Purpose: This work is a retrospective clinical case study evaluating the efficacy of Injinoryung-san granule administration to patients who showed an abnormal hepatic function test level. Methods: We analyzed the chart records of seven patients with elevated levels of the hepatic function test treated with Injinoryung-san granules. Results: The patients who were treated with Injinoryung-san showed a significant improvement in their elevated hepatic function test levels. Conclusion: In patients with elevated hepatic function test levels, Injinoryung-san granules can improve the hepatic level without adverse effects or changes in existing drugs.
Purpose: To evaluate intra- and inter-observer variability and guideline adherence amongst pediatricians in treating children aged between 4 and 18 years referred with recurrent abdominal pain (RAP) without red flags. Methods: The first part of the study is a retrospective single-center cohort study. The diagnostic work-ups of eight pediatricians were compared to the national guidelines. Intra- and inter-observer variability were examined by Cramer's V test. Intra-observer variability was defined as the amount of variation within a pediatrician and inter-observer variability as the amount of variation between pediatricians in the application of diagnostic work-up in children with RAP. Prospectively, the same pediatricians were requested to provide a report on their management strategy with a fictitious case to prove similarities in retrospective diagnostic work-up. Results: A total of 10 patients per pediatrician were analyzed. Retrospectively, a (very) weak association between pediatricians' diagnostic work-ups was found (0.22), which implies high inter-observer variability. The association between intra-observer diagnostic was moderate (range, 0.35-0.46). The Cramer's V of 0.60 in diagnostic work-up between pediatricians in the fictitious case implied the presence of a moderately strong association and lower inter-observer variability than in the retrospective study. Adherence to the guideline was 66.8%. Conclusion: We found a high intra- and inter-observer variability and moderate guideline adherence in daily clinical practice amongst pediatricians in treating children with RAP in a teaching hospital.
Radiation is used for various purposes such as cancer therapy, research of industrial and drugs. However, in case of radiation accidents such as terrorism, collapsing nuclear plant by natural disasters like Fukushima in 2011, very high radiation does expose to human and could lead to death. For this reason, many people are concerning about radiation exposures. Therefore, assessment and research of retrospective radiation dose to human by various path is an necessary task to be continuously developed. Radiation exposure for workers in radiation fields can be generally measured using a personal exposure dosimeter such as TLD, OSLD. However, general people can't be measured radiation doses when they are exposed to radiation. And even if radiation fields workers, when they do not in possession personal dosimeter, they also can't be measured exposure dose immediately. In this study, we conduct retrospective research on reconstruction of dose after exposure by using smart chip card of personal items through Optically Stimulated Luminescence (OSL). The OSL signal of smart chip card shows linear response from 0.06 Gy to 15 Gy and results of fading rate 45 %, 48% for 24 and 48 hours due to the natural emission of radiation in sample, respectively. The minimum detectable limit (MDD) was 0.38 mGy. This values are expected to use as correction values for reconstruction of exposure dose.
Sun, Hyun Woo;Kim, Hohyun;Jeon, Chang Ho;Jang, Jae Hoon;Kim, Gil Hwan;Park, Chan Ik;Park, Sung Jin;Kim, Jae Hun;Yeom, Seok Ran
Journal of Trauma and Injury
/
v.34
no.2
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pp.98-104
/
2021
Purpose: Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures. Methods: A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed. Results: The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability. Conclusions: The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.
Kim, Do Gon;Cho, Hyun Geun;Ryu, Jeong Yeop;Lee, Joon Seok;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
Archives of Craniofacial Surgery
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v.22
no.3
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pp.141-147
/
2021
Background: Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. Methods: Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. Results: Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. Conclusion: Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.
Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.
Purpose: Vital sign are used to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. Researchers are using vital sign data and AI(artificial intelligence) to manage a variety of diseases and predict mortality. In order to analyze vital sign data using AI, it is important to select and extract vital sign data suitable for research purposes. Methods: We developed a method to visualize vital sign and early warning scores by processing retrospective vital sign data collected from EMR(electronic medical records) and patient monitoring devices. The vital sign data used for development were obtained using the open EMR big data MIMIC-III and the wearable patient monitoring device(CareTaker). Data processing and visualization were developed using Python. We used the development results with machine learning to process the prediction of mortality in ICU patients. Results: We calculated NEWS(National Early Warning Score) to understand the patient's condition. Vital sign data with different measurement times and frequencies were sampled at equal time intervals, and missing data were interpolated to reconstruct data. The normal and abnormal states of vital sign were visualized as color-coded graphs. Mortality prediction result with processed data and machine learning was AUC of 0.892. Conclusion: This visualization method will help researchers to easily understand a patient's vital sign status over time and extract the necessary data.
