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A Clinical Study on Fiberoptic Bronchoscopy (화이버기관지경검사에 관한 임상적 연구)

  • 홍영호;정해영;민양기;김중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.7.1-7
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    • 1979
  • This paper was attempted to analyze 31 cases of fiberoptic bronchoscopy during the period of 8 months from October 1978 till February 1979 in the Chung-Ang University Hospital. The results were as follows; 1) Among 31 cases. 20 cases were male, 11 cases female. Sex ratio was 2 : 1. 2) In age distribution, 22 cases (70.1%) were in 4th-7th decade, and the other age groups showed relatively even distribution. 3) The chief complaints were hemoptysis (11 cases, 35.5%), coughing (9 cases, 29.0%), chest pain (6 cases, 19.4%), dyspnea (3 cases, 9.7%) and others (2cases, 6.5%). 4) In Gram staining of bronchial secretion, Gram (-) diplococci were in 12 cases (38.7%), Gram (+) cocci 10 cases (32.3%), Gram (+) rods 6 cases (19.4%)and Gram (-) rods 3 cases (9.7%). In culture of bronchial secretion, no growth were in 17 cases (54.8%). Neisseria group 6 cases (19.4%), Proteus and Klebsiella group 1 case (3.2%) and mixed group 3 cases (9.7%). In histopathological study, 11 cases (35.5%) revealed chronic bronchitis, 9 cases (29.0%) bronchogenic carcinoma, 3 cases (9.7%) chronic granulomatous disease and 2 cases (6.5%) no specific findings. In 6 cases biopsy specimens were too small to be examined histopathologically. 5) In diagnosis by bronchoscopic appearance and by laboratory examination of bronchoscopically removed specimens, 9 cases(29.0%) were primary carcinoma of bronchus, 6 cases (19.4%) chronic bronchitis, 4 cases (12.9%) pneumonia in the order of freguency

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A Survey for the Construction of Nursing Theory According to Korean Culture -Traditional View of Human and Expectation of Sick Role- (한국문화에 따른 간호정립을 위한 기초조사연구 I -전통적인 인간관과 환자역할기대를 중심으로-)

  • 박정숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.782-798
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    • 1996
  • This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, 1-test, F-test and Scheffe post hoc contrasts, with the SAS program. The results of this study are summerized as follows : 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important" (3.31), "Think of family more than a individual" (2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45.42) and Seoul (47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke (2.16) and psychosis(2.40), in which case almost no daily general tasks were expected, followed by arthritis 4.06, peptic ulcer 4.79, headache 4.99 and cough 5.58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64), peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban /rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.or over the 61 year old group.

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A Study on Efficacy of Preemptive Analgesia - A Comparison on Efficacy of Preoperative and Postoperative Analgesic Administration - (선행적 진통 요법의 효과성에 대한 연구 -발치 전과 후 진통 요법의 효과 비교-)

  • Jung, Young-Soo;Kim, Moon-Key;Park, Hyung-Sik;Lee, Eui-Wung;Kang, Jeong-Wan
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.10-18
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    • 2003
  • Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, preemptive analgesia is being used as a method to control the postoperative pain. Many studies on its efficacy have been processed in different ways about various drugs, administration methods and times for various operations. And the value of preemptive analgesia are still controversial regarding the results of other clinical studies. The authors performed a clinical study on efficacy of preemptive analgesia using an non-steroidal anti-inflammatory drug (NSAID) for the surgical extraction of impacted third molar teeth and present the more effective pain treatment after oral surgery with literature review. Methods: Using a randomized double blind test design, this study compared the analgesic efficacies of an NSAID, Talniflumate 370 mg. This drug administrated first either 1 hour preoperatively (experimental group) or when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) to respective 30 patients undergoing the removal of impacted third molars. Pain intensity and the time from the end of surgery were assessed postoperatively whenever the patients demanded additional drug over 5 scale for forty eight hours using same verbal rating scales. Results: The sex distribution, the age of the patients. and the time required for surgery in two groups were similar. The average first time for demanding additional drug after surgery was 163.9 minutes in experimental group and 191.5 minutes in control group. At this time, the average pain intensity was 5.8 in experimental group and 6.1 in control group. And the average second time for demanding additional drug was 365.5 minutes in experimental group and 351.8 minutes in control group. At this time. the average pain intensities were 6.6 in experimental group and 6.2 in control group. No statistically significant difference was found between the average first times and second times, and the average pain intensities at first and second times in two groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administrated preoperatively in present practices have weak efficacy of preemptive analgesia for postoperative pain, thus the authors recommend that only postoperative analgesics are adequate without preoperative use of analgesics.

