• Clinical and Experimental Pediatrics
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• v.58 no.12
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• pp.478-483
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• 2015

Purpose: Information on the clinical features of lung abscess, which is uncommon in children, at hospitalization is helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. Methods: The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Results: Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. Conclusion: The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.2
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• pp.130-140
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• 2024

Objective: To assess whether local anesthetic infiltration could minimize the carotid baroreceptor reflex (CBR) which has an incidence after carotid artery stenting (CAS) that varies from 29% to 51%. Methods: This retrospective single-center study included 51 patients (mean age, 70.47 years) who underwent CAS for carotid stenosis. The groups included patients who underwent CAS for asymptomatic ischemic stroke (n=41) or symptomatic disease (n=10). Preprocedural percutaneous lidocaine injections (PPLIs) were administered to 70.6% and 5.9% of patients who underwent elective CAS and emergency CAS, respectively. Results: Among patients who received PPLIs, the mean degree of stenosis was 80.5% (95% confidence interval [CI]: ±10.74, 51-98%). The mean distance from the common carotid artery bifurcation to the most stenotic lesion (CSD) was 8.3 mm (95% CI: ±0.97, 6.3-10.2 mm); the mean angle between the internal carotid artery and common carotid artery (CCA) trunk (IAG) was 65.6° (95% CI: ±2.39, 61-70°). Among patients who did not receive PPLIs, the mean degree of stenosis was 84.0% (95% CI: ±8.96, 70-99%). The mean CSD was 5.9 mm (95% CI: ±1.83, 1.9-9.9 mm); the mean IAG was 60.4° (95% CI: ±4.41, 51-70°). The procedure time was longer in the PPLI group than in the no PPLI group (28.19 [n=39] vs. 18.88 [n=12] days) (P=0.057); the length of intensive care unit stay was shorter in the PPLI group (20.01 [n=36] vs. 28.10 [n=5] days) (P=0.132). Conclusions: Targeted PPLI administration to the carotid bulb decreased aberrant heart rates and blood pressure changes induced by carotid stent deployment and balloon inflation. As CBR sensitivity increases with decreasing distance to the stenotic lesion from the CCA bifurcation, PPLIs may help stabilize patients during procedures for stenotic lesions closer to the CCA.

• Journal of the Korea Society for Simulation
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• v.18 no.4
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• pp.107-116
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• 2009

Overcrowding in an Emergency Department (ED) of hospital is a common phenomenon. To improve the service quality and system performance of the ED, a task assignment rule for the Registered Nurses (RNs) is proposed in this paper. At each task assignment point, the rule prioritizes all treatment requests based on the urgency which is determined by the multiple attributes such as accomplishment time of treatment task, elapsed time of treatment request, total remain time to patient discharge, and number of remain treatments. The values of partial urgency with a single criterion are determined and then overall urgency is computed to find the most urgent one among current requests with the importance weights assigned to the criteria. Through computer simulation, the performance of the proposed rule is compared with current rule in terms of the length of stay and system throughput in a simplified ED system of the hospital M.

• Journal of Korean Critical Care Nursing
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• v.16 no.1
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• pp.71-86
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• 2023

Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

• Journal of the Korean Society of School Health
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• v.10 no.1
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• pp.75-86
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• 1997

Blindness or visually handicaps are found to be an important factor destroying lifestyles as well as a physical problem. According to the data of handicapped person's(v.h.p) registered in Korea, the number of v.h.p. has not decreased. Especially, visual handicapped adolescents (v.h.a.) suffer from an insufficiency of social support under the current education system. There is a special education system for v.h.a. in Korea, and, as a result v.h.a.'s are educated separately from general students and communites. Compared with the self-conception of general students, v.h.a.'s have a more negative self-conception. Among former studies 51.7% of v.h.p's are not in good health. This, of course, means that their handicap impacts on other health problems. The first purpose of this study is to find out the causes of disease and the degree of social support, self-esteem, health management behavior provided and then to analyze the effect of self-esteem and social support on their behavior. To accomplish these purposes, visually handicapped the middle and high school students in Seoul city and Kyung-gi province were selected and 300 students sampled. The main results are as follows : 1) The highest specific handicap is impaired lenses (19.7%). 2. There were high correlations between health management behavior, self-esteem, and social support. 3. Social support is a more important variable than self-esteem on health management behavior. 4. Age of entry and length of stay in their special dormitories, and teacher's support account for 16% of psychological health management behavior 5. Age of entry in their special dormitory and total degree of social support account for 12% of preventive health behavior.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.6-12
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• 2024

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

• Journal of the Korean Geographical Society
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• v.38 no.3
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• pp.413-425
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• 2003

This article aims to validate empirically and verify theoretically, the applicability of the spa town life cycle model to Bath Spa located in United Kingdom. In order to test the model, the indicators of the model that associated with the rate of transportation infrastructure, the length of stay, tourist facilities, competitive resorts, advertising, tourism policy, environmental problem and the attitude of residents were examined through a comparative analysis. According to the result of this research, the indicators of 7 items excepting competitive resorts applied to Bath Spa. The competitive resorts of Bath Spa emerge at the maturity stage differing from the model that appeared at the stagnation stage. In conclusion if the new hypothesis of competitive resorts is added to the model, the model will be applied to western spa town, which has a small scale and a long history.

• Health Policy and Management
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• v.32 no.2
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• Hip & pelvis
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• v.36 no.2
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• pp.144-154
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• 2024

Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.187-195
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• 2014

Purpose: Laparoscopic gastrectomy in obese patients has been investigated in several studies, but its feasibility has rarely been examined in morbidly obese patients, such as in those with a body mass index (BMI) of ${\geq}30kg/m^2$. The present study aimed to evaluate the technical feasibility and safety of laparoscopic gastrectomy in morbidly obese patients with gastric cancer. Materials and Methods: A total of 1,512 gastric cancer patients who underwent laparoscopic distal gastrectomy (LDG) were divided into three groups: normal (BMI< $25kg/m^2$, n=996), obese (BMI $25{\sim}30kg/m^2$, n=471), and morbidly obese ($BMI{\geq}30kg/m^2$, n=45). Short-term surgical outcomes, including the course of hospitalization and postoperative complications, were compared between the three groups. Results: The morbidly obese group had a significantly longer operating time (240 minutes vs. 204 minutes, P=0.010) than the normal group, but no significant differences were found between the groups with respect to intraoperative blood loss or other complications. In the morbidly obese group, the postoperative morbidity and mortality rates were 13.3% and 0%, respectively, and the mean length of hospital stay was 8.2 days, which were not significantly different from those in the normal group. Subgroup analysis showed that postoperative complication rates were not high in morbidly obese patients, independent of the type of anastomosis technique used and level of lymph node dissection. Conclusions: LDG is technically feasible and safe in morbidly obese patients with a BMI of ${\geq}30kg/m^2$ and early gastric carcinoma. Except for a longer operating time, LDG might represent a reasonable treatment option in these patients.