• 제목/요약/키워드: electronic medical records

검색결과 346건 처리시간 0.022초

Association of Specific Immunoglobulin E to Staphylococcal Enterotoxin with Airway Hyperresponsiveness in Asthma Patients

  • Kim, Seong Han;Yang, Seo Yeon;You, Jihong;Lee, Sang Bae;You, Jin;Chang, Yoon Soo;Kim, Hyung Jung;Ahn, Chul Min;Byun, Min Kwang;Park, Hye Jung;Park, Jung-Won
    • Tuberculosis and Respiratory Diseases
    • /
    • 제79권4호
    • /
    • pp.295-301
    • /
    • 2016
  • Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.

청심연자탕 복용에 따른 생체 징후, 혈액 검사, 기능 검사 결과의 변화 (Changes in Results of Vital Signs, Blood Tests, and Functional Tests after Taking Cheongsimyeonja-tang)

  • 조재현;배고은;서희정;최진용;심소현;한창우;김소연;최준용;박성하;윤영주;이인;권정남;이시우;홍진우
    • 대한한방내과학회지
    • /
    • 제38권6호
    • /
    • pp.971-979
    • /
    • 2017
  • Objectives: The aim of this study was to analyze the effects of Cheongsimyeonja-tang on the human body. Methods: This was a retrospective study, conducted using electronic medical records (EMR). Appropriate clinical cases were identified and databased through EMR. Changes of vital signs, blood tests, and functional tests before and after taking Cheongsimyeonja-tang were determined. Results: There were several significant changes after taking Cheongsimyeonja-tang. Hemoglobin, total blood proteins, and total bilirubin were increased. Eosinophil, aspartate aminotransferase, total cholesterol, and low-density lipoprotein cholesterol were decreased. Conclusions: Cheonseomyeonja-tang had significant effects, including improvement of blood cell count (increase of red blood cells and hemoglobin), improvement of blood lipid level (decrease of total cholesterol and LDL-cholesterol), and blood pressure control (reduction of systolic blood pressure).

Hearing Outcome after Gamma Knife Stereotactic Radiosurgery in Vestibular Schwannoma Patients with Serviceable Hearing

  • Cho, Jae-Hoon;Paek, Sun-Ha;Chung, Hyun-Tai;Jeong, Sang-Soon;Jung, Hee-Won;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
    • /
    • 제40권5호
    • /
    • pp.336-341
    • /
    • 2006
  • Objective : The authors conducted a retrospective study to evaluate the preservation rates of serviceable hearing and to determine its prognostic factors after gamma knife stereotactic radiosurgery[GK SRS] in the patient with vestibular schwannomas. Methods : Between December 1997 and March 2005, 54 patients with a sporadic vestibular schwannoma and serviceable hearing [Gardner Robertson grade I-II] were enrolled in this study. Electronic database of medical records and radiological examinations before and after GK SRS were investigated to the last follow up. The mean marginal dose was $12.3{\pm}0.7Gy$. The mean maximum dose delivered to the tumor center was 24.7Gy [$22{\sim}30Gy$]. The median tumor volume was 2cc [$0.1{\sim}9.1cc$]. The median follow-up period of magnetic resonance[MR] imaging was 31 months [$6{\sim}99\;months$], and the mean follow-up period of audiometry was 24 months [$4{\sim}70\;months$]. Results : The tumor control rate was 100% in the patients with the follow up period more than 2 years. The trigeminal and facial nerve preservation rates were 98% and 100%, respectively. Twenty-eight [52%] of the 54 patients preserved serviceable hearing and 16 [30%] patients retained their pre-GK G-R grade level after GK SRS. In the univariate and multivariate analysis, there was no significant prognostic factor in preservation of the serviceable hearing. Conclusion : The hearing preservation rate is still unsatisfactory compared with the results of other cranial nerve preservation and tumor control in the treatment of vestibular schwannoma by GK SRS. More sophisticated strategy during and after GK SRS is necessary to improve long-term hearing preservation.

경장영양을 시행한 환자에서 영양집중지원에 따른 영양상태 비교 (A comparison of nutritional status by intensive nutritional support in enteral nutrition patients)

  • 김보희;김혜숙;권오란
    • Journal of Nutrition and Health
    • /
    • 제51권2호
    • /
    • pp.132-139
    • /
    • 2018
  • 본 연구는 일반병동에 입원하여 3일 이상 경장영양을 시행한 성인 환자 95명을 대상으로 영양집중지원팀의 중재 효과를 평가하기 위해 영양중재를 받은 중재군과 받지 못한 군으로 분류하여 열량 및 단백질 지원율과 생화학적 지표를 비교 분석 하였다. 연구결과를 통해 환자의 입원초기부터 적절한 영양관리를 계획하고, 영양집중지원팀의 영양중재로 체계적인 관리를 실시하면 환자의 영양상태가 개선되는 것을 확인할 수 있었다. 결론적으로 영양불량 문제가 있는 환자에게 영양집중지원팀의 중재를 받아 문제를 개선할 수 있도록 절차를 마련한다면, 이는 환자의 임상적 치료에 긍정적인 영향을 줄 것으로 생각된다. 본 연구는 국내에서 경장영양을 시행한 일반병동 환자를 대상으로 영양집중 지원팀의 중재 효과에 대한 초기 연구이며, 집중영양치료료 수가 신설 이후 진행된 연구다. 추후 일반병동 환자를 대상으로 영양집중지원팀의 중재효과에 대한 연구가 다양하게 시행된다면 의료진의 관심이 증대 될 것이고, 나아가 영양집중지원팀의 중재를 통해 진료의 질을 높일 수 있을 것이다.

