• Journal of Korean Neurosurgical Society
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• 제67권1호
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• pp.84-93
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• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• 한방안이비인후피부과학회지
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• 제22권3호
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• pp.178-187
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• 2009

5개월 동안 외래를 통해 꾸준한 약물치료 및 외치요법을 실시하여 호전되던 중 재발한 중증의 아토피피부염 소아환자에게 10일간의 단기입원치료를 통하여 약물치료 뿐만 아니라 한약 외용제,습포제 및 기타 치료 및 교육을 적극적으로 실시한 결과 객관적인 SCORAD score 및 주관적인 평가에서 긍정적인 변화가 있었음을 확인할 수 있었다. 한 명의 동일한 환자에게 증상의 정도가 비슷한 상태에서 외래와 입원이라는 방법으로 똑같은 치료를 수행했을 때, 다른 결과가 나왔는데 이는 집에서 자가적 치료가 원활하게 이루어지지 않았기 때문으로 생각되며, 단기입원을 통한 아토피피부염 치료는 외래치료의 한계를 극복하는 대안이 될 수 있을 것으로 기대된다.

• 대한간호학회지
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• 제29권2호
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• pp.271-280
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• 1999

The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malnutrition among these patients. The study was performed from May to July l996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured. The results were as follows : 1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more than 2 weeks. 2) There was a statistically significant difference in nutritional status(lympocyte : P＝.002 ; skinfold thickness in four areas : p＜0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients. 3) There was a correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.

• Journal of Nutrition and Health
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• 제44권4호
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• pp.326-337
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• 2011

The purpose of this study was to investigate dietary intake and to evaluate patient satisfaction toward the quality of hospital foodservice. Questionnaires were distributed to 203 hospitalized patients in 3 hospitals having 300 beds. The intake rates for served amounts of rice, side dishes, and soup were 72.5%, 68.2%, and 62.6%, respectively. The main reasons for left-overs were 'no appetite' (25.8%) and 'not salty enough' (19.9%). The rate of patients eating outside food was about 33.5%. The average score for quality satisfaction of meal characteristics was 3.34 ${\pm}$ 0.61, and the average score for quality satisfaction of sanitation and service characteristics was 3.58 ${\pm}$ 0.61. 'Seasoning' showed the lowest score and 'temperature' showed the highest score for quality satisfaction of meal characteristics. In the quality satisfaction of sanitation and services, 'explanation of meals' showed the lowest score and 'exactness of meal times' showed the highest score. The patients hospitalized for 10 days showed significantly lower average scores than those hospitalized over 60 days for quality satisfaction of meal characteristics. The patients with 'little appetite' and 'regular appetite' showed significantly lower average scores than those with 'much appetite' for the quality satisfaction of meal, sanitation, and service characteristics. The patients who 'rarely had leftovers' showed significantly higher average scores than those who 'always had leftovers' and 'often had leftovers' for quality satisfaction of meal characteristics. Meal characteristic scores were significantly correlated with age (r = 0.216), length of admission (r = 0.310), appetite (r = 0.251), leftovers (r = 0.233), and intake of soup (r = 0.205). Also, sanitation and service characteristics scores were significantly correlated with age (r = 0.327), education (r = -0.202), length of admission (r = 0.168), and appetite (r = 0.155). Thus, it would seem to be desirable that hospital foodservices improve the taste and seasoning of meals and provide appropriate nutrition education and counseling in mid-sized hospitals.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.275-278
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• 2017

Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

• Journal of Acupuncture Research
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• 제34권1호
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• pp.59-66
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• 2017

Objectives : This study aims to report the effectiveness and safety of Korean medicine with thread embedding acupuncture in the treatment of trigeminal neuralgia (TN). Methods : A 73-year-old man who had suffered from severe facial pain for one year and who had had a healthy tooth extracted due to the pain is reported. He could not eat or sleep due to the severe pain. Acupuncture, thread embedding acupuncture, cupping, herbal steam, and herbal medicines were used for the treatment. Numeric Rating Scale (NRS) and adverse events were checked daily, and other outcomes (Baseline Evaluation, Visual Analogue Scale [VAS], Short Form Health Survey 36-Bodily Pain [SF-36 BP], and Patient Global Assessment [PGA]) were measured at hospital admission and discharge. During the follow-up examinations, his pain was evaluated roughly, without using any formal measurements, on the basis of a global assessment. Results : All measured parameters, including pain, quality of life, and patient satisfaction were noted to have improved at the time of discharge compared to admission: VAS from 10 to 1.5, NRS from 7-8 to 1-2, and SF-36 BP from 0 to 22.5, and the patient's global assessment was somewhat improved. He did not take any analgesics after discharge and noted only mild adverse events, like pain where the acupuncture and thread embedding acupuncture needles were inserted. His pain relief was maintained for 6 months. Conclusion : Korean medicine with thread embedding acupuncture might be a safe and effective treatment for TN. In the future, larger sample sizes and high quality randomized clinical trials are warranted to confirm its efficacy and safety.

