• 제목/요약/키워드: A University Hospital

검색결과 43,972건 처리시간 0.07초

Multidrug-Resistant Tuberculosis Presenting as Miliary Tuberculosis without Immune Suppression: A Case Diagnosed Rapidly with the Genotypic Line Probe Assay Method

  • Ko, Yousang;Lee, Ho Young;Lee, Young Seok;Song, Junwhi;Kim, Mi-Yeong;Lee, Hyun-Kyung;Shin, Jeong Hwan;Choi, Seok Jin;Lee, Young-Min
    • Tuberculosis and Respiratory Diseases
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    • 제76권5호
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    • pp.245-248
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    • 2014
  • Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen was resistant to ethambutol and streptomycin in addition to isoniazid and rifampicin. The patient was then treated with effective antituberculous drugs without delay after diagnosis of MDR-TB. To the best of our knowledge, this is the first case of miliary TB caused by MDR-TB pathogen in Korea.

GWP 구현을 위한 조직문화 증진활동의 효과 (Promoting a nursing organizational culture for Great Workplace(GWP): a Korean experience)

  • 김영미;이지애;김대희;김보열;이순형;박현미;김혜선
    • Perspectives in Nursing Science
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    • 제6권1호
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    • pp.21-37
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    • 2009
  • The purpose of this GWP project was two-fold:(1) to launch an organizational culture improvement for great workplace (2) to improve the perception of nursing personnel on communication and team work in a surgical nursing department of a teaching hospital in Seoul. Using one group pretest-posttest design, nursing personnel's perception on organizational culture related to communication and team work was evaluated. A 10-item, 5-point scale (1.5) survey was administered to 209 nursing personnel in January 2009 and again to 191 nursing personnel in October 2009. From January 2009, AMANNA team has taken activities focused on trust, pride, and fun. AMANNA is an abbreviation of Korean language, which means wonderful meeting and sharing in English. Monthly activities are as follows: choral concerts by nurse managers, welcome and farewell events, praising members for their services, explaining current circumstances, etc. Special activities are as follows: a New Year's greeting party, a spring picnic, beauty classes, a lecture on drug administration, cultural lectures using videos, and presentations of academic posters and another activity. The reliability of measurement was Cronbach's ${\alpha}$: 0.917(pretest), 0.954(posttest). Most nursing personnel's perception on organizational culture was improved (pretest mean=3.50 and posttest mean=3.78, p<.001). "A sense of belonging" showed the greatest improvement among the 10 items(3.18 vs. 3.56, p<.001). "Trust each other" showed the highest score (mean=3.98) in posttest. Frequency of participation and satisfaction showed a significant relationship(r=0.179, p=.021). We believe that this project has made a contribution towards a positive organizational culture. The keys to this initiative's preliminary success have been the leadership support and flexibility in implementing the interventions tailored to the hospital.

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The Busan Regional CardioCerebroVascular Center Project's Experience Over a Decade in the Treatment of ST-segment Elevation Myocardial Infarction

  • Lim, Kyunghee;Moon, Hyeyeon;Park, Jong Sung;Cho, Young-Rak;Park, Kyungil;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.351-359
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    • 2022
  • Objectives: The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI). Methods: Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort. Results: In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI. Conclusions: A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.

Intestinal Helminthic Infections Diagnosed by Colonoscopy in a Regional Hospital during 2001-2008