완전탈구 후 재식한 영구 절치의 예후에 대한 후향적 연구 (Prognosis of Replanted Permanent Incisors after Avulsion Injury: A Retrospective Study)

  • 이형섭;김영진;김현정;김소현;남순현
    • 대한소아치과학회지
    • /
    • 제43권3호
    • /
    • pp.254-263
    • /
    • 2016
  • 지금까지 완전탈구된 치아의 예후에 대해 많은 연구가 발표되었으나, 국내의 소아와 청소년을 대상으로 한 추적 조사 연구는 거의 없다. 이에 본 연구에서는 6-14세 환자 142명의 재식치 184개를 대상으로 전자의무기록지와 치근단 방사선 사진을 평가함으로써 재식된 영구 절치의 치유와 예후에 영향을 미치는 인자에 대해 분석하였다. 재식치의 치근 발육 단계가 낮을수록 치수의 재혈관화 가능성이 높았다. 구외 시간이 60분 이상인 경우 염증성 치근 흡수의 발생률은 미성숙 치아에서 높게 나타났으며, 대치성 치근 흡수의 발생률은 성숙 치아에서 높게 나타났다. 20일 이상 경과하여 발수한 경우 염증성 치근 흡수의 발생률이 증가하였으며, 대치성 치근 흡수에 비해 염증성 치근 흡수가 생존 기간의 감소에 더 큰 영향을 미치는 것으로 나타났다. 치근의 발육 단계와 재식치의 생존 기간 간에 상관관계는 없었으나, 대치성 치근 흡수가 발생한 경우 미성숙 치아의 생존 기간은 성숙 치아에 비해 짧았다. 본 연구는 장기간의 추적 조사를 통해 수행한 연구로서, 완전탈구된 치아의 치료 지침과 예후 평가에 대한 기초 자료로 활용될 수 있으리라 생각된다.

Colistimethate 분무요법 시행 환자에서 투여 전후 신기능의 변화 (Changes in Renal Function by Nebulized Colistimethate Treatment)

  • 안혜진;정유진;김재송;김수현;손은선
    • 한국임상약학회지
    • /
    • 제27권2호
    • /
    • pp.92-98
    • /
    • 2017
  • Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment ($SCr_0$ vs. $SCr_1$; $0.85{\pm}0.80$ vs. $1.00{\pm}0.82mg/dL$, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health $system^a$. Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. $^a$ : SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL.

Clinical analysis and review of literature on pilomatrixoma in pediatric patients

  • Hu, Ju Long;Yoo, Hyokyung;Kwon, Sung Tack;Kim, Sukwha;Chung, Jee Hyeok;Kim, Hyeonwoo;Kim, Jinhyun;Yu, Na Hee;Kim, Byung Jun
    • 대한두개안면성형외과학회지
    • /
    • 제21권5호
    • /
    • pp.288-293
    • /
    • 2020
  • Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion: Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.

중증 외상 특성화 센터에서 사망률에 영향을 미치는 인자 분석 (Factors Contributing to Mortality for Patients at a Newly-designated Regional Trauma Center)

  • 장익완;김훈;신희준;전우찬;박준민;신동운;박준석;김경환;박제훈;최승운
    • Journal of Trauma and Injury
    • /
    • 제25권4호
    • /
    • pp.188-195
    • /
    • 2012
  • Purpose: An increase in the demand for specialized Trauma Centers led to a government-driven campaign, that began in 2009. Our hospital was selected as one of the Trauma Centers, and we reviewed data on trauma patients in order to correlate the mortality at a regional Trauma Center with its contributing factors, such as the severity of the injury, the means of arrival, and the time duration before arrival at our center. Methods: Data on the patients who visited our Trauma Center from January 2010 to November 2011 were retrospectively reviewed using electronic medical records. The patients who had revised trauma scores (RTSs) less than 7 or injury severity scores (ISSs) greater than 15 were included. The patients were categorized as survivors and non-survivors, and the means of arrival as transferred or visited directly. Time durations before arrival of less than one hour were also taken intoconsideration. Results: Two hundred(200) patients were enrolled, and the mortality rate was 36.5%. The most common cause of the accident was an automobile accident, and the most common cause of death was brain injury. The RTSs and the ISSs were significantly different in the non-survivor and the survivor groups. The mortality rate of the patients who were transferred was not statistically different from that of patients who visited directly. However, a time duration before arrival of less than one hour was statistically meaningful. Conclusion: The prognosis of the trauma patients were correlated with the severity of the trauma as can be expected, but the time between the incidence of accident and the arrival at hospital and whether the presence of transfer to trauma center were not statistically significant to the prognosis.

소아 환자의 코뼈 골절 진단을 위한 실제적 접근 (Practical Approach to the Diagnosis of Pediatric Nasal Bone Fractures)

  • 이율곡;오성찬;조석진;김혜진;강태경;최승운;유한빈;류석용
    • Journal of Trauma and Injury
    • /
    • 제27권4호
    • /
    • pp.95-100
    • /
    • 2014
  • Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.

Celiac Plexus Neurolysis for the Treatment of Patients with Terminal Cancer at a Tertiary University Hospital in Korea

  • Byeon, Gyeong-Jo;Park, Ju Yeon;Choi, Yun-Mi;Ri, Hyun-Su;Yoon, Ji-Uk;Choi, Eun-Ji
    • Journal of Hospice and Palliative Care
    • /
    • 제23권1호
    • /
    • pp.5-10
    • /
    • 2020
  • Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea. Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed. Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%). Conclusion: CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.