• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.157-166
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• 2020

Background: Infectious conditions may increase the risk of venous thromboembolism. The purpose of this study was to evaluate the risk factor for combined infectious disease and its influence on mortality in patients with pulmonary embolism (PE). Methods: Patients with PE diagnosed based on spiral computed tomography findings of the chest were retrospectively analyzed. They were classified into two groups: patients who developed PE in the setting of infectious disease or those with PE without infection based on review of their medical charts. Results: Of 258 patients with PE, 67 (25.9%) were considered as having PE combined with infectious disease. The sites of infections were the respiratory tract in 52 patients (77.6%), genitourinary tract in three patients (4.5%), and hepatobiliary tract in three patients (4.5%). Underlying lung disease (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.926-7.081; p<0.001), bed-ridden state (OR, 2.84; 95% CI, 1.390-5.811; p=0.004), and malignant disease (OR, 1.867; 95% CI, 1.017-3.425; p=0.044) were associated with combined infectious disease in patients with PE. In-hospital mortality was higher in patients with PE combined with infectious disease than in those with PE without infection (24.6% vs. 11.0%, p=0.006). In the multivariate analysis, combined infectious disease (OR, 4.189; 95% CI, 1.692-10.372; p=0.002) were associated with non-survivors in patients with PE. Conclusion: A substantial portion of patients with PE has concomitant infectious disease and it may contribute a mortality in patients with PE.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7863-7867
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• 2014

Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.37-43
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• 2009

Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.474-481
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.11-23
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• 2016

Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

• Journal of Acupuncture Research
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• v.27 no.5
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• pp.97-104
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• 2010

Objectives : The purpose of this study is to understand the characteristics of the musculoskeletal patients who visited the emergency room of an oriental medicine hospital and provide better first-aid medical service. Methods : We performed a retrospective study of 1,472 patients who visited the emergency room of an oriental medicine hospital, from June 1st, 2007 to May 31st, 2010. Results : Of 1,472 total patients, the male to female ratio was 1.06:1 and people in their 30s were the peak age group. The majority of patients visited the emergency room between 10:00 to 24:00(midnight). Most patients visited the emergency room from Saturday to Sunday. By monthly distribution, the patients increased slightly during February, April, September and October. The majority of patients visited the emergency room within 24hours of onset. The patients were categorized as follows : low back pain 64.81%, cervical pain 11.82%, ankle pain 10.67%. 27.51% of patients used stretcher cars when visiting the emergency room. The admission rate was 22.96%. Conclusions : Of the patients who visited the emergency room of an Oriental hospital, low back pain, cervical pain and ankle pain was the most frequent, in this order. By meticulously preparing for the continued increase in musculoskeletal treatment demand, we can further assist and speed the specialization and popularization of Oriental medical services.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.134-141
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• 2009

Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.205-211
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• 2004

Objective : This study is designed to provide clinical data about patients of scoliosis for clinicians. Methods : We investigated 112 patients who have signs and symptoms of scoliosis. visited Vertebral -Joint Center of Conmaul Oriental Medical Hospital from January 2003 to July 2004. We measured Cobb's angle in the 112 patients' X-ray of full spine AP and lateral view and also analyzed age, sex, chief complaints. Results : 1. We investigated 72 female and 40 male patients. The most common distribution of age was 20's in both sex. 2. In the scoliosis angle : The average scoliosis angle was $9.27^{\circ}{\pm}6.06^{\circ}$ in 112 patients. The average scoliosis angle of 40 male patients was$8.9^{\circ}{\pm}6.77^{\circ}$. The average scoliosis angle of 72 female patients was $9.48^{\circ}{\pm}5.67^{\circ}$. 3. The most common region of scoliosis was thoracic spine with 37 patients. 4. The most common chief complaint was low back pain with 69 patients. In the 48 patients. self awareness of scoliosis was included in the chief complaint.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.471-479
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• 2018

Objectives: This study was aimed to analyze the correlation of clinical characteristics of cancer patients treated with Korean Medicine and their natural killer cell activity (NKA). Methods: The medical records of 52 cancer patients who conducted NKA test at Cheonan Korean Medicine Hospital of Daejeon University from March 2016 to May 2018 were reviewed. NKA was determined at Seegene Medical institute using NK Vue Gold(R) kit, evaluating activated $IFN-{\gamma}$ by enzyme immunoassay after incubation of whole blood. Careful investigations were conducted by categorizing the patients by their sex, origin, stage, ECOG scale, and conventional treatment type. We used data from the medical records and statistical analysis using SPSS 25.0 V. Results: The average NKA of all patients was $623.1{\pm}722.0pg/mL$. The NKA value was higher for females than for males. No correlation was evident between age and NKA, but patients aged over 70 years had the lowest NKA average result. Stage III and IV patients showed clearly lower NKA values when compared to stage I and II patients. NKA and ECOG scale values showed no evident relationship. Conclusions: This study presented the characteristics of NKA in cancer patients treated with Korean medicine. The NKA result differed by gender and stage. Based on these findings, further study is needed regarding the clinical meaning of NKA.