Objectives : The purpose of this study is to investigate the effectiveness of treating low back pain patients with Foot acupuncture. Methods : Clinical study was conducted to 40 patients who were treated in Dept. of Acupuncture and Moxibusion, Woosuk University Hospital from March 1 to December 31, 2010. Subject were randomly divided into two groups. In one group(test group), patients were treated with both acupuncture and Foot acupuncture. And in the other group(control group), patients were treated with acupuncture. To estimate the efficacy of treatments, Visual Analog Scale(VAS) and Oswestry disability index(ODI) were checked. 12 patients were excluded and we investigated 14 patients of control group and 14 patients of test group entirely. Results : 1. In both two groups, VAS and ODI of patients were decreased significantly. 2. ODI of patients in test group were decreased more significantly than ODI of patients in control group. Conclusions : We suggest that cotreatment of acupuncture and foot acupuncture on low back pain patients can be recommended as a useful therapy.
Background: Relationships between smoking and bladder neoplasms, one of the common malignancies, are well-known. Different smoking-related malignancies may occur together. In this study, we evaluated the stage and grade of bladder neoplasms in patients also featuring lung or larynx cancer. Materials and Methods: From January 2006 to February 2012, patients who underwent surgery for bladder neoplasms in our clinic were screened retrospectively. In the evaluation, 5 patients had larynx cancer and 20 patients have lung cancer in addition, all having been smoking for a long time. The bladder tumor stage and grade were investigated in these 25 cases. Results: Mean age of patients was 66.8 (49-78). In the evaulation, all of 5 patients who had larnyx cancer also had high grade urothelial cancer. One had T2 urothelial, and 3 T1 urothelial cancer. In the same way, all of the 20 patients with lung cancer also have high grade urothelial cancer, three T2, and 13 T1. Bladder cancer stage and grade were determined to be significantly increased in patients with concomitant bladder and lung or larynx cancer. Conclusions: In the patients who have smoking releated second malignancy, bladder cancer prognosis appears more aggressive. We now need a larger series and multi-center studies for understanding relevant pathophysiology.
Jung, Ho Hyung;Han, Sang Kyoon;Lee, Sung Wha;Park, Sung Wook;Park, Soon Chang;Yeom, Seok Ran;Min, Moon Gi;Kim, Yong In;Ryu, Ji Ho
Journal of Trauma and Injury
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v.27
no.4
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pp.108-114
/
2014
Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.
Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.
Eight patients with polycythemia vera were diagnosed from 1965 through 1977 among the patients of Seoul National University Hospital. In our series there were 4 men and 4 women with average age of 54 years at the time of diagnosis. Symptoms of facial plethora, headache, pruritus and dizziness were the most frequent manifestations of disease in order of frequency. At inital examination 8 of 8 patients had facial plethora, 6 of 8 patients splenomegaly and 4 if 8 patients hepatomegaly. The laboratory data revealed mean Red cell volume of 55+10ml/kg which was elevated in all cases. Leukocytosis was observed in 5 of 8 patients and thrombocytosis 2 of 8 patients. Leukocyte alkaline phosphatase was increased in all cases. Bone marrow aspiration disclosed typical panmyelosis in 5 of 8 patients. In one patient there was diffuse myelofibrosis on bone marrow biopsy. The combined diseases included 2 patient with hypertension and 1 patient with thrombosis of aorta and left renal artery. The patients were treated with phlebotomy alone in 2 patients, chemotherapy with busulfan in 1 patient and $^{32}P$ in 5 patients with favorable results. During the mean 29.9 months follow up period, there were development of iron deficiency in 3 patients, hyperuricemia in 2 patients and thrombosis in 1 patient. The occurrence of acute leukemia of myelofibrosis was not observed in the course of disease.