  • Do, Kyong-Rock;Cho, Young-Seok;Kim, Hyung-Keun;Hwang, Byung-Hee;Shin, Eun-Jung;Jeong, Hae-Bin;Kim, Sung-Soo;Chae, Hiun-Suk;Choi, Myung-Gyu
    • Parasites, Hosts and Diseases
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    • 제48권1호
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    • pp.75-78
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    • 2010
  • The present study investigated characteristics of 24 parasite infection cases detected during colonoscopy in a regional hospital from January 2001 to December 2008. Sixteen patients were confirmed with Trichuris trichiura infection, 6 patients were with Ascaris lumbricoides infection, 1 patient with Enterobius vermicularis infection, and 1 patient with Anisakis infection. Among them, 7 patients (43.8%) were asymptomatic. Colonoscopy findings were normal in 18 patients (75.0%). Among the patients with T. trichiura infection, colonoscopy showed several erosions in 2 patients (8.3%) and non-specific inflammation of the affected segment of the colon in 3 patients (12.5%). In 1 patient with anisakiasis, colonoscopy revealed a markedly swollen colonic wall. Stool examinations were performed before treatment in 7 patients (29.2%) and were all negative for parasite eggs or worms. These results suggest that colonoscopy is a useful diagnostic approach for parasitic infections even for asymptomatic patients and for patients with negative stool examinations.

Celiac Plexus Neurolysis for the Treatment of Patients with Terminal Cancer at a Tertiary University Hospital in Korea

  • Byeon, Gyeong-Jo;Park, Ju Yeon;Choi, Yun-Mi;Ri, Hyun-Su;Yoon, Ji-Uk;Choi, Eun-Ji
    • Journal of Hospice and Palliative Care
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    • 제23권1호
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    • pp.5-10
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    • 2020
  • Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea. Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed. Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%). Conclusion: CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.

황산 손상 환자의 임상적 고찰 (A Clinical Analysis of Patient Exposure to Sulfuric Acid Injured)

  • 오세광;신희준;유병대;전덕호;이동하;김기환
    • 대한임상독성학회지
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    • 제14권1호
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    • pp.33-36
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    • 2016
  • Purpose: This study was conducted to identify the characteristics associated with sulfuric acid injury in the emergency department. Methods: Data were collected retrospectively from January 2007 to December 2015 on all sulfuric acid injuries presenting to the emergency department in Gu-mi Soonchunhyung University Hospital. Patients injured by sulfuric acid were recorded over a nine year study period and collected data included demographics, injury mechanism, injured body part, hospital care and final diagnosis. Results: A total of 26 cases were identified. Most patients were male (88.5%) and the face was the most commonly injured body part. The most common mechanism of injury was splashing injury. A total of 16 (61.5%) patients were identified as having lesions worse than second degree burns. Conclusion: Sulfuric acid can cause severe and fatal skin burn. When working with sulfuric acid, acid proof protect clothing, goggles and glove should be worn. Furthermore, safety education and workplace environment improvement are necessary to reduce sulfuric acid injury.

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폐색전증으로 오인된 폐동맥내막육종 1예 (A Case of Pulmonary Artery Intimal Sarcoma Masquerading as Pulmonary Embolism)

  • 김진숙;박혜경;이혜란;강승대;배상철;김수영;장선희;장우익;강승희;이성순
    • Tuberculosis and Respiratory Diseases
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    • 제72권2호
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    • pp.218-222
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    • 2012
  • Pulmonary artery intimal sarcoma is a rare tumor with no characteristic symptoms. It is frequently misdiagnosed as pulmonary embolism. We report a case of pulmonary artery intimal sarcoma in a 48-year-old man with dyspnea, cough and blood-tinged sputum. He was initially suspected and treated as a pulmonary embolism. Computed tomography of the chest showed filling defects occupying the entire luminal diameter of the right and left pulmonary artery as well as extraluminal extension of the intraluminal mass. Surgical resection of the tumor confirmed pulmonary artery intimal sarcoma. After surgery, he received 8 cycles of combined chemotherapy consisting of doxorubicin and ifosfamide. After 8 cycles, Computed tomography of the chest showed interval regression of the residual tumor. Radiotherapy was done as total 6,000 cGy for 5 weeks, following the 8th chemotherapy. The patient's condition was successfully stabilized with chemotherapy and radiotherapy.