Park, Han-song;Yoo, Hee-jung;Ha, Ji-su;Park, Hyun-seo;Seo, Ho-seok;Kim, Jin-won
The Journal of Internal Korean Medicine
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v.43
no.3
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pp.413-422
/
2022
Objectives: To investigate the weight loss effect of Gambi-tang in obese and overweight adults. Methods: From September 1, 2016 to December 31, 2021, a retrospective chart analysis was conducted on adult men and women who were prescribed Gambi-tang to address obesity and overweight in the National Medical Center (NMC). Partial analysis by age, obesity (Body Mass Index, BMI), duration of dose, and cumulative dose was also conducted. Results: The weight and BMI of the study subjects showed a significant decrease of more than 5% on average before and after treatment. In an analysis of age, significant differences by age could not be confirmed. In the analysis by obesity level, the effect of reducing weight, body fat, and abdominal fat rates in the obese and highly obese groups was greater than in the normal and overweight groups. There was no significant difference by group in the analysis by dosage period. In the analysis by cumulative dose, the greater the cumulative dose up to 1,800 g, the greater the decrease in weight and body fat. The side effect that patients appealed to the most was misjudgment, but not to a serious extent. Conclusions: Gambi-tang has been shown to be effective in weight and body fat loss for both obese and overweight adult men and women.
Objectives To compare the therapeutic effect of ultrasound guided soyeom pharmacopuncture therapy and unguided soyeom pharmacopuncture therapy on cervical facet joint of patient who have cervical pain caused by traffic accidents. Methods The study was planned as a retrospective study that analyzes the patient's medical records. We analyzed medical records of 20 patients with acute cervical pain caused by traffic accidents from April 1, 2022 to May 31, 2022. 10 patients (Group A) were treated ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint, 10 patients (Group B) were treated unguided soyeom pharmacopuncture therapy on cervical facet joint. We used visual analogue scale (VAS) and neck disability index (NDI) to evaluate improvements in cervical functions and pain, five point Likert scale to estimate patient's satisfaction. We used the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA) for statistical analysis. Results Group A showed a significant decrease in the VAS on the 5th day of the soyeom pharmacopuncture therapy (p=0.001). However, there was no statistically significant difference of VAS between two groups (p=0.142). Group A showed significant decrease in the NDI on the 5th day of the therapy (p=0.002). Also, there was statistically significant difference on NDI between two groups (p=0.018). Difference of five point Likert scale between two groups was not statistically significant (p=0.407). Conclusions In patients of acute cervical pain caused by traffic accidents, ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint showed significant efficacy on reduction of neck disability compared with unguided therapy.
Kim, Cheol-hyun;Kim, Kwangho;Lee, Young-ung;Kang, Sunny;Kang, Geonhui
The Journal of Internal Korean Medicine
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v.42
no.6
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pp.1349-1355
/
2021
Objectives: The aim of this study was to evaluate the effectiveness of additional administration of Banha-sasim-tang formulation to patients with gastrointestinal symptoms that did not improve with Western medicines. Methods: The patients who met the inclusion and exclusion criteria were analyzed retrospectively. A paired t-test was performed on the Nepean Dyspepsia Index-Korean version (NDI-K) scores before and after administering the Banha-sasim-tang formulation. Results: A total of 27 subjects were included. The mean duration of taking the Banha-sasim-tang formulation was 15.6±3.1 days. The most commonly used Western medicine before taking the Banha-sasim-tang formulation was rebamipide. The means of the NDI-K score were 57.4±21.8 before administering Banha-sasim-tang formulation and 34.9±16.5 after administration, and the difference was statistically significant (p<0.0001). No serious side effects were encountered while taking the Banha-sasim-tang formulation. Conclusions: For patients whose gastrointestinal symptoms do not improve with Western medicines, additional administration of Banha-sasim-tang formulation may be an option. However, as this study is a retrospective chart review, prospective, large-scale, double-blind studies are needed in the future.
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