• Korean Journal of Adult Nursing
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• v.24 no.4
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• pp.348-357
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• 2012

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, $x_2$-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender ($x_2$=6.11, p=.025), age ($x_2$=32.81, p<.001), hearing difficulty ($x_2$=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.8-12
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• 2014

Purpose: The aim of this retrospective chart review was to evaluate the four-year survival rate of a titanium implant system. Methods: A total of 352 sand-blasted, thermally acid-etched titanium implants were inserted into 181 partially or completely edentulous patients. Their cumulative survival rate was evaluated retrospectively. Associated factors, such as the implant distribution and treatment type were included in the evaluation. Results: The implants were equally distributed between the maxilla (52.3%) and the mandible (47.7%). 48 implants (13.6%) were placed in the anterior region and 304 implants (86.4%) in the posterior region. The majority of the implants were inserted into bone of type II and III quality (89.8%) and volume (quantity B and C, 87.2%). Most of the implants (70.7%) were restored as single crowns; 28.7% supported a bridge construction and 0.6% a full denture. Only one implant failed, resulting in a four-year cumulative survival rate of 99.7%. Conclusions: The implant system showed an excellent four-year survival rate. It proved to be a safe and predictable means for restoration of the dentition in partially or completely edentulous patients.

• Journal of Korean Academy of Nursing
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• v.44 no.2
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• pp.219-227
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• 2014

Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.31-37
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• 2011

Purpose: We performed this study to evaluate the clinical presentation as well as the proper surgical intervention for ovarian metastasis from gastric cancers and these tumors were identified during postoperative follow-up. This will help establish the optimal strategy for improving the survival of patients with this entity. Materials and Methods: 22 patients (3.2%) with ovarian metastasis were noted when performing a retrospective chart review of (693) females patients who had undergone a resection for gastric cancer between 1981 and 2008. The covariates used for the survival analysis were the patient age at the time of ovarian relapse, the size of the tumor, the initial TNM stage of the gastric cancer, the interval to metastasis and the presence of gross residual disease after treatment for Krukenberg tumor. The cumulative survival curves for the patient groups were calculated with the Kaplan-Meier method and they were compared by means of the Log-Rank test. Results: The average age of the patients was 48.6 years (range: 24 to 78 years) and the average survival time of the 22 patients was 18.8 months (the estimated 3-year survival rate was 15.8%) with a range of 2 to 59 months after the diagnosis of Krukenberg tumor. The survival rate for patients without gross residual disease was longer than that of the patients with gross residual disease (P=0.0003). In contrast, patient age, the size of ovarian tumor, the initial stage of gastric adenocarcinoma, the interval to metastasis and adjuvant chemotherapy were not prognostic indicators for survival after the development of ovarian metastasis. Conclusions: Early diagnosis and complete resection are the only possible hope to improve survival. As the 3-year survival rate after resection of Krukenberg tumor is 15.8%, it seems worthwhile to consider performing tumorectomy as the second cytoreduction.

• The Journal of Korean Medicine
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• v.39 no.1
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• pp.86-94
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• 2018

Objectives: This study is aimed to examine the effect of Geopungchunghyul-dan on circumferential strain of carotid artery in outpatients of Kyung Hee University hospital of Korean Medicine. Methods: Retrospective chart review is used from June 2016 to August 2017 for outpatients of Kyung Hee University hospital of Korean Medicine. 14 patients taking Geopungchunghyul-dan over 1 month were speculated. Data of circumferential strain and intima-media thickness was taken from carotid ultrasonography and processed by Wilcoxon signed-rank test. Results: Geopungchunghyul-dan lowered circumferential strain of both carotid arteries after 1 month of administration (p<0.05). Intima-media thickness of both carotid arteries did not changed significantly. Conclusions: Geopungchunghyul-dan may ameliorate arterial stiffness.

