Nam, Kyoung Hyup;Choi, Hyuk Jin;Lee, Jae Il;Ko, Jun Kyeung;Han, In Ho;Cho, Won Ho
Journal of Trauma and Injury
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v.28
no.1
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pp.9-14
/
2015
Purpose: The aim of this study was to estimate the seropositive prevalence of blood-borne infection in neurotrauma patients who underwent emergent surgical intervention, especially patients with hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and human immunodefIciency virus (HIV). Methods: A retrospective review identified 559 patients with traumatic brain injury and spinal trauma who underwent emergent surgery between 2007 and 2014. We reviewed the medical records and extracted data, including age, sex, location of lesion, result of serologic tests, time interval of admission and surgery after presenting to emergency room. Serologic tests for HBV, HCV, syphilis and HIV were performed and analyzed to determine whether the seropositive results were confirmed by the surgeon before surgery. Results: The majority of the patients were male (74.6%), and the mean age was $55.4{\pm}20.2years$. Most patients underwent surgery due to traumatic brain injury (90.0%). Fifty-three patients (10.0%) showed a positive result on at least one serologic test. Seropositive rates according to pathogens were 0.5% for syphilis, 5.2% for HBV and 3.9% for HCV. No positive results were noted on the serologic tests for HIV. HBV in patients with spinal cord injury and age from 40 to 49 years were associated with high serologic positive rate, and that result was statistically significant. However, no statistically significant differences were found in the other variables. Serologic results could not confirmed before surgery in the majority of the cases (62.1%), and 10.4% of these patients showed seropositive results. Conclusion: The results of this study emphasize the importance of taking precautions and conducting rapid serologic testing in preventing the occupational transmission of blood-borne viruses to health-care workers.
Han, Koon Hee;Jung, Bock Hyun;Kim, Young Don;Hwang, Jung Won;Hong, Hyun Il;Yoon, Sung Kyu;Kim, Mi Hye;Ryu, Dae Sik;Kang, Gil Hyun
Tuberculosis and Respiratory Diseases
/
v.59
no.1
/
pp.109-113
/
2005
Miliary tuberculosis is the most serious form of tuberculous disease, but is rarely complicated with acute respiratory distress syndrome (ARDS). When a patient with miliary tuberculosis initially presents with ARDS, the mortality is much higher. Therefore, the early detection of miliary tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. The diagnosis of miliary tuberculosis may be easy if the patient presents typical clinical manifestations associated with the characteristic pattern of miliary nodules on chest radiology. However, the diagnosis of miliary tuberculosis when complicated with ARDS can be difficult due to the nonspecific radiologic patterns, such as diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. However, these nonspecific patterns are known as less likely findings of miliary tuberculosis. We experienced a pregnant woman with miliary tuberculosis, mimicking ARDS due to bilateral severe pneumonia. She was admitted, via the emergency room, with sudden onset of fever, chill, cough and dyspnea. The initial chest PA and HRCT showed diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. All bacteriological studies, including blood and sputum cultures, tuberculosis-PCR and serologic study for infectious disease were negative. However, the definite diagnosis of unusual miliary tuberculosis as the underlying cause of ARDS was confirmed from the radiological finding and transbronchial fiberoptic lung biopsy. We report this case, with a review of the literature.
Necessity and purpose of this study: In a large number of countries it has been founded that children′s domestic accidents are at great risk year by year In the United States, they publish detailed accident statistics at regular intervals. In Korea. there have been just a few studies on Accidents-At-Home of preschool children. But it can not be said that there have been any systematic statistics about this area. and any study accounting for the relations of home accidents and preschool: children in detail, Therefore, the purpose of this thesis was focused on the inquire of these relations so as to make a little contribution to Korean preschool children′s health and security measures. So, the detail-purposes are to study following questions and to testify following hypothesis. Prob. 1. What the types of accidents of Preschool children, where the place accidents occurred\ulcorner Prob. 2. What the cause of accidents and, the main factors of the cause\ulcorner Prob. 3. How about the number of their children. the disparity of age among their children and mother′s age in each case of accidents\ulcorner hypothesis 1. There will be differences in the density of protection of parents according to the number of their children. hypothesis 2, There will be differences in accident-types and first-aid methods according to parents socio-economic background. Method; This study employed the interviewing survey method, in which 130 preschool children ware random.sampled, who visit hospital to have medical care. These children (from 1 to 6 years olds) were selected at the emergency room of five hospitals in Seoul (Hosp: Severance, Woosok, Medical Center, Hanyang Medical College Hospital and Seoul Medical Col1age Hospital during study-period (from Aug. to Oct, 1973). Four head nurses in above Hospitals were employed as accident members for this study. Concerning research analysis, the method of hypothesis verifying is used. Conclusion: As two American experts on this subject. Dr, Raymond Neuter and Mr. Ross Mc Garland have drawn attention to "minor epidemics of accidents" that could be avoided by fairly simple measures. preschool children′s accidents could be avoided by parents fair attentions. In other words, one of the most common causes of preschool children′s accidents derived from their parent′s inattention. Therefore, one important task on this subject is to instruct the parents fairly about the children′s accidents. Many accidents could be avoided by the exorcist of a little self-discipline. Also, as much the prevention of accidents is important, as the first-aid Is Important and necessary at the case of the accidents. So, the methods of proper first-aid treatment must be emphasized, and must be taught in school, especially in girls school. And there could be other means available for prevention of accidents. Firstly, the public authorities can take legal measures. More stringent safety standards can be made enforceable by law. Building materials and equipment for domestic us: ought to meat minimum safety criteria at all times. Next the public itself has to understand the seriousness of the problem, and here the dissemination of information is of great importance. All mass media should be brought into play to promote greater public awareness of the question. At last, it will be needed to obtain more detailed epidemiological data through additional surveys and statistics after this study.