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The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.96-106
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    • 2022
  • Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea (우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인)

  • Suh, Soo-Kyung;Kim, Yoon;Park, Jong-Ik;Lee, Myung-Soo;Jang, Hong-Suk;Lee, Sun-Young;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.416-423
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    • 2009
  • Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

Assessment of the Severity of Coronavirus Disease: Quantitative Computed Tomography Parameters versus Semiquantitative Visual Score

  • Xi Yin;Xiangde Min;Yan Nan;Zhaoyan Feng;Basen Li;Wei Cai;Xiaoqing Xi;Liang Wang
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.998-1006
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    • 2020
  • Objective: To compare the accuracies of quantitative computed tomography (CT) parameters and semiquantitative visual score in evaluating clinical classification of severity of coronavirus disease (COVID-19). Materials and Methods: We retrospectively enrolled 187 patients with COVID-19 treated at Tongji Hospital of Tongji Medical College from February 15, 2020, to February 29, 2020. Demographic data, imaging characteristics, and clinical data were collected, and based on the clinical classification of severity, patients were divided into groups 1 (mild) and 2 (severe/critical). A semiquantitative visual score was used to estimate the lesion extent. A three-dimensional slicer was used to precisely quantify the volume and CT value of the lung and lesions. Correlation coefficients of the quantitative CT parameters, semiquantitative visual score, and clinical classification were calculated using Spearman's correlation. A receiver operating characteristic curve was used to compare the accuracies of quantitative and semi-quantitative methods. Results: There were 59 patients in group 1 and 128 patients in group 2. The mean age and sex distribution of the two groups were not significantly different. The lesions were primarily located in the subpleural area. Compared to group 1, group 2 had larger values for all volume-dependent parameters (p < 0.001). The percentage of lesions had the strongest correlation with disease severity with a correlation coefficient of 0.495. In comparison, the correlation coefficient of semiquantitative score was 0.349. To classify the severity of COVID-19, area under the curve of the percentage of lesions was the highest (0.807; 95% confidence interval, 0.744-0.861: p < 0.001) and that of the quantitative CT parameters was significantly higher than that of the semiquantitative visual score (p = 0.001). Conclusion: The classification accuracy of quantitative CT parameters was significantly superior to that of semiquantitative visual score in terms of evaluating the severity of COVID-19.

10% Pentastarch Versus 5% Albumin Solution for Volume Expansion Following Cariopulmonary Bypass in Patients Undergoing Open Heart Surgery (개심수술후 혈량 증가를 위한 10% Pentastarch와 5% Albumin 용액의 비교연구)

  • 장병철
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.177-186
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    • 1994
  • Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.

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Protective effects of Korean Red Ginseng against sub-acute immobilization stress-induced testicular damage in experimental rats