• Clinical and Experimental Pediatrics
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• v.59 no.6
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• pp.252-255
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• 2016

Purpose: Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center. Methods: We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed. Results: Fifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4-18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was $5,156cells/mm^3$ (range, $20-5,111cells/mm^3$). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4-33 days). Overall mortality at 60 days was 35.7% (5 of 14). Conclusion: Majority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.297-305
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• 2018

Purpose: There is a lack of scholarly reports on pediatric emergency department (PED) exposure to hyperbilirubinemia. We aimed to describe the epidemiology of hyperbilirubinemia in patients presenting to a PED over a three-year period. Methods: This was a retrospective cohort study, completed at an urban quaternary academic PED. Patients were included if they presented to the PED from 2010 to 2012, were 0 to 18 years in age, and had an elevated serum bilirubin for age. A chart review was completed to determine the incidence of hyperbilirubinemia, etiology, diagnostic work up and prognosis. The data set was stratified into four age ranges. Results: We identified 1,534 visits where a patient was found to have hyperbilirubinemia (0.8% of all visits). In 47.7% of patients hyperbilirubinemia was determined to have arisen from an identifiable pathologic etiology (0.38% of all visits). First-time diagnosis of pathologic hyperbilirubinemia occurred in 14% of hyperbilirubinemia visits (0.11% of all visits). There were varying etiologies of hyperbilirubinemia across age groups but a male predominance in all (55.0%). 15 patients went on to have a liver transplant and 20 patients died. First-time pathologic hyperbilirubinemia patients had a mortality rate of 0.95% for their initial hospitalization. Conclusion: Hyperbilirubinemia was not a common presentation to the PED and a minority of cases were pathologic in etiology. The etiologies of hyperbilirubinemia varied across each of our study age groups. A new discovery of pathologic hyperbilirubinemia and progression to liver transplant or death during the initial presentation was extremely rare.

• Anxiety and mood
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• v.9 no.1
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• pp.19-24
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• 2013

Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1527-1530
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• 2014

Background: Time to colposcopy (TC) after abnormal Pap smears was evaluated for influence on cytohistologic correlation (CHC). Materials and Methods: This retrospective study assessed the correlation between TC and CHC of women who had abnormal Pap smears. Colposcopic chart review included participants from 2010-2013 who attended a colposcopic clinic, Thammasat University Hospital, Thailand. Results: Four hundred and sixty cases who had abnormal Pap smears were recruited. Pap reports were atypical smears with low grade squamous intraepithelial lesion (SIL), high grade SIL and cancer at 339, 114 and 7 cases, respectively. One hundred and twenty four patients underwent loop electrosurgical excision procedure (LEEP). A half of the cases were colposcopically examined within 1-2 months after abnormal Pap collection. CHC was 88 percent and not affected at all by TC. Subjects who attended cervical cancer screening from affiliated health providers had shorter TC than those screened in our tertiary hospital. Conclusions: Time to colposcopy with abnormal Pap smears conducted at Thammasat University Hospital had a highest frequency of 42 days, in line with the literature. Length of TC does not affect the correlation between Pap and histopathologic reports. A longer waiting period for colposcopy did not alter progression or regression of the disease.

• Journal of Haehwa Medicine
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• v.22 no.2
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• pp.155-162
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• 2014

Objective : The purpose of this study was to investigate the effects of acupuncture treatment on frequently adopted acupuncture point and self exercise therapy for lumbar sprain patient Methods : For this study, a retrospective chart review was conducted. Data are derived from lumbar sprain patients who have received hospital treatment in Daejeon Univ. Cheon-Ahn Korean Hospital. All patients were treated with acupuncture treatment on high frequency acupuncture point (BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34), physical therapy and herbal medicine and self exercise therapy(Swiss ball exercise, Lumbar stabilization exercise.) We measured visual analogue scale(VAS), Oswestry disability index(ODI), Pain threshold twice(pre-treatment and post-treatment) on 1st day and 5 days later. Results : After being treated, lumbar sprain patients were meaningful improved in VAS, ODI, pain threshold The VAS score, ODI score were statistically decreased after treatment and the pain threshold was statistically increased after treatment. Conclusion : In this study, treatment on frequently adopted acupuncture point and self exercise therapy were effective on lumbar sprain patient.