• Title/Summary/Keyword: days of hospitalization

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A Study of the Factors Affecting the Term of Engraftment During Hematopoietic Stem Cell Transplantation with a Focus on the Inhibitors of Oral Intake and the Period of Nutritional Support (조혈모세포이식 시 조기생착에 영향을 주는 요인 분석 - 경구섭취 저해인자 및 영양지원 시기를 중심으로 -)

  • Kim, Hye-Jin;Noh, Min-Young;Jung, Myeong-Ji;Hong, Jeong-Im;Jung, Yeon-Sun
    • Journal of the Korean Dietetic Association
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    • v.15 no.2
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    • pp.168-178
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    • 2009
  • Hematopoietic stem cell tranntation is being widely used in an attempt to treat many hematological diseases such as leukemia, anemia, and lymphoma. To evaluate the success of hematopoietic stem cell transplantation, it is very important to determine how rapidly engraftment occurs. Therefore, this retrospective study was conducted to determine which factors affected the term of engraftment during hematopoietic stem cell transplantation, while focusing on the oral intake status. To accomplish this, 416 patients who underwent transplant operations at St. Mary's hospital from May 2006 to April 2008 were evaluated. The long-term engraftment group was characterized as having longer fasting days and more frequent vomiting, diarrhea, and oral mucositis incidences than the short-term engraftment group. In addition, the inhibitors of oral intake such as vomiting, diarrhea, and oral mucositis developed frequently between the pre-transplantation and 2 weeks after transplantation. A significantly negative correlation was observed between the oral intake volume and the duration of the oral intake inhibitors. A multiple regression analysis revealed that the frequency of vomiting and oral mucositis during hematopoietic stem cell transplantation, the length of hospitalization, and the hematocrit level in the 2 weeks after hematopoietic stem cell transplantation were significant predictors of engraftment. The results of this study could be used to establish a guideline for nutritional assessment, nutritional goals, and nutritional support for patients during hematopoietic stem cell transplantation.

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A Case Study on Korean Medicine Treatment for Chronic Leukorrhea Diagnosed with Qi Deficiency (기허(氣虛)로 변증된 만성 대하증(Chronic Leukorrhea) 환자의 치험 1례)

  • Park, Kang-In;Pak, Yeon-Kyoung;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Chang-Hoon;Jang, Jun-Bok;Lee, Jin-Moo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.3
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    • pp.107-118
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    • 2015
  • Objectives Chronic leukorrhea is troublesome symptom to many women. It is well known that Korean medicine is safe and effective on chronic leukorrhea. So this study aims to report the clinical effect of Korean medicine on chronic leukorrhea diagnosed with qi deficiency. Methods The patient received herbal medication, acupuncture, moxibustion, cupping therapy, and Gong-jin therapy during hospitalization (about 17 days). Ikkijeseup-tang (IJST) was applied. Results Chronic leukorrhea, lethargy and loss of appetite was effectively reduced after the treatment. Qi deficiency questionnaire score decreased from 90 to 33. Visual Analogue Scale for chronic leukorrhea decreased from 7 to 0. SF-36 score increased from 268 to 323. Conclusions This case shows that Korean medicine is effective on chronic leukorrhea diagnosed with qi deficiency. Further experimental studies and clinical studies are needed.

A Clinical Aspect Analysis of the Cervical Necrotizing Fasciitis (경부에 발생한 괴사성 근막염에 대한 임상적 양상 분석)

  • Yang, Jeong Hwan;Choi, Hyo Geun;Lee, Ju Han;Park, Bumjung
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.223-228
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    • 2018
  • Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

A Case of Late Onset Neonatal Bacteremia and Meningitis Caused by Streptococcus lutetiensis (Streptococcus lutetiensis 에 의한 지발형 신생아 균혈증과 수막염 1례)

  • Kim, Ji Sook;Hong, Yoo Ra;Yang, Hee Yeong;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.219-224
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    • 2014
  • Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.