Journal of agricultural medicine and community health
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v.44
no.4
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pp.195-208
/
2019
Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.
Kim, Young-Jun;Kim, Tae-Ryeong;Woo, Chang-Hoon;Park, Jae-Hong
Journal of Korean Medicine Rehabilitation
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v.26
no.4
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pp.97-105
/
2016
Objectives The purpose of this study is to investigate traffic accident patients who were admitted to Korean and Western medicine hospital. Methods According to the medicine record from Dong-eui university, 908 traffic accident patients who were admitted to Korean medicine hospital and Western medicine hospital from 1st January 2011 to 31th July 2016 were analyzed. We classified the patients' sex, age, classification of diseases, hospitalization. Results 1. According to age and sex, the rate of male was 35.4%, and that of female was 64.6% in Korean medicine hospital. However, the rate of male was 46.6%, and that of female was 53.4% in Western medicine hospital. 2. According to admission procedures, the most patients (93.3%) went through out-patient department in Korean medicine hospital and 53.5% of patients went through emergency room in Western medicine hospital. 3. According to principal diagnosis, 'sprain and strain of neck level' was 65.4 percentage Korean medicine hospital and 'intracranial injury' was 63.2 percentage in Western medicine hospital. 4. There was no statistical significant in hospitalization periods between male and female in Korean medicine hospital. However, hospitalization periods of female were longer than that of male in Western medicine hospital. 5. There was no correlation between age and hospitalization period in both Korean and Western medicine hospital. 6. Average hospitalization period of Korean medicine hospital patients were shorter than that of Western medicine hospital patients. 7. According to automobile insurance review organization, hospitalization periods were not significantly different in both Korean and Western medicine hospital. Conclusions It is concluded that there is difference of characteristics between inpatients who were admitted to Korean and Western medicine hospital due to traffic accident.
Corticosteroids are widely used in the treatment of various diseases because of its potent antiinflammatory effect. According to recent knowledge, bronchial asthma is also chronic inflammatory disease. Therefore antiinflammtory agent such as cromoyln sodium and corticosteroid is highly recommended for treament of chronic bronchial asthma. Especially hydrocortisone succinate (Solu-Cortef) is commonly used for treament to acute asthmatic attack via intravenous injection due to have rapid therapeutic onset and short duration. Since Sunaga et al. reported acute asthma attack after hydrocortisone injection in 1973, several cases of bronchospam with or without angioedema and urticaria after intravenous injection of hydrocortisone have been reported. We experienced a case of severe bronchospasm and acute respiratory failure after intraveous injection of hydrocortisone succinate in 64 year-old female asthmatic patient who visited to emergency room for acute asthmatic attack. About 5 minites after Solu-Cortef injection, a severe bronchospasm with arterial hypoxemia was developed. In order to confirm the suspected relationship between the offending drug(Solu-Cortef) and acute bronchospasm, we examed intravenous and inhalation provocation test by hydrocortisone succinate and methylprednisolone(control). After administration of hydrocortisone succinate via intravenous and inhalation route, severe asthmatic attack occurred. But administration of intravenous methylprednisolone and orall triamcinolone and saline were not provoke bronchospasm. Skin test using hydrocortisone sodium succinate was also positive. Administration of hydrocortisone is very serious to asthmatic patient with hydrocortisone hypersensitivity. Therefore, the clinician must be have history taking about previous adverse reaction of steroid before its clinical use. And methylprednisone may be useful and safe drug to the treatment of acute asthmatic patient with hydrocortisone hypersensitivity.
This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.
Journal of agricultural medicine and community health
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v.27
no.1
/
pp.79-86
/
2002
Thirty six patients, female 21(58.4%), male 15(58.4%), with centipede bite visited emergency room of Gimcheon Medical Center, from September 1998 to August 1999. The number of patients accompanying the seasons were increased once in June and were high in August and September; peaked in September, which conforms to the habitude that centipede likes the warmer climate. Frequency accompanying the time was high after sunset(from 6 p.m. to 6 a.m. next morning) than before sunset, which conforms to the habitude that centipede is nocturnal. Distribution of the bite sites was finger(30%), neck(28%), foot(25%) and hand(14%) as same as the previous researches showed. In case of finger and hand, patients got bitten while they were wearing gloves or doing works; foot, wearing shoes. They got bitten the neck while sleeping. Among the localized symptoms were localized pain: 36 patients(100%), swelling: 36 patients(100%), erythema: 26 patients(72.2%), paresthesia: 5 patients (13.9%). Systemic symptoms were dizziness 2 patients(5.6%) and nausea 1 patient(2.8%). Mostly the localized pain was improved within 48 hours, swelling in 48 hours and within 72 hours in case of paresthesia. Systemic symptoms such as dizziness and nausea were improved within 24 hours. Treatment and prognosis of scolopendra have similarity in many countries. We suggest that Korean standard treatment manual is needed so that the localized symptom, systemic symptom and external wound can be cured soon.
The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.
Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.
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