• Journal of Haehwa Medicine
• /
• v.10 no.2
• /
• pp.155-165
• /
• 2002

From July 1th 2001 to October 31th 2001, the Clinical investigation studies were carried out 10 cases of patient with Bell' palsy using Trigger point treatment group, who had been treated in Han-seung Oriental Medical Clinic. The results were like below: 1. The distribution of sex : Male were 4cases. female were 6case and the female to male ratio was 1.5 : 1. 2. The distribution of contributing factor : Unknown reason was most predominant 4 cases, and then were revealed to labor too hard. mental stress(3 cases), trauma common cold(1 case) in turn. 3. The distribution of perid to fall ill : Under a week was the most number 6cases, and then were revealed a week under two weeks(3 cases), over two weeks(1 case) in turn. 4. About period of treatment : The Trigger Point treatment group is shorter than the Acupuncture treatment group. 5. The distribution of grade on admission in descending order : Gr I was the most number and then GrII, GrIII in turn. 6. The distribution of clinical symptoms on admission : Mastoid pain was the most number 9 cases and then lacrimal gland disorder 8 cases, dysgeusia 4cases, hyperacusis 2 cases, the others 2 cases in turn. 7. About effect of treatment : The Trigger point treatment group is more excellent than the Acupuncture treatment group. 8. The more patient age is young, the more effect of treatment was excellent, had nothing to do with both groups. 9. The more perid to fall ill is short, the more effect of treatment was excellent. had nothing to do with both groups. 10. About period of improved frontal belly : The Trigger point treatment group is more excellent than the Acupuncture treatment group.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.18 no.3
• /
• pp.75-83
• /
• 2005

Objective: The purpose of this study is to investigate the clinical studies on 254 cases of patient with facial paralysis. Methods: We examined the sex, age, region, month, season, physical condition, attened symptoms, the period before admission, the period of treatment the times of treatment, the point of the recovery Results: 1. The distribution of sex was male 119 cases, female 125 cases(1.032:1). The distribution of age was disclosed that fifty was the most in 53 cases(20.9%) 2. In distribution of the region of facial palsy, the ratio of the male-left was 27.6%(70 cases), female-left was 24.4%(62cases), male-right was 23.2%(59 cases), female-right was 24.8%(63 cases). 3. In distribution of contributing frequence in month, January was the most in number(29 cases, 11.4%), In distribution of contributing number in season winter was the most in number(76 cases, 29.9%). 4. In distribution of physical condition, fatigue(99 cases, 40.0%), stress(66 cases 26.0%), cold exposure(43 cases, 16.9%) were investigated highly than other conditions. 5. In distribution of attended symptoms, stylomastoid pain(91 cases, 35.8%), tears(40 cases 15.7%). taste paralysis(29 cases, 11.4%) were investigated highly than other symptoms. 6. In distribution of the period before admission in descending order the first under the third day was the most number in 92 cases(62.2%), over two weeks 22 cases(14.9%) 7. In distribution of the period of treatment, over eight weeks was the most number in 91 cases(35.8%), under a week in 50 cases(19.7%). In distribution of the times of treatment under five times was the most number in 56 cases(14.2%). 8. In distribution of the point of the recovery, under two weeks was the most number in 77 cases(52%).

• Pediatric Infection and Vaccine
• /
• v.24 no.2
• /
• pp.87-94
• /
• 2017

Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.12 no.2
• /
• pp.92-96
• /
• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• Journal of the Korea Convergence Society
• /
• v.10 no.1
• /
• pp.339-351
• /
• 2019

