• Title/Summary/Keyword: 감염환자 분류

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Congenital Quadricuspid Aortic Valve (선천성 사엽성 대동맥판막)

  • Na Chan-Young;Oh Sam-Sae;Whang Seong Wook;Lee Cheul;Kim Jae Hyun;Seo Hong Ju;Baek Man-Jong
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.164-167
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    • 2005
  • Quadricuspid aortic valve is a rare congenital abnormality but it is well recognized as the cause of significant aortic regurgitation. We describe 5 patients who underwent surgery for severe aortic regurgitation associated with quadricuspid valve. In all patients, this abnormality had been incidentally detected during surgery. Two of the patients had infective endocarditis. In accordance with the Hurwitz and Roberts classification, two valves were type d, two were type a, and one was type c.

A COVID-19 Chest X-ray Reading Technique based on Deep Learning (딥 러닝 기반 코로나19 흉부 X선 판독 기법)

  • Ann, Kyung-Hee;Ohm, Seong-Yong
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.789-795
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    • 2020
  • Many deaths have been reported due to the worldwide pandemic of COVID-19. In order to prevent the further spread of COVID-19, it is necessary to quickly and accurately read images of suspected patients and take appropriate measures. To this end, this paper introduces a deep learning-based COVID-19 chest X-ray reading technique that can assist in image reading by providing medical staff whether a patient is infected. First of all, in order to learn the reading model, a sufficient dataset must be secured, but the currently provided COVID-19 open dataset does not have enough image data to ensure the accuracy of learning. Therefore, we solved the image data number imbalance problem that degrades AI learning performance by using a Stacked Generative Adversarial Network(StackGAN++). Next, the DenseNet-based classification model was trained using the augmented data set to develop the reading model. This classification model is a model for binary classification of normal chest X-ray and COVID-19 chest X-ray, and the performance of the model was evaluated using part of the actual image data as test data. Finally, the reliability of the model was secured by presenting the basis for judging the presence or absence of disease in the input image using Grad-CAM, one of the explainable artificial intelligence called XAI.

A Clinical Analysis of the Intestinal Atresia (선천성 장 폐쇄증의 임상적 분석)

  • Park, Jin-Young
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.99-106
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    • 2004
  • Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.

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The Changes in the Outbreak of Rotavirus Gastroenteritis in Children after Introduction of Rotavirus Vaccines: A Retrospective Study at a Tertiary Hospital (로타바이러스 백신 도입 후 로타바이러스 위장관염의 추이: 일개 3차 병원의 후향적 연구)

  • Park, Dong Kyu;Chung, Ju-Young
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.167-173
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    • 2014
  • Purpose: This study aimed to examine the changes in the outbreak of acute gastroenteritis, rotavirus gastroenteritis after the introduction of the rotavirus vaccine in Korea. Methods: The current study investigated the number of inpatients in the pediatric ward of Inje University Sanggye Paik Hospital during the periods of 2005-2006 and 2011-2012. A retrospective analysis was conducted on the medical records of 2,840 patients <5 years of age who were hospitalized at Inje University Sanggye Paik Hospital in these time periods. Results: When we compared 2 separate sets of data from before (2005-2006) and after (2011-2012) vaccine introduction, there were statistically significant decreases in the number of patients who were hospitalized for acute gastroenteritis across all of the groups of patients <5 years of age except those <2 months of age. The number of patients with rotavirus gastroenteritis in all age groups declined except for children <2 months of age and those 2-5 months of age. Conclusion: These results show that after the introduction of a rotavirus vaccine in Korea, the incidence of rotavirus gastroenteritis decreased in 6-59-month-old patients hospitalized for acute gastroenteritis.

Antimicrobial Effects of Essential Oils for Multidrug-Resistant Acinetobacter baumanii (다제내성 아시네토박터 바우마니의 에센셜 오일에 대한 항균효과)

  • Park, Chang-Eun;Kwon, Pil Seung
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.431-437
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    • 2018
  • Acinetobacter baumannii is categorized as a red alert pathogen that is increasingly associated with a high mortality rate in infected patients because of its resistance to extensive antibiotics. This study evaluated the antibacterial activities of some essential oils (tee tree, rosemary, and lavender oils) against 18 clinical isolates of multidrug-resistant A. baumannii (MRAB). The carbapenemase screening Hodge test showed that all 20 strains of A. baumannii were resistant to imipenem. The identification of multidrug-resistant microbes was carried out using the VITEK system. The antimicrobial activity of essential oils was tested by a disk diffusion method against MRAB. In the disk diffusion method, tea tree showed the largest increase in inhibition size compared to lavender oil, and rosemary had no antibacterial effect. These results proved the antimicrobial effect of multidrug resistance A. baumannii. Tee tree oil would be a useful alternative natural product for the treatment and prevention of most common human pathogens and MRAB infections. This is expected to be used as an antimicrobial agent, such as hand disinfectant using natural essential oil in the future.

A Study on the Demand of K-Nursing in Southeast Asian Nursing Colleges to Activate International Exchange Convergence in the Untacked Era (언택드 시대에 국제교류융합 활성화를 위한 동남아시아 간호대학에서 한국 간호에 대한 수요도 조사연구)

  • Kim, Seon Jeong;Kim, Kyung-yong;Choi, Byung Hwan;Song, Mei Ling
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.429-438
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    • 2020
  • The purpose of this study was to investigate the demand of K-nursing in Southeast Asian nursing colleges, and to promote international exchange convergence. In this study, we surveyed the professors and students who were living in Thailand, Vietnam, and the Philippines. For investigating the demands of the topics, two times of surveys were conducted using the google form In the first survey, the emergency care and infectious control showed the most frequent. In the second survey, the classification of emergency patients, showed the most, according the highest priority of emergency department. In infectious control department, management of new infectious diseases, such as COVID-19, showed the most, according to the highest priority. Based on the result, we make a suggestion to develop the contents, according to the highest priority, and to utilize them in international exchange programs.

