• Title/Summary/Keyword: 입원실

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Kikuchi-Fujimoto Disease with Prolonged Fever in Children (장기간 발열을 보인 아급성 괴사성 임파선염의 임상적 연구)

  • Yeon, Yeong-Heum;Lee, Kyung-Yil
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.170-175
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    • 2004
  • Purpose : We experienced 7 patients with Kikuchi-Fujimoto disease(KFD) who had presented a prolonged fever and lymphadenopathy. The clinical and the laboratory aspects of the patients were analyzed. Methods : The medical records of the 7 KFD patients, who were confirmed by excisional lymph node biopsy from January 1996 through December 2003, were retrospectively analyzed. Results : The mean age of the children was $11.4{\pm}2.8$ years(ranging from 8 to 15 years). The male to female ratio was 1.3 : 1. The median duration of the fever prior to admission and the total duration of the fever were 12 days(ranging from 5 to 65 days) and 27 days(ranging 9 to 75 days), respectively. One patient had supraclavicular lymphadenopathy, 5 had cercical involvement, and 1 had axillary lymphadenopathy. All the histologic findings of the lymph nodes biopsies showed the characteristic findings consistent with KFD such as paracortical necrosis with karyorrhexis and an increase in the number of phagocytic histiocytes and atypical lymphocytes. As for the laboratory findings, leukopenia($3,800{\pm}700/mm^3$), anemia(hemoglobin, $11.0{\pm}1.2g/dL$), an elevated erythrocyte sedimentation rate($42{\pm}17mm/hr$), and a relatively low C-reactive protein level($1.3{\pm}0.9mg/dL$) were noted. Four patients received conservative therapy with antipyretics, and 3 patients were treated with prednisolone. Conclusion : KFD is a rare disease, yet should be considered in the differential diagnosis for older children with prolonged fever and lymphadenopathy.

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Clinical Significance of C-reactive Protein in Measles (홍역 환아에서 C-반응 단백(CRP)의 의의)

  • Choi, Sang-Lim;Lee, Kyung-Yil;Lee, Hyung-Shin;Hong, Ja-Hyun;Whang, Kyung-Tai
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.480-483
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    • 2003
  • Purpose : We evaluated clinical manifestations and laboratory findings in patients with measles according to C-reactive protein(CRP) concentration. Methods : A retrospective analysis was performed using the medical records of patients with measles at The Catholic University of Korea, Daejeon St. Mary's Hospital from October 1999 to May 2000. We divided the patients with measles into four groups according to CRP level, i.e., those with below 5 mg/L(134 patients, negative group), those with 6-19 mg/L(85 patients), those with 20-49 mg/L(27 patients), and those over 50 mg/L(7 patients). We compared clinical and laboratory characteristics among these four groups. Results : The mean CRP level of all patients was $11.1{\pm}7.5mg/L$. No statistical differences were present between the negative group and the 6-19 mg/L group or the 20-49 mg/L group in the duration of fever, hospitalization days, complications determined with longer hospitalization for more than eight days, white blood cell count, and incidence of hepatitis. Compared with the negative group, the over 50 mg/L group showed a longer duration of fever($4.7{\pm}1.7$ vs $7.2{\pm}3.9days$), duration of hospitalization($5.4{\pm}1.4$ vs $9.4{\pm}4.7days$), incidence of complications(5.2% vs 42.9%) and a higher mean level of WBC count($5,900{\pm}2,700/mm^3$ vs $12,700{\pm}6,700/mm^3$). With an increasing CRP level, there was a tendency for the duration of fever, complications and WBC count to increase. However the levels of liver enzymes(AST/ALT) were not associated with CRP level. Conclusion : A CRP level of over 50 mg/L in measles is associated with severity and complications.

Severe Pneumonia Caused by 2009 Pandemic Influenza A (H1N1) Virus in Children and Corticosteroid Treatment (소아에서 2009 신종 인플루엔자 A (H1N1) 중증 폐렴과 스테로이드 치료)

  • Sohn, Yu Rak;Kim, Jong Hee;Ma, Sang Hyuk;Lee, Kyung Yil;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.193-200
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    • 2011
  • Purpose : The effect of corticosteroid on severe pneumonia caused by 2009 pandemic influenza (H1N1) A virus is controversial. This study was aimed to present the effects of early, short-term corticosteroid treatment for severe pneumonia with this virus infection. Methods : A retrospective analysis was performed on severe pneumonia patients (37 patients) who had severe respiratory distress at presentation requiring oxygen therapy and received intravenous methylprednisolone (MP, 8-10 mg/kg, divided in 4 doses/day for 2-3 days) with oseltamivir. The clinical and laboratory characteristics of the patients were evaluated through the medical records and chest radiographic findings. Results : The mean age and male-to-female ratio of the patients were 6.5${\pm}$2.9 years of age, and 3.4:1 (male 29 patients), respectively. The 5-9 aged group was predominant among the age groups (25 patients, 67.6%). Duration of fever prior to admission was 1.4${\pm}$0.6 days and dyspnea developed within 24 h after beginning of respiratory symptoms in all patients. All patients were previously healthy and received oseltamivir within 48 h. Thirteen patients (35.1%) developed dyspnea during oseltamivir treatment. Following MP infusion, all 37 patients including 13 progressive pneumonia patients during oseltamivir treatment showed an immediate halt in the progression of pneumonic infiltration with rapid clinical improvement. There were no side-effects following steroid use. Conclusion : For severe pneumonia patients, early corticosteroid treatment halted clinical exacerbation, and possibly prevented progression to acute respiratory distress syndrome. Further controlled clinical studies are needed for the role of corticosteroids and antivirals on severely affected patients with influenza virus infections.

