• 대한조현병학회지
• /
• 제22권1호
• /
• pp.1-7
• /
• 2019

Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.

• Journal of Trauma and Injury
• /
• 제24권2호
• /
• pp.168-170
• /
• 2011

Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.

• Neonatal Medicine
• /
• 제17권2호
• /
• pp.161-167
• /
• 2010

Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF) is defined as the sudden impairment of kidney function (estimated from the glomerular filtration rate [GFR]) that results in the lack of excretion of waste products. More than 30 definitions of AKI exist in the literature, most of which are based on serum creatinine. Lack of a uniform and multidimensional AKI definition has led to failure to recognize significant renal injury, delays in treatment, and inability to generalize single-study results. The RIFLE criteria were developed to standardize the diagnosis of ARF and in the process the term AKI has been proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy. Large prospective studies are needed to test definitions and to better understand risk factors, incidence, independent outcomes, and mechanisms that lead to poor short- and long-term outcomes. Early biomarkers of AKI need to be explored in critically ill neonates.

• Journal of Chest Surgery
• /
• 제32권10호
• /
• pp.947-950
• /
• 1999

Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

• 대한물리의학회지
• /
• 제18권4호
• /
• pp.29-35
• /
• 2023

PURPOSE: High-intensity physical therapy may help improve some gross motor developmental delays through an increased treatment frequency. This study describes an increase in physical therapy frequency and intensity over an eight-week time frame for a child with a rare genetic neurodevelopmental disorder. METHODS: A single-subject research was performed. The subject was a nine-year-old boy with MECP2 Duplication Syndrome. The outcome measure consisted of one time before and after the intervention. An intensive physical therapy program was applied to this subject. The treatments included reciprocal crawling, high kneeling, tailor sitting, weight-bearing and shifting training to facilitate ankle balance strategies and training to walk without assistance. RESULTS: After the eight-week follow-up, the child achieved a gradual improvement in the gross motor function measures, and the mother reported that the child frequently engaged in tailor sitting and independently walking. CONCLUSION: This case study highlights that intensive physical therapy improved the overall motor function of a child with MECP2 duplication syndrome.

• The Journal of Korean Physical Therapy
• /
• 제29권4호
• /
• pp.211-217
• /
• 2017

Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.

• 보건행정학회지
• /
• 제33권4호
• /
• pp.440-449
• /
• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

• 한국작물학회지
• /
• 제34권4호
• /
• pp.408-421
• /
• 1989

제주지방에 있어서 쌀보리와 맥주보리의 청초 및 종실 겸용재배에 알맞은 파종기, 파종량, 시비량, 청초이용기간 등을 밝히고자 쌀보리(새쌀보리)와 맥주보리(두산 22호)를 공시하여 시험한 결과를 요약하면 다음과 같다. 1. 새쌀보리는 파종기, 파종량, 시비량, 청예시기에 관계없이 청예후 100% 생존하였으나 조파한 두산 22호는 증파, 증비할수록 1~2월에 예취시 청예후 생존율이 떨어졌다. 2. 두 품종 모두 조파할수록, 청예종기가 늦을수록 청초수량이 많았다. 증파, 증비함에 따라 청초수량이 증가하는 경향이었다. 3. 건초의 조회분 및 조지방은 파종량, 시비량, 청예시기 등에 따른 차이가 없었으나 조단백질은 증비할수록 증가되었고 청예시기가 늦을수록 감소되었다. 가용생무질소물은 층예시기가 늦어짐에 따라 증가하였고 증비에 의해 감소되는 경향이었다. 4. 조파할수록 일찍 출수 및 성숙되었다. 청예에 의한 출수지연이 새쌀보리에서느 적었으나 두산 22호에서는 매우 컸었고 조파할수록, 정예종기가 늦을수록 정예에 의한 출수지연이 컸었다. 증비에 의해 두산 22호의 성숙기가 3~5일 지연되었다. 5. 새쌀보리에서 보다 두산 22호에서 청예에 의한 간장단축이 컸었고 두 품종 모두 청예종기가 늦을수록 간장이 작아졌다. 6. m$^2$당 수수 및 수당입수가 새쌀보리에서는 청예에 의하여 감소되지 않았지만 두산 22호에서는 청예종기가 늦어질 경우 감소되었다. 7. 두 품종 모두 청예종기가 늦어짐에 따라 종실수량이 감소되었으나 새쌀보리에서는 청예종기가 2월 27일이어도 6~11%의 감수에 그치었다. 두산 22호에서는 12월 28일 이후 예취에 의하여 종실수량이 6~66% 감소되었다. 청예후 종실수량은 파종량과 시비량에 따른 차이가 없었다. 8. 제주지방에서 쌀보리와 맥주보리를 9월 중순부터 10월 중순까지 파종하여 10월 하순부터 2월 중순(맥주보리 12월 하순)까지 방목에 이용하여도 적절히 관리할 경우 관행재배와 비슷한 종실수량을 얻을 수 있는 것으로 보여진다.

• 보건행정학회지
• /
• 제16권2호
• /
• pp.96-116
• /
• 2006

To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.

• Clinical and Experimental Pediatrics
• /
• 제61권11호
• /
• pp.348-354
• /
• 2018

Purpose: The purpose of this study was to identify the causes, symptoms, and complications of hypoproteinemia to prevent hypoproteinemia and provide appropriate treatment to children with atopic dermatitis. Methods: Children diagnosed with atopic dermatitis with hypoproteinemia and/or hypoalbuminemia were retrospectively reviewed. The patients' medical records, including family history, weight, symptoms, treatment, complications, and laboratory test results for allergies and skin cultures, were examined. Results: Twenty-six patients (24 boys) were enrolled. Seven cases had growth retardation; 7, keratoconjunctivitis; 6, aural discharges; 5, eczema herpeticum; 4, gastrointestinal tract symptoms; and 2, developmental delays. In 21 cases, topical steroids were not used. According to the blood test results, the median values of each parameter were elevated: total IgE, 1,864 U/mL; egg white-specific IgE, $76.5kU_A/L$; milk IgE, $20.5kU_A/L$; peanut IgE, $30kU_A/L$; eosinophil count, $5,810/{\mu}L$; eosinophil cationic protein, $93.45{\mu}g/L$; and platelet count, $666.5{\times}10^3/{\mu}L$. Serum albumin and total protein levels decreased to 2.7 g/dL and 4.25 g/dL, respectively. Regarding electrolyte abnormality, 10 patients had hyponatremia, and 12, hyperkalemia. Systemic antibiotics were used to treat all cases, and an antiviral agent was used in 12 patients. Electrolyte correction was performed in 8 patients. Conclusion: Hypoproteinemia accompanying atopic dermatitis is common in infants younger than 1 year and may occur because of topical steroid treatment continuously being declined or because of eczema herpeticum. It may be accompanied by growth retardation, keratoconjunctivitis, aural discharge, and eczema herpeticum and can be managed through skin care and topical steroid application without intravenous albumin infusion.