Choe, Yunsoo;Lee, Jiwon M.;Kim, Ji Hyun;Cho, Myung Hyun;Kim, Seong Heon;Lee, Joo Hoon;Park, Young Seo;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
Childhood Kidney Diseases
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v.23
no.2
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pp.59-66
/
2019
Background: Primary hyperoxaluria (PH), a rare inborn error of glyoxylate meta bolism causing overproduction of oxalate, is classified into three genetic subgroups: type 1-3 (PH1-PH3) caused by AGXT, GRHPR, and HOGA1 gene mutations, respectively. We performed a retrospective case series study of Korean pediatric patients with PH. Methods: In total, 11 unrelated pediatric patients were recruited and their phenotypes and genotypes were analyzed by a retrospective review of their medical records. Results: Mutational analyses revealed biallelic AGXT mutations (PH1) in nine patients and a single heterozygous GRHPR and HOGA1 mutation in one patient each. The c.33dupC was the most common AGXT mutation with an allelic frequency of 44%. The median age of onset was 3 months (range, 2 months-3 years), and eight patients with PH1 presented with end stage renal disease (ESRD). Patients with two truncating mutations showed an earlier age of onset and more frequent retinal involvement than patients with one truncating mutation. Among eight PH1 patients presenting with ESRD, five patients were treated with intensive dialysis followed by liver transplantation (n=5) with/without subsequent kidney transplantation (n=3). Conclusion: Most patients presented with severe infantile forms of PH. Patients with two truncating mutations displayed more severe phenotypes than those of patients with one truncating mutation. Sequential liver and kidney transplantation was adopted for PH1 patients presenting with ESRD. A larger nation-wide multicenter study is needed to confirm the genotype-phenotype correlations and outcomes of organ transplantation.
Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.
Journal of Korean Academy of Nursing Administration
/
v.2
no.1
/
pp.141-150
/
1996
As the medical markets have gradually changed from suppliers' markets to consumers' ones, the demands for consumer-centered strategies of hospital management and marketing, improved medical services, etc., have been increasing. Under such circumstances, this study was aimed at evaluating the marketing policies of our hospitals centering around the internal, cxternal and mutual marketing for consumers, and thereby presenting more influential strategies for hospitals. For this purpose, the employees and patients of a third stage general hospital in Seoul were surveyed by means of a questionnaire. All in all, 285 patients and 284 employees answered the questionnaire. The results of the survey can be summarized as follows : First, patients come to a hospital directly, according to rumors or being introduced by its employee. Second, the important factors determining patients' choice of a hospital are facility, medical staff, traffic and employee. Other factors are patient's age, living area, distance between patient's house and hospital, etc. Third, patients' perception of a hospital affects their choice of the hospital. Fourth, employees and patients perceive differently the marketing strategies of the hospital. Fifth, well-planned marketing strategies may change some sources of inconveniences into those of conveniences. Based on the above findings, effective marketing strategies for gonoral hoopitale can be presented as followes. 1. The poblic relations of hospital should be established first with visiting patients and employees. 2. The marketing strategies should be-based on the factors determing patient's preferences for hospital. 3. The marketing strategies should be flcxiblc enough to complement the weak points of the hospital. 4. The marketing strategies should be directed towards the improved medical services as well as mutual actions between consumers and employccs. 5. The marketing strategies should take into consideration employees perception and thus induce their voluntary participation. All in all, the study may be limited in that its results cannot be easily generalizod due to its small size, patients' variublcs rather than qualitative medical services are primarily reviewed, and that it depended on a straight forward questlonnaire survey.
Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
Health Policy and Management
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v.29
no.2
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pp.237-244
/
2019
Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.
Kang, Yewon;Jo, Eun-Jung;Eom, Jung Seop;Kim, Mi-Hyun;Lee, Kwangha;Kim, Ki Uk;Park, Hye-Kyung;Lee, Min Ki;Mok, Jeongha
Tuberculosis and Respiratory Diseases
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v.84
no.1
/
pp.74-83
/
2021
Background: This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. Methods: Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. Results: A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m2, previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. Conclusion: The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.
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