Role of Neoadjuvant Chemotherapy in the Management of Advanced Ovarian Cancer

  • Zhao, Dan;Wu, Ling-Ying;Wang, Xiao-Bing;Li, Xiao-Guang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2369-2373
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    • 2015
  • Objective: To analyze efficacy of neoadjuvant chemotherapy for advanced ovarian cancer. Materials and Methods: A total of 107 patients with advanced ovarian cancer undergoing cytoreductive surgery were divided into a neoadjuvant chemotherapy group (n=61) and a primary debulking group (n=46) and retrospectively analyzed. Platinum-based adjuvant chemotherapy was applied to both groups after cytoreductive surgery ande overall and progression-free survival times were calculated. Results: No significant difference was observed in duration of hospitalization ($20.8{\pm}6.1$ vs. $20.2{\pm}5.4$ days, p>0.05). The operation time of neoadjuvant chemotherapy group was shorter than the initial surgery group ($3.1{\pm}0.7$ vs. $3.4{\pm}0.8$ h, p<0.05). There were no significant differences in median overall survival time between neoadjuvant chemotherapy group and surgery group (42 vs. 55 months, p>0.05). Similarly, there was no difference in median progression-free survival between neoadjuvant chemotherapy group and surgery group (16 vs. 17 months, p>0.05). The surgical residual tumor size demonstrated no significant difference between initial surgery and neoadjuvant chemotherapy groups (p>0.05). Multivariate analysis showed that more than 3 cycles of regimen with neoadjuvant chemotherapy was associated with more resistance to chemotherapy compared with patients without receiving neoadjuvant chemotherapy (OR: 5.962, 95%CI: 1.184-30.030, p<0.05). Conclusions:Neoadjuvant chemotherapy can shorten the operation time. However, it does not improve survival rates of advanced ovarian cancer patients.

Acute kidney injury in pediatric patients with rhabdomyolysis

  • Lim, Young Shin;Cho, Heeyeon;Lee, Sang Taek;Lee, Yeonhee
    • Clinical and Experimental Pediatrics
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    • v.61 no.3
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    • pp.95-100
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    • 2018
  • Purpose: This study aimed to evaluate the clinical findings in pediatric rhabdomyolysis and the predictive factors for acute kidney injury (AKI) in Korean children. Methods: Medical records of 39 Korean children, who were newly diagnosed with rhabdomyolysis from January 2008 to December 2015, were retrospectively analyzed. The diagnosis was made from the medical history, elevated serum creatinine kinase level >1,000 IU/L, and plasma myoglobin level >150 ng/mL. Patients with muscular dystrophy and myocardial infarction were excluded. Results: The median patient age at diagnosis was 14.0 years (range, 3-18 years), and the male to female ratio was 2.5. The most common presenting symptom was myalgia (n=25, 64.1%), and 14 patients (35.9%) had rhabdomyolysis-induced AKI. Eighteen patients (46.2%) had underlying diseases, such as epilepsy and psychotic disorders. Ten of these patients showed rhabdomyolysis-induced AKI. The common causes of rhabdomyolysis were infection (n=12, 30.7%), exercise (n=9, 23.1%), and trauma (n=8, 20.5%). There was no difference in the distribution of etiology between AKI and non-AKI groups. Five patients in the AKI group showed complete recovery of renal function after stopping renal replacement therapy. The median length of hospitalization was 7.0 days, and no mortality was reported. Compared with the non-AKI group, the AKI group showed higher levels of peak creatinine kinase and myoglobin, without statistical significance. Conclusion: The clinical characteristics of pediatric rhabdomyolysis differ from those observed in adult patients. Children with underlying diseases are more vulnerable to rhabdomyolysis-induced AKI. AKI more likely develops in the presence of a high degree of albuminuria.

The Consequences of Long-period Dosages of Herbal Medicine Including Boo-ja and Cheon-o on Liver Injury.(II) (부자(附子) 및 천오(川烏)를 함유한 처방(處方)이 간기능(肝機能)에 미치는 영향(影響)(II))

  • Song, Su-Jin;Jang, Ja-Won;Hwang, Won-Duk
    • The Journal of Internal Korean Medicine
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    • v.27 no.2
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    • pp.407-415
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    • 2006
  • Objectives: Boo-ja and Cheon-o are not commonly prescribed, but are necessary for some clinical conditions, dispite the fact that some negative effects have been known to occur with these medicines. Hence, consequences for aspartate aminotransferase (AST), alanine aminotransferase(ALT) due to herbal medicines, including boo-ja and cheon-o are here reported. Methods: From January 2005 to July 2005, iresults were analyzed for 40 inpatients belonging to the sixth internal medicine department of Dongeui Oriental Medical Hospital who took herbal medicine, including boo-ja and cheon-o, over 20 days. The study is about the comparison and the investigation of LFT, and all results were taken upon their hospitalization and upon their departure. The standard of liver injury was used as a standard for their examinations. Results : 1. No Change in normal limit . 34 of the 40 2. Increased AST. ALT from when they were hospitalized : 2 of 40 Normalized AST, ALT from when they were hospitalized with results higher than normal : 6 of 40 3. These results show no side-effects, therefore suggest that these herbal medicines, including boo-ja and cheon-o. do not cause adverse side-effectsfor patients of this kind if administered as was done in this study.