• 척추신경추나의학회지
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• 제8권2호
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• pp.131-139
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• 2013

Objectives : The purpose of this study is to investigate the efficacy of conservative treatment on Achondroplasia patient who has low back pain with radiation. Methods : The patient was treated by conservative treatment including acupuncture, pharmaco acupuncture, chu-na manipulation, herbal medicine. Numeric rating scale(NRS), Oswestry disability index(ODI) were used to evaluate pain reduction. Physical examination also used to compare with admission state and discharge state. Results : After 1 month admission treatment, NRS decreased 9 to 6, ODI dcreased 56 to 42, ROM improved as normal person. Conclusions : It was efficient that Achondroplasia patient who has low back pain with radiation treated as conservative treatment including acupuncture, pharmaco acupuncture, chu-na manipulation, herbal medicine. But It was just one case and treatments were carried out in Integrative Package. So further studies are required to compare that which treatment is efficient.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.573-581
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• 2005

Breast cancer is the second leading cause of death in woman. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. This paper introduces the breast reconstruction by use of pectoralis major muscle transfer with breast implant for small size defect after skin sparing mastectomy for more satisfaction. We reviewed 24 consecutive patients who underwent breast reconstruction by pectoralis major muscle transfer with implant and only breast implant in Dong-A University from April 2002 to March 2004. The patient's age ranged between 29 and 54 years with mean of 42.3 years. We used pectorals major muscle transfer with breast implant in 12 patients and breast implant alone in 12 patients as control. The follow-up period of patients ranged from 10 months to 3 years with mean of 18.5 months. The points of comparison with control group reconstructed by breast implant alone were doctor and patient satisfaction score, operation time, duration of admission, amount of drainage, complication and satisfaction according to mass location. In conclusion, there is no difference with control group in the point of operation time, mount of drainage, duration of admission. And there is higher level of doctor's and patient's satisfaction in group reconstructed by pectoralis major muscle transfer with breast implant than implant only group. Especially, pectoralis major muscle transfer with breast implant was especially necessary for the defect in upper lateral quadrant of the breast to get more satisfaction. The advantage of pectoralis major muscle transfer with breast implant is prevention of the protruding and palpability of implant and aesthetically satisfactory result by intraoperative modification of breast shape.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.114-117
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• 2017

A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess. At admission to our department, the patient reported aggravated low back pain. Blood test results, including the erythrocyte sedimentation rate and C-reactive protein levels, were slightly elevated. Biopsy samples of the L4, L5 vertebral bodies and disk were obtained. The material underwent aerobic, anaerobic, fungal, mycobacterial cultures and histologic examination. Results of all cultures were negative. Histologically, necrosis of the bone was evident from the number of empty osteocyte lacunae. In addition, there was no evidence of infection based on biopsy results. No antibiotic treatment was administered on discharge. Repeat computed tomography and MRI performed 12 months after IDET showed a bony defect in the L4 and L5 vertebral bodies, and a decrease in the size of the L4-5 intervertebral disc lesion. We report a case of lumbar vertebral osteonecrosis induced by IDET and discuss etiology and radiologic features.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.494-496
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• 2018

No previous reports have described a case in which deep brain stimulation elicited an acute mood swing from a depressive to manic state simply by switching one side of the bilateral deep brain stimulation electrode on and off. The patient was a 68-year-old woman with a 10-year history of Parkinson's disease. She underwent bilateral subthalamic deep brain stimulation surgery. After undergoing surgery, the patient exhibited hyperthymia. She was scheduled for admission. On the first day of admission, it was clear that resting tremors in the right limbs had relapsed and her hyperthymia had reverted to depression. It was discovered that the left-side electrode of the deep brain stimulation device was found to be accidentally turned off. As soon as the electrode was turned on, motor impairment improved and her mood switched from depression to mania. The authors speculate that the lateral balance of stimulation plays an important role in mood regulation. The current report provides an intriguing insight into possible mechanisms of mood swing in mood disorders.