• Title/Summary/Keyword: 환자격리

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MESIODENS EXTRACTION OF A PATIENT WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA (로비노 증후군(Robinow syndrome) 환자의 전신마취 하 과잉치 발치)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.1-5
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    • 2016
  • Robinow syndrome is skeletal dysplasia with both autosomal dominant and recessive inheritance patterns. It is characterized by short-limbed dwarfism, abnormalities in the head and face, as well as vertebral segmentation. A 2-year-7-month old boy with Robinow syndrome had visited Seoul National University Dental Hospital, for the evaluation of tooth palatal eruption on maxilla. He had micrognathia, delayed tooth eruption, cleft lip with bifid uvula. He also had an erupted mesiodens on the palatal side of maxillary primary incisors, which was tuberculated and 8mm in major diameter. The patient was scheduled for mesiodens extraction under general anesthesia. He was a young child with delayed development, so general anesthesia was inevitable. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. There were no postoperative complications related to anesthesia and dental treatment. Robinow syndrome patients have craniofacial dysmorphism and eruption disorders. Therefore, he requires regular check-ups as well as dental managements.

Antibiotics-Resistant Bacteria Infection Prediction Based on Deep Learning (딥러닝 기반 항생제 내성균 감염 예측)

  • Oh, Sung-Woo;Lee, Hankil;Shin, Ji-Yeon;Lee, Jung-Hoon
    • The Journal of Society for e-Business Studies
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    • v.24 no.1
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    • pp.105-120
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    • 2019
  • The World Health Organization (WHO) and other government agencies aroundthe world have warned against antibiotic-resistant bacteria due to abuse of antibiotics and are strengthening their care and monitoring to prevent infection. However, it is highly necessary to develop an expeditious and accurate prediction and estimating method for preemptive measures. Because it takes several days to cultivate the infecting bacteria to identify the infection, quarantine and contact are not effective to prevent spread of infection. In this study, the disease diagnosis and antibiotic prescriptions included in Electronic Health Records were embedded through neural embedding model and matrix factorization, and deep learning based classification predictive model was proposed. The f1-score of the deep learning model increased from 0.525 to 0.617when embedding information on disease and antibiotics, which are the main causes of antibiotic resistance, added to the patient's basic information and hospital use information. And deep learning model outperformed the traditional machine hospital use information. And deep learning model outperformed the traditional machine learning models.As a result of analyzing the characteristics of antibiotic resistant patients, resistant patients were more likely to use antibiotics in J01 than nonresistant patients who were diagnosed with the same diseases and were prescribed 6.3 times more than DDD.

Adaptation of Isolation Guidelines for Health Care Settings (수용개작방법을 활용한 의료기관의 격리주의지침 개발)

  • Ryu, Jae Geum;Jeong, Jae Sim;Jeong, Ihn Sook;Kim, Jeong Hye;Hong, Eun-Young;Kim, Hyang Sook;Jung, Young Sun;Kwon, Jeong Soon;Lee, Ji Young;Choi, Ji Youn;Kim, Kyung Sug;Kim, Eun Hyun;Cha, Gyeong Suk;Kim, Eun Jin;Park, Kyung Hee;Seo, Hyun Ju
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.2
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    • pp.209-226
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    • 2018
  • Purpose: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. Methods: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. Results: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. Conclusion: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.

Evaluation of Caregivers' Exposed Dose and Patients' External Dose Rate for Radioactive Iodine (I-131) Therapy Administration in Isolated Ward (방사성요오드(I-131) 격리병실 치료 관리를 위한 환자의 체외방사선량률과 상주 보호자의 피폭선량평가)