The Pathology of Infection in the Department of Radiology (영상의학과 검사실의 감염 실태)

  • Shin, Seong-Gyu;Lee, Hyo-Yeong
    • Journal of radiological science and technology
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    • v.35 no.3
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    • pp.211-218
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    • 2012
  • This study was performed to understand the bacteriologic contamination level of radiological equipments which have frequent contacts with patients in the Department of Radiology of an university hospital in Busan area. Before sterilizing in-patient of the radiology rooms, MRSA, VRE, acinetobacter baumannii, candida albicans, and enterococcus sp. were detected. After sterilization, all the bacteria were not found. As examine times become longer, more bacteria were detected and after 7 hours, bacillus sp.(GPR), CNS, acinetobacter baumannii, and Enterococcus sp. were detected. After examining infected patients, bacillus sp.(GPR), VRE, enterococcus sp. CNS, and micrococcus sp. were detected and on the hands of radiological technologists, CNS, enterococcus sp. escherichia coli, and enterobacter sp. were detected. Similar species of bacteria were detected from each radiology room, but pseudomonas aeruginosa was detected on the handles of portable radiological equipments and the chair in the waiting room. Therefore, it is the most important to regularly sterilize radiological equipments and devices which have frequent contacts with patients and to sterilize them right after the use of infected patients in order to prevent the spread of infection. Also, thorough hand washing, education on infection and management for the characteristics of Department of Radiology should be performed for the systematic prevention of infection.

The Clinical Characteristics of Influenza B Infection during the 2011-2012 Influenza Season (2011-2012절기 B형 인플루엔자 감염의 임상 양상)

  • Kim, Min Sun;Sung, Hyun Woo;Bae, E Young;Han, Seung Beom;Jeong, Dae Chul;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.20 no.2
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    • pp.89-97
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    • 2013
  • Purpose: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. Methods: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. Results: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older ($4.7{\pm}4.1$ years vs. $3.3{\pm}2.5$ years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. Conclusions: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.

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A Clinical Study of Congenital Duodenal Obstruction (선천성 십이지장 폐쇄증의 임상적 고찰)

  • Huh, Young-Soo;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.39-48
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    • 1990
  • Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients(81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight(50%), annular pancreas in six(38%), type 1 atresia in one(6%), and wind-sock anomaly in one(6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were ; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten asociated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases(31%).

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Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice (신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구)

  • Na, Dong Cheon;Seo, Jae Min;Lee, Jung Hyun;Lee, Won Uk;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.143-153
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    • 2011
  • Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

Correation between Microalbuminuria Checked by RIA & Micral - Test$^{(R)}$ (방사면역측정법 및 MICRAL-TEST$^{(R)}$ 로 측정한 미세단백요 사이의 상관관계에 대한 연구)

  • Lee, Chan-Woo;Won, Kyu-Chang;Choi, Soo-Bong
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.158-163
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    • 1991
  • It is evident that an elevation of airway albumin excreation rate without clinical proteinuria strongly predicts a later progression on diabetic renal disease. So we studied the correation between Microalbumin checkly RIA & Mitral-Test$^{(R)}$. We collected urine between 08 : 00 h and 08 : 00 h next day and then checked microalbuminuria by radioimmunoassay method and Mitral-Test$^{(R)}$ The results are as follows : 1. There was significant correation between microalbuminuria checked by RIA & Micral-Test$^{(R)}$ 2. There was poor correations between diabetes duration or HV-A1c and maximal change in albumin excreation rate. 3. So we conclued that Micral-Test$^{(R)}$ can be used in laboratory instead of RIA.

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Incidence of Falls and Risk Factors of Falls in Inpatients (입원환자의 낙상 실태 및 위험요인 조사연구)

  • Yoon, Soo-Jin;Lee, Chun-Kyon;Jin, In-Sun;Kang, Jung-Gu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

Histiocytic Medullary Reticulosis - A case report- (조직구성 수성 망상증 - 1예 보고 -)

  • Lee, Kyeong-Hee;Hyun, Myung-Soo;Kim, Young-Jo;Shim, Bong-Sup;Kim, Kyeong-Dong;Kim, Chung-Soak;Choi, Won-Hee;Lee, Tae-Soak
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.165-172
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    • 1987
  • The term histiocytic medullary reticulosis first was introduced by Scott and Robb-Smith. It is a clinicopathologic symdrome characterized by wasting, fever, lymphadenopathy, hepatosplenomegaly, pancytopenia, and is often accompanied by jaundice, purpura. Cardinal pathologic features are systemized proliferation of atypical, neoplastic, erytherophagocytic histiocyte. We are here reporting one case which considered compatible for HMR, with a few elementary reviewed literatures.

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