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The Study of Dosages of Herbal Medicine Including Aconiti Lateralis Preparata Radix and Aconiti Tuber on Aspartate Aminotransferase, Alanine Aminotransferase (부자(附子) 및 천오(川烏)를 포함한 처방이 혈중 Aspartate Aminotransferase, Alanine Aminotransferase 수치에 미치는 영향)

  • Han, Hyun-Young;Hwang, Won-Duk
    • The Korea Journal of Herbology
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    • v.24 no.4
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    • pp.87-93
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    • 2009
  • Objectives : Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏) are not commonly prescribed, but are necessary for some clinical conditions, despite of the fact that some negative effects have been known to occur with these medicines. This study shows the consequences for aspartate aminotransferase (AST), alanine aminotransferase (ALT) due to herbal medicines, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏). Methods : From 1st June 2007 to 10th May 2009, the results were analyzed for 64 patients belonging to the OO Oriental Medical Hospital who took herbal medicine, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏), more than 20 days. This is the study about the comparison and the investigation of AST, ALT. And the results were taken upon their hospitalization and to their departure. The Criteria of Diagnosis in Liver Injury of CIOMS was used as a standard for their examinations. Results : AST, ALT (total 64). The number of patients who were within normal reference value : 49. The number of patients who exceed the normal reference value after dosage, without satisfying the Criteria of Diagnosis in Liver Injury : 5. The number of patients who were recovered in normal reference value after dosage : 9. The number of patients who satisfying the Criteria of Diagnosis in Liver Injury after dosage : 1. Conclusions : This results suggest that these herbal medicines, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏), didn't cause adverse side-effects on AST, ALT of the patients who are taking them.

Developing Activity Based Clinical Pathway for Patients with Total Hip Replacement (활동기준관리를 적용한 인공고관절 전치환술 Clinical Pathway 개발)

  • Hong, Yoon-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.4
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    • pp.669-689
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    • 2002
  • Purpose : The purpose of the present study is to develop a clinical pathway applied with activity-based management methodology for efficient clinical management to cope with rapid changing medical environments. Method : After making a preliminary pathway based on which a conceptual frame of reference was established to develop a clinical pathway, the final one was confirmed by verifying experts validity and clinical validity. The ultimate activity-based clinical pathway was restructured after clarifying, schematizing and analyzing the whole activities of clinical pathway in accordance with the conducting process of activity-based management. Result : A clinical pathway for total hip replacement was developed, in which the vertical axis consisted of assessment, examination, consultation, medication, treatment, diet, activity, and education, and the horizontal axis was composed of six days of hospitalization. Then, on the basis of the development, the clinical pathway including the improved contents and information was restructured after making the reform measure by analyzing each of activities in the pathway. And the list of contents related to the clinical management activity was made, which was described its main contents and the pre-activities that ought to be completed before conducting each of activities in the pathway. Conclusion : The clinical pathway applied with activity-based management may be used as a standard guidance for providing continuous and consistent patient care. It will provide the information for nursing activities to nurses and the management information about hospital and nursing activities to the hospital administrators. It will also be used as a tool for communication between medical staff. Besides, it will contribute to creating profits for the hospital by shortening the length of stay in patients.

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Breast Feeding Rates and Factors Influencing Breast Feeding Practice in Late Preterm Infants: Comparison with Preterm Born at Less than 34 Weeks of Gestational Age (후기 미숙아의 모유수유 실천 정도와 모유수유 실천 예측 요인: 재태기간 34주 미만 미숙아와의 비교 분석)

  • Jang, Gun-Ja;Lee, Sang-Lak;Kim, Hyeon-Mi
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.181-189
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    • 2012
  • Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.