  • Kang, Seok-Jin;Lee, Doo-Hyeon;So, Young;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.45 no.4
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    • pp.347-353
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    • 2022
  • In this study, the radiation dose rate was measured by time and distance and evaluated whether radiation dose rate was suitable for domestic and international discharge criteria. In addition, the radiation dose emitted from the patient was measured with a glass dosimeter to evaluate the exposure dose if the caregiver stays in the isolated ward by placing a humanoid phantom instead of the caregiver at a distance of 1 m from the patient, on the second day of treatment. After 23 hours of isolation, the radiation dose rates at a distance of 1 m were 20.54 ± 6.21 µSv/h at 2.96 GBq administration and 27.94 ± 12.33 µSv/h at 3.70 GBq administration. The radiation dose rates at a distance of 1 m were 25.90 ± 2.21 µSv/h when 2.96 GBq was administered and 34.22 ± 10.06 µSv/h when 3.70 GBq was administered after 18 hours of isolation. However, if the isolation period is short may cause unnecessary radiation exposure to the third person. The reading of the attached dosimeter from the morning of the second day of treatment until removal was 0.01 to 0.95 mSv, which is a surface dose determined by the International Commission on Radiation Units and Measurements. And the depth dose was 0.01 to 0.99 mSv. On the second day of treatment, even if the patient caregivers stayed in the isolation ward, the exposure dose of the patient family did not exceed the effective dose limit of 5 mSv recommended by the ICRP and NCRP.

Appropriate Technology, Responding to the COVID-19 Pandemic - Redefined Roles in a Public Health Crisis (Part I) (COVID-19 대유행에 대응하는 적정기술 : 보건 위기에서 재정의된 역할 - 파트 1)

  • Lee, Sungwoo;Suh, Jungwoo;Kim, Jaeeun;Jang, Dongyoon;Pyun, Nayoon;Shin, Kwanwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.238-255
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    • 2020
  • As COVID-19, which occurred at the end of 2019, has become a global pandemic, it has emerged as an unprecedented event that quickly destroys a nation's medical and healthcare system in both developed and developing countries. In the 21st century, most of the civil society that aimed for hyperconnected society is facing a new crisis that has not been experienced so far. Indeed, lack of personal protective equipment, isolation of clustered communities, disruption of medical systems necessary for diagnosis and treatment, and disruption of educational and economic activities due to social isolation are emerging. Since the COVID-19 has occurred, many of the difficulties that have occurred in the past six months indicate the basic infrastructure a society should have particularly in a pandemic. These include personal protective equipment (PPE), decontamination and quarantine tools essential for effective response, rapid and precise large-scale diagnosis, medical devices required for patient care, and identification and fast and wide on-line networks that can be used in social isolation. In this first part, we would like to introduce some representative examples of 1) personal protective equipment, 2) prevention of personal and community health, 3) social response through big data and networks within the framework of appropriate technology.

An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

The Changing Patterns of Antibiotic Susceptibility for Acinetobacter baumannii in Pediatric Burn Patients (소아 화상환자에서 배양된 Acinetobacter baumannii에 대한 항생제 감수성 양상의 변화)

  • Lee, Sang-Min;Lee, So-Yeon;Kim, Young-Ho;Lee, Kyu-Man;Jang, Young-Chul;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.146-151
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    • 2008
  • Purpose : Multidrug-resistant Acinetobacter baumannii (A. baumannii) is recognized to be the most difficult pathogen to control and treat in pediatric burn centers. We analyzed the antibiotic susceptibility pattern of A. baumannii in our pediatric burn intensive care unit during the past 7 years. Methods : We retrospectively evaluated 56 patients (105 samples) under the age 15 years and who were infected with A. baumannii between January 1999 and December 2005. Results : Fot the 56 patients, the ratio of males to females was 1.15:1 and the median age was 48.3 months. The sites of 105 isolates were wounds (65%), sputum (20%), blood (6 %), cutdown tips (5%), endo-tip tubes (2%) and urine (2%). A. baumannii presented yearround. The annual antimicrobial resistance rate increased and the multidrug resistant rate for two or more antibiotics was 93.33%. For 3 patients in whom resistance emerged, the interval period between the susceptible and resistant strains after antibiotic use was a mean of 10 days. The A. baumannii isolated from blood were all multi-drug resistant pathogens. Conclusion : Multidrug resistance of A. baumannii is increasing. Strict infection control guidelines and active surveillance are needed for the prevention and treatment of A. baumannii in hospitals.