변형 구개 유경 판막을 이용만 상하악 전방골 본절 성형술 : 증례 보고 (Anterior segmental maxillary osteotomy using a modified Couper's method with circumcrevicular incision : A Case Report)

  • 박영주;남정훈;연병무;송준호;노경록;방은오;김다영;김준현;안장훈;강태인
    • 대한치과의사협회지
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    • 제47권6호
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    • pp.373-378
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    • 2009
  • This article presents a modified palatal pedicled incision design in anterior segmental maxillary osteotomy. This method included the circumcrevicular incisions and two vertical relaxing incisions. Then, it is different from the Couper's method with vestibular horizontal incision and other anterior segmental osteotomy techniques. The main advantages of this method are an improved visibility of surgical field and favorable preservation of palatal pedicle. A patient who had been operated by anterior segmental maxillary and mandibular osteotomy without pre operative orthodontic treatment was analyzed for advantages and complications during the intraoperative and early post operative period. There are no specific major complications such as infection, gingival recession and dehiscence. And the patient had a pleasing esthetic facial appearance.

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ANCA 음성인 전신성 베게너육아종증 1예 (A Case of ANCA-Negative Generalized Wegener's Granulomatosis)

  • 김승규;권용진;박혜성;이광원;하지윤;고희성;김기현;변민광
    • Journal of Yeungnam Medical Science
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    • 제30권1호
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    • pp.17-20
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    • 2013
  • Wegener's granulomatosis is a very rare systemic vasculitis characterized by necrotizing granulomatosis. The detection of antineutrophil cytoplasm antibody (ANCA) is a valuable finding in diagnosing Wegener's granulomatosis because ANCA is positive in approximately 90 percent of patients with active, generalized Wegener's granulomatosis. But ANCA is not necessarily positive to make a diagnosis. A 59-year-old man was transferred to our hospital. He was diagnosed with lung abscess and treated with antibiotics at previous hospital. Initially, the ANCA was negative in immunofluorescence assay but we suspected Wegener's granulomatosis because of systemic inflammatory symptoms. Clinical symptoms deteriorated rapidly so we did bronchoscopic biopsy early. Wegener's granulomatosis was diagnosed according to pathologic finding that reported necrotizing granulomatous inflammation associated with vasculitis. Thus we treated with steroid then clinical symptoms and laboratory findings were improved.

GOLPH3, a Good Prognostic Indicator in Early-stage NSCLC Related to Tumor Angiogenesis

  • Lu, Ming;Tian, Yu;Yue, Wei-Ming;Li, Lin;Li, Shu-Hai;Qi, Lei;Hu, Wen-Si;Gao, Cun;Si, Li-Bo;Tian, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5793-5798
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    • 2014
  • Background: Golgi phosphoprotein-3 (GOLPH3) is implicated in cancer development and progression. The aim of this study was to evaluate the prognostic significance of GOLPH3 protein and its association with tumor angiogenesis in patients with early-stage NSCLC. Materials and Methods: Immunohistochemistry was performed to determine GOLPH3 protein expression and allow assessment of intratumoral microvessel density (MVD) by counting CD-34 positive immunostained endothelial cells. Correlations of expression with MVD, clinicopathologic features and clinical prognosis were analyzed. Results: A notably higher level of GOLPH3 expression was found in early-stage NSCC tissues at the protein level. However, we do not find any correlation between GOLPH3 expression and clinicopathologic features (p>0.05), although higher MVD was positively associated with GOLPH3 overexpression (p<0.001). Expression of GOLPH3 was found to be an independent prognostic factor in early-stage NSCLC patients, those expressing high levels of GOLPH3 exhibiting a substantially lower 5-year overall survival than GOLPH3-negative patients (adjusted HR =1.899, 95% CI: 1.021-3.532, p=0.043). Conclusions: High expression of the GOLPH3 protein is common in early-stage NSCC, and is closely associated with tumor progression, increased tumor angiogenesis, and poor survival. We conclude a possibility of its use as a diagnostic and prognostic marker in early-stage NSCC patients.