  • Lee, Sang-Ho;Choi, Kyung-Hwa;Cha, Kyu-Min;Hwang, Seock-Yeon;Park, Un-Kyu;Jeong, Min-Sik;Hong, Jae-Yup;Han, Chang-Kyun;In, Gyo;Kopalli, Spandana Rajendra;Kim, Si-Kwan
    • Journal of Ginseng Research
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    • v.43 no.1
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    • pp.125-134
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    • 2019
  • Background: Excessive stress causes varied physiological and psychological disorders including male reproductive problems. Here, we attempted to investigate the protective effects of Korean Red Ginseng (Panax ginseng Meyer; KRG) against sub-acute immobilization stress-induced testicular damage in experimental rats. Methods: Male rats (age, 4 wk; weight, 60-70 g) were divided into four groups (n = 8 in each group): normal control group, immobilization control group, immobilization group treated with 100 mg/kg of KRG daily, and immobilization group treated with 200 mg/kg of KRG daily. Normal control and immobilization control groups received vehicle only. KRG (100 mg/kg and 200 mg/kg) was mixed in the standard diet powder and fed daily for 6 mo. Parameters such as organ weight, blood chemistry, sperm kinematic values, and expression levels of testicular-related molecules were measured using commercially available kits, Western blotting, and reverse transcription polymerase chain reaction. Results: Data revealed that KRG restored the altered testis and epididymis weight in immobilization stress-induced rats significantly (p < 0.05). Further, KRG ameliorated the altered blood chemistry and sperm kinematic values when compared with the immobilization control group and attenuated the altered expression levels of spermatogenesis-related proteins (nectin-2, cAMP responsive element binding protein 1, and inhibin-${\alpha}$), sex hormone receptors (androgen receptor, luteinizing hormone receptor, and follicle-stimulating hormone receptor), and antioxidant-related enzymes (glutathione S-transferase m5, peroxiredoxin-4, and glutathione peroxidase 4) significantly in the testes of immobilization stress-induced rats. Conclusion: KRG protected immobilization stress-induced testicular damage and fertility factors in rats, thereby indicating its potential in the treatment of stress-related male sterility.

Prediction of Patient Management in COVID-19 Using Deep Learning-Based Fully Automated Extraction of Cardiothoracic CT Metrics and Laboratory Findings

  • Thomas Weikert;Saikiran Rapaka;Sasa Grbic;Thomas Re;Shikha Chaganti;David J. Winkel;Constantin Anastasopoulos;Tilo Niemann;Benedikt J. Wiggli;Jens Bremerich;Raphael Twerenbold;Gregor Sommer;Dorin Comaniciu;Alexander W. Sauter
    • Korean Journal of Radiology
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    • v.22 no.6
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    • pp.994-1004
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    • 2021
  • Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients' needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79-0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77-0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85-0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66-0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.

A Study on the Characteristics of Patients Treated for Dizziness with Jeoreongchajeonja-tang: A Retrospective Analysis of 63 Cases (저령차전자탕을 이용해 현훈을 치료한 환자의 특징 고찰 : 63례의 후향적 분석)

  • Jung, Nu-ri;Kim, Ki-tae;Shin, Seon-mi;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1122-1135
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    • 2019
  • Purpose: The purpose of this study was to conduct a clinical analysis of patients treated for dizziness with Jeoreongchajeonja-tang, evaluate the effect of Jeoreongchajeonja-tang administration, and present indications of Jeoreongchajeonja-tang in dizziness. Methods: A retrospective study was conducted on 63 patients who were admitted to the Oriental Hospital of Se-Myung University from August 2012 to June 2019, complaining of dizziness, so who took Jeoreongchajeonja-tang. Results: 1) As a result of the analysis of the general characteristics of patients who took Jeoreongchajeonja-tang with dizziness, women were 2.7 times more than men. The age distribution was: patients in their 70s, 36.5%; in their 50s, 20.6%; in their 60s, 15.8%; and in their 80s, 12.6%. Patients had a history of hypertension (46.0%), diabetes (22.2%), stroke (17.4%), lung disease (12.6%), and cancer (11.1%). According to the diagnosis, 48 patients (76.1%) were assigned to the peripheral dizziness group, 7 patients (11.1%) to the central dizziness group, and 8 patients (12.6%) to other dizziness groups. 2) Compared with the peripheral dizziness group, the central dizziness group was older, their history of hypertension 8.4 times greater, their history of stroke 7.8 times greater, and the duration of herbal medicine administration was longer. 3) The vertigo grade was significantly decreased after taking Jeoreongchajeonja-tang (p=0.000). 4) As age increased by one year, odds ratio of improvement in the vertigo grade decreased by 0.924 times after taking Jeoreongchajeonja-tang (p=0.010). 5) Sex, disease duration, past history, diagnosis, the duration of herbal medicine administration, whether or not Yanggyuksanhwa-tang was combined with the Jeoreongchajeonja-tang and whether or not Western medicine was used did not affect improvement in the vertigo grade after taking Jeoreongchajeonja-tang. Conclusions: In patients with dizziness, Jeoreongchajeonja-tang can be used as a treatment without side effects.