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Different Clinical Outcomes by Subgroups in Organophosphorus Poisoning (유기인계 농약 중독 환자에서 약물의 종류에 따른 임상 양상 및 예후의 차이)

  • Lee, Duk-Hee;Jung, Jin-Hee;Jung, Koo-Young;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.8-14
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    • 2007
  • Purpose: Organophosphorus insecticides tend to be regarded as a homogeneous single entity. We aimed to determine whether organophosphate poisoning differs by subgroups in clinical features and severity. Methods: We retrospectively reviewed medical records of all patients with acute organophophorus poisoning from January 1998 to December 2006. We investigated clinical features, Glasgow coma scale (GCS), laboratory findings, QTc intervals, management, and outcomes. Results: A total of 109 patients were included. The dimethoxy group experienced significantly longer times than the diethoxy group for ventilation duration (0.6 day vs. 0.2 day, p=0.006), ICU duration (2.0 day vs. 0.8 day, p=0.037), and total admission duration (2.8 day vs. 0.9 day, p=0.008), except in cases of dichlorvos poisoning. Also, the GCS of the dimethoxy group (except with dichlorvos) was significantly lower than for the diethoxy group (dimethoxy, $11.2{\pm}5.2$ vs. diethoxy, $13.8{\pm}2.4$, p= 0.021). QTc intervals for the dimethoxy group (except with dichlorvos) tended to be somewhat greater than for the diethoxy group (dimethoxy, $452.9{\pm}16.1\;msec$ vs. diethoxy, $429.6{\pm}40.9\;msec$). There were 65 patients with dichlorvos ingestion, and 2 of these patients (3%) died. Conclusion: When compared to the diethoxy group, the dimethoxy group of organophosphates (with the exception of dichlorvos) were associated with poorer prognostic value for indicators such as GCS, QTc interval, requirement for intubation, ICU duration, and total admission duration. Within the dimethoxy group, patients with dichlorvos poisoning had relatively better prognoses than for the other dimethoxy group organophosphates studied.

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Schwannoma of the Orbit

  • Kim, Kwang Seog;Jung, Jin Woo;Yoon, Kyung Chul;Kwon, Yu Jin;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.16 no.2
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    • pp.67-72
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    • 2015
  • Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.

A Study on Conservation of the Natural Environment in Chosun-Dynasty, Korea (조선시대 자연환경보전에 관한 연구)

  • 오승봉;안동만
    • Journal of the Korean Institute of Landscape Architecture
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    • v.23 no.1
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    • pp.51-65
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    • 1995
  • Conservation of the natural environiment In chosun-Dynasty, Korea, is analysed on the basis of the of official records of the king's offices(Chosun-wangjo-sillok). In the popular ideologies of the dynasty, Seongleehak(philosophy of humanity arid natural laws) and Pungsu (geomancy) , the naturnal enviroment is defined as an entity con-sisting of Cheon (heaven) , San(mnountains) , Su (water), Geumsu (animals)and Chomok (plants) .the notion of Tacksi-Tackmul(being careful to take natural resources at the right time) was one of the Cheonmyung (eavenly decrees) . It was believed that violation of this principle resulted in natural disasters. Sasan(four mountains surrounding Hansungbu-, the capital city, now Seoul) , were strictly preserved according to geomancy practices. In areas other than the capital city, Sanlimcheontack (mountains, forests, rivers and ponds) were con-served for sustained production of building materials especially pinetrees for ship building, foods, firewoods, horses, and orter useful natural resources. Various conservation policy insturuments were adopted. Prunning trees was permitted only in October. Capturing fishes was allowed only after the spawning period. Protection areas were designated in Sasan, Seongjoesiplee (surroundings of the capital city) , Geumsan(protected mountains), Kangmujang(hunting and army training grounds), Sijang(firewood areas), Mokmajang(horse ranches) and Neungyuk(royal tombs) . Activities prohibited for conservation purposes included cutting timbers, burning, building houses or tombs, dumping wastes, farming and breaking up fresh land, grazing, hunting and trespassing. Positive actions for conservation were rituals to Heaven ennoblement of natural elements such as mountians or rivers, planting trees, Boto (supplementing soil on low ridges) , Josan (mounding) and making ponds. Boto, Josan and making ponds were to make ideal terrains for geomancy. Many government bodies and civil servants were engaged in the conservation activities. For example, Sanjik(forest keeper) was a special position with responsibility for forest management.

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The Prognostic Factors of Solitary Pulmonary Nodule (고립성 폐결절의 예후에 관여하는 인자)

  • Jeong, Yun-Seop;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.425-435
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    • 1989
  • The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

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Clinical Analysis of Primary Malignant Lymphoma of the Lung (원발성 폐림프종의 임상 고찰)

  • Kim, Jae-Bum;Park, Nam-Hee;Kum, Dong-Yoon;Noh, Dong-Sub;Lee, Jae-Hoon;Han, Seung-Bum;Jung, Hye-Ra;Park, Chang-Kwon
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.435-440
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    • 2007
  • Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.