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The Developmental Program of Emergency Medical System in Correctional Facilities (교정시설 내 응급의료체계 발전방안)

  • Kim, Su-Il
    • Journal of forensic and investigative science
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    • v.3 no.1
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    • pp.60-73
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    • 2008
  • The purpose of Emergency Medical System(EMS) is what a patient returns to society with recovering mental tone in the shortest time as giving prompt and proper medical treatment to patient in emergency situation, and the Correctional Administration(CA) is purposed for the convict to return and settle down to society after release from prison in success as executing schooling, enlightenment activity, vocational training to convict who was quarantined from the society for the term of imprisonment. The EMS and CA will coincide each other which is reverting people to society in safety. This study aims to suggest the developmental program of EMS in correctional facilities through the cause of emergency situation, system, human resources, establishment, medical equipments, state of budget and the point issue for safety of victim who has many chances that is exposed to physical damage and disease because of particularity of lower culture in correctional facilities and the staff who works there. First, in the view of the correctional facility security system, a proper number of the emergency rescuers should be employed. Second, the effective transportation system along with some emergency medical equipment needs to be established. Third, the correctional officers and the prisoners should be learned the first-aid training which is realistic, practical and systematic. Fourth, the cooperative system should be established such as 1339 emergency medical information center in society. Fifth, the Ministry of Health and Welfare must increase EMS budget for correctional facilities.

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Evaluation of environmental surface contamination and disinfection effects on multidrug-resistant organism (다제내성균 환경표면 오염도 및 소독 효과 평가)

  • Kim, Jae Yeun;Park, Jung Ae;Lee, Mi Hyang;Kim, Sang Ha;Jeong, Sun Young
    • Journal of Digital Convergence
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    • v.19 no.1
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    • pp.211-216
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    • 2021
  • This study was carried out to evaluate the effects of disinfection using environmental disinfectant after having assessed the extent of contamination through microbial culture testing and the Adenosine Triphosphate Bioluminescence method among the environmental management evaluation methods used for the environment in the hospital ward of patients infected by multidrug-resistant organisms. This study was conducted with the patient wards isolated due to multidrug-resistant organisms as the environmental surface. Specimens were collected from five locations including infusion pumps, IV poles, bedside cabinets, bed railings, keyboards, and blood pressure measurement cuffs. ATP and microbial culture testing were executed prior to, immediately after, and five minutes post-disinfection. According to the result contamination of the infusion pumps was statistically significantly reduced after disinfection. In addition, the bacteria before and after disinfection reduced in IV pole, bed railing, and keyboard. That is, regular environmental surface disinfection can provide safer environments to patients against infection. Therefore, it is necessary to establish guidelines including disinfection methods and intervals for environmental surfaces by evaluating the persistence of disinfectants at various institutions in the future.

COVID-19 in a 16-Year-Old Adolescent With Mucopolysaccharidosis Type II: Case Report and Review of Literature

  • Park, So Yun;Kim, Heung Sik;Chu, Mi Ae;Chung, Myeong-Hee;Kang, Seokjin
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.70-76
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    • 2022
  • Coronavirus disease 2019 (COVID-19) in patients with underlying diseases, is associated with high infection and mortality rates, which may result in acute respiratory distress syndrome and death. Mucopolysaccharidosis (MPS) type II is a progressive metabolic disorder that stems from cellular accumulation of the glycosaminoglycans, heparan, and dermatan sulfate. Upper and lower airway obstruction and restrictive pulmonary diseases are common complaints of patients with MPS, and respiratory infections of bacterial or viral origin could result in fatal outcomes. We report a case of COVID-19 in a 16-year-old adolescent with MPS type II, who had been treated with idursulfase since 5 years of age. Prior to infection, the patient's clinical history included developmental delays, abdominal distension, snoring, and facial dysmorphism. His primary complaints at the time of admission included rhinorrhea, cough, and sputum without fever or increased oxygen demand. His heart rate, respiratory rate, and oxygen saturation were within the normal biological reference intervals, and chest radiography revealed no signs of pneumonia. Consequently, supportive therapy and quarantine were recommended. The patient experienced an uneventful course of COVID-19 despite underlying MPS type II, which may be the result of an unfavorable host cell environment and changes in expression patterns of proteins involved in interactions with viral proteins. Moreover, elevated serum heparan sulfate in patients with MPS may compete with cell surface heparan sulfate, which is essential for successful interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and the host cell surface, thereby protecting against intracellular penetration by SARS-CoV-2.