough to use for tooth whitening.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.10
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pp.490-498
/
2017
The purpose of this study was to investigate how many kindergarten parents use after-school programs and specialization activities and to suggest effective policy improvement plans based on the results. After 693 parents were interviewed by the investigators, the collected data were presented by calculating the percentages, averages, and standard deviations. First of all, the results of after-school are presented. First, about 38.2% of the surveyed parents spent additional expenses to use after - school program, and the average of additional costs was about 62,850 won. When the cost burden and satisfaction were evaluated as 5 points, it was rated as normal. Second, the main reason for participating in the after-school program was both parents were working, followed by the parents' wishes for their children to spend time with their friends. Next, the results for specialization activities at kindergartens are presented. First, the proportion of children using after-school specialization activities was 68.2%, of which 79% were expenditures, the number of activities was 2.69, and the average cost was 83,540 won. Second, the most preferred after-school specialization activity by age group was English, and the most common reason for this was that the children liked to participate. Improvement of the educational contents suggested as the most important thing to improve after-school specialization activities. Lastly, the results showed that after-school specialization activities reduced parents' spending on private education. On the basis of the results, some discussions are presented included the development after-school programs focusing on the different needs of children and parents accordingly.
Parikh, Darshit;Ieso, Paolo De;Garvey, Gail;Thachil, Thanuja;Ramamoorthi, Ramya;Penniment, Michael;Jayaraj, Rama
Asian Pacific Journal of Cancer Prevention
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v.16
no.2
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pp.641-646
/
2015
Breast cancer (BC) is potentially a traumatic stressor which may be associated with negative outcomes, such as post-traumatic stress disorder (PTSD) or positive changes, such as post-traumatic growth (PTG). This study aims to identify the core issues of BC related PTSD, PTG and psychological distress by interrogating the literature in BC survivors. We have also highlighted issues related to the assessment, diagnosis and clinical management of PTSD and PTG. The authors systematically reviewed studies published from 1985 to 2014 pertaining to PTSD, psychological distress and PTG in BC survivors with particular attention paid to incidence rates and causative factors. Multiple studies intimated that women with BC have evidence of PTSD at the initial stages of diagnosis, whereas PTG develops once patients undergo treatment. Early diagnosis and treatment of PTSD/PTG is paramount from literature review but the previously mentioned relationship between PTSD and PTG in BC patients could not be verified. It is evident from the literature that a small percentage of BC patients experience PTSD, while the majority experience PTG after BC diagnosis and treatment. Future research should include prospective studies focusing on high-risk patients, causative factors and the development of psychological interventions.
Objective : The aim of this study is to implement a critical pathway (CP) for patients undergoing lumbar laminectomy or microdiscectomy and describe the results before and after the CP in terms of length of hospital stay and cost. Methods : From March 2008 to February 2009, 61 patients underwent lumbar laminectomy or microdiscectomy due to stenosis or one- or two-level disc herniation in our department and were included in the prepathway group. After development and implementation of the CP in March 2009, 58 patients were applicable for the CP, and these were classified as the postpathway group. Results : The CP, which established a 6-day hospital stay (5 bed-days), was fulfilled by 42 patients (72.4%) in the postpathway group. The mean length of stay was 5.4 days in the postpathway group compared to 6.9 days in the prepathway group, demonstrating a 20% reduction, which was a statistically significant difference ($p{\leq}0.000$). There was a statistically significant reduction in charges for bed and nursing care (p=0.002). Conclusion : Implementation of a CP for lumbar laminectomy or microdiscectomy produced significant decreases in length of hospitalization and charges for bed and nursing care. We believe that this CP reduces the unnecessary use of hospital resources without increasing risk of adverse events.
Purpose: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. Methods: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. Results: The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004). Conclusion: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.
Purpose: The purpose of this study is to examine and evaluate the effects of auricular acupressure on musculoskeletal pain, depression and sleep of the elderly who are institutionalized in long-term care facilities. Methods: The research was conducted in a non-equivalent control group and non-synchronized design with data collected from October to December, 2016. The subjects were from long-term care facilities for the elderly in D city and divided into an experimental group (24 subjects) and a control group (25 subjects). Results: After the intervention, the experimental group showed significant improvement in degree of musculoskeletal pain on time ($x^2=23.89$, p<.001) and degree of depression on time and group ($x^2=37.42$, p<.001, U=122.0, p<001) and degree of sleep on time ($x^2=33.62$, p<.001). Thus, the suggested hypothesis is partially supported. Conclusion: Auricular acupressure therapy is expected to be a practical and efficient nursing intervention for the elderly institutionalized in long-term care facilities.
Purpose: Epilepsy is the most common neurological disorder in childhood. Hospital nurses, who are the first to recognize seizures in epilepsy patients in the ward environment, possess expertise related to epilepsy and play a central role in epilepsy management. The purpose of this study was to develop an algorithm-based education program and to improve nurses' knowledge and self-efficacy related to providing nursing care to children with epilepsy. Methods: The education program consisted of lectures on the definition, cause, classification, diagnosis, treatment, and nursing of epilepsy based on a booklet, as well as practice using an algorithm for nursing interventions when a child experiences a seizure. Twenty-seven nurses working at pediatric neurological wards and a pediatric emergency room participated in the education program. The data were analyzed using descriptive statistics and the paired t-test. Results: Nurses' knowledge and self-efficacy showed a statistically significant improvement after participation in the education program on nursing care for children with epilepsy. Conclusion: The application of this education program for hospital setting is expected to improve nurses' capability to care for children with epilepsy, thereby contributing to a higher quality of nursing.
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