Update on the Taxonomy of Clinically Important Anaerobic Bacteria (임상적으로 중요한 무산소성 세균의 분류 업데이트)

  • Myungsook, Kim
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.239-248
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    • 2022
  • The taxonomy of bacteria in the field of clinical microbiology is in a state of constant flux. A large-scale revamping of the classification and nomenclature of anaerobic bacteria has taken place over the past few decades, mainly due to advances in molecular techniques such as 16S rRNA and whole genome sequencing (WGS). New genera and species have been added, and existing genera and species have been reclassified or renamed. A major role of the clinical microbiological laboratories (CMLs) is the accurate identification (ID) and appropriate antimicrobial susceptibility testing (AST) for clinically important bacteria, and rapid reporting and communication of the same to the clinician. Taxonomic changes in anaerobic bacteria could potentially affect the choice of appropriate antimicrobial agents and the antimicrobial breakpoints to use. Furthermore, current taxonomy is important to prevent treatment failures of emerging pathogenic anaerobes with antimicrobial resistance. Therefore, CMLs should periodically update themselves on the changes in the taxonomy of anaerobic bacteria and suitably inform clinicians of these changes for optimum patient care. This article presents an update on the taxonomy of clinically important anaerobic bacteria, together with the previous names or synonyms. This taxonomy update can help guide antimicrobial therapy for anaerobic bacterial infections and prevent treatment failure and can be a useful tool for both CMLs and clinicians.

Different Clinical Courses of Henoch-Schönlein Purpura in Children, Adolescents and Adults (Henoch-Schönlein Purpura에서 연령에 따른 임상 양상 및 예후에 관한 고찰)

  • Hong, Joo Hee;Na, Hyung Joon;Namgoong, Mee Kyung;Choi, Seung Ok;Han, Byng Geun;Jung, Soon Hee;Kim, Hwang Min
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1244-1251
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    • 2005
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is the most common and benign systemic vasculitis in children. Few reports have focused on worse outcomes of HSP in adults. The age of onset is suggested as a main risk factor. We assessed the characteristics of adolescent-onset HSP. Methods : We retrospectively analyzed 205 cases presented from Aug. 1993 to Oct. 2003. Patients were classified as children(<10 years of age), adolescents(10-20 years of age), and adults(>20 years of age). Results : The mean age was $5.7{\pm}1.8years$ in 149 children, $13.5{\pm}2.4years$ in 38 adolescents, and $44.9{\pm}14.5years$ in 18 adults. The male to female ratio was 1.2 : 1 in children and adolescents, and 2 : 1 in adults. Previous upper respiratory infections were found in 53.4 percent of children, 32.4 percent of adolescents, and 33.3 percent of adults. Positivity of stool occult blood was more frequent in adults(50.5 percent) than in children(23.0 percent)(P<0.05). Renal involvement was found in 46 cases (30.9 percent) of children, 23 cases(60.5 percent) of adolescents, and 15 cases(83.3 percent) of adults. Recurrences occurred in 23 cases(15.4 percent) of children, nine cases(23.7 percent) of adolescents, and three cases(16.7 percent) of adults. Among the cases with renal involvement, 97.8 percent of children and 87.0 percent of adolescents improved to normal or asymptomatic urinary abnormalities. 60.0 percent of adults persisted with severe nephropathy and 13.3 percent progressed to renal insufficiency. Conclusion : Although the outcome of adolescent HSP was as good as children, the clinical manifestations were similar to those of adults. Adolescents had the highest rate of recurrences. Thus long term observations may be needed in adolescent onset HSP.

A clinical study of the treatment prescribed Hwalsuckgosamtang(滑石苦蔘湯) for the acute diarrhea (급성설사(急性泄瀉)를 활석고삼탕(滑石苦蔘湯)으로 치료(治療)한 증례(症例))

  • Park, Eun-kyung;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.385-389
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    • 1999
  • Acute diarrhea is fastly progressing and its most symptom are caused by virus. It usually continue within 3 weeks. And also it company fever, chilling sign, anorexia and vomitting. Mostly, it is getting better by basic treatment but must be cautious about progressing to dehydration, sepsis or other complications. In this study, it is experienced that acute diarrhea patient, got sick by food, became better by treating in the point of Sasang Medicine. 75 years old male patient having abdominal pain with aqueous diarrhea (about 10th a day before admission), chilling sign, general weakness was classed as Soyangin having Shinhanbocktongmangeumjeung(身寒腹痛亡陰證). I prescribed Hwalsuckgosamtang(滑石苦蔘湯) by Peueumganggy(表陰降氣) therapy and his symptom was getting better. So report it.

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Early and Mid-term Results of Operation for Infective Endocarditis on Mitral Valve (감염성 승모판 심내막염의 중단기 수술 성적)

  • Ahn, Byong-Hee;Chun, Joon-Kyung;Yu, Ung;Ryu, Sang-Wan;Choi, Yong-Sun;Kim, Byong-Pyo;Hong, Sung-Bum;Bum, Min-Sun;Na, Kook-Ju;Park, Jong-Chun;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.27-34
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    • 2004
  • Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.