This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

• Journal of Nutrition and Health
• /
• v.55 no.1
• /
• pp.85-100
• /
• 2022

Purpose: This study is aimed to examine the association between initial enteral nutrition (EN) and the clinical prognosis among patients with severe and multiple traumatic injuries, and to investigate whether this association is modified by the patients' catabolic status. Methods: This was a retrospective study of 302 adult patients with severe and multiple traumatic injuries admitted between January 2017 and September 2020 at Ajou University hospital in Suwon, Korea. The initial nutritional support by EN and parenteral nutrition were monitored up to day 7 after admission. Patients were classified into "No", "Low", and "High" EN groups according to the level of initial EN. Multivariable-adjusted logistic regression and linear regression models were used to estimate the association of the initial EN levels at hospital admission with the risk of mortality, morbidities, and levels of nutrition-associated biochemical markers. Results: High EN support was associated with reduced mortality (odds ratio, 0.07; 95% confidence interval [CI], 0.02, 0.32) and lower levels of C-reactive protein (β, -0.22; 95% CI, -8.66, 1.48), but longer stay in the intensive care unit (β, 0.19; 95% CI, 1.82, 11.32). In analyses stratified by catabolic status, there were fewer incidences of hospital-acquired infections with increasing EN levels in the moderate or higher nitrogen balance group than in the mild nitrogen balance group. Conclusion: Our observation of the inverse association between levels of initial EN administration with mortality risk and inflammatory markers may indicate the possible benefits of active EN administration to the recovery process of severe and multiple trauma patients. Further studies are warranted on whether the catabolic status modifies the association between the initial EN and prognosis.

• Korean Journal of Radiology
• /
• v.21 no.6
• /
• pp.736-745
• /
• 2020

Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.4
• /
• pp.309-315
• /
• 2015

Objective : An advantage of surgical treatment over conservative treatment of spontaneous intracerebral hemorrhage (ICH) is controversial. Recent reports suggest that contrast extravasations on CT angiography (CTA) might serve as a crucial predictor of hematoma expansion and mortality. The purpose of this study was aimed at investigating the efficacy of surgical treatment in patients with spot sign positive ICH. Methods : We used our institutional medical data search system to identify all adult patients who admitted for treatment of ICH between January 1, 2007 and January 31, 2012. Patients were classified two groups into a surgical group (n=27) and a conservative treatment group (n=28). Admission criteria were the following: age 20-79 years, spontaneous supratentorial ICH, Glasgow Coma Score Ranging from 9 to 14, ICH volume ${\geq}20mL$, and treatment within 24 hours. Results : Fifty-five patients were analyzed. There was no significant difference in the ICU stay between the conservative treatment group ($7.36{\pm}3.66days$) and the surgical treatment group ($6.93{\pm}2.20days$; p=0.950). There was a significant difference in the in-hospital stay between the conservative treatment group ($13.93{\pm}8.87days$) and the surgical treatment group ($20.33{\pm}6.37days$; p=0.001). Overall mortality at day 90 after ICH was 36.4%; this included 16 of 28 patients (57.1%) in the conservative group and 4 of 27 patients (14.8%) in the surgical group. In univariate analysis, there was a positive effect of the surgical treatment in reducing mortality at 90 days (p=0.002), Glasgow Outcome Scale (GOS) at 90-day (p=0.006), and modified Rankin Scale (mRS) at 90-day (p=0.023). In multivariate logistic analysis, there was a significant difference in mortality (odds ratio, 0.211; 95% confidence interval, 0.049-0.906; p=0.036) between the groups at 90-day follow-up. However, there was no significant difference in GOS (odds ratio, 0.371; 95% confidence interval, 0.031-4.446; p=0.434) and mRS (odds ratio, 1.041; 95% confidence interval, 0.086-12.637; p=0.975) between the groups at 90-day follow-up. Conclusion : In this study of surgical treatment of supratentorial ICH in patients with spot sign positive in CTA was associated with less mortality despite of long duration of in-hospital stay. We failed to show that clinical outcome benefit of surgical treatment compared with conservative treatment in patients with spot sign positive ICH.

• Childhood Kidney Diseases
• /
• v.8 no.2
• /
• pp.229-238
• /
• 2004

Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1116-1120
• /
• 2005

Purpose : Although the rotavirus-related neonatal death occurred in western part of Kyeonggi Province recently, there were just a few reports about rotavirus gastroentertis in domestic since 2000. We proposed to investigate changes of epidemiology and clinical features of rotavirus gastroenteritis for the last 2 years. Methods : We selected 166 patients diagnosed as gastroenteritis from January, 2002 to July, 2003 and reviewed the admission records retrospectively such as age distribution, sex ratio, seasonal distribution, admission period, laboratory data and dehydration type in the rotavirus group(RVG) and non-RVG. Results : The percentage of patient under 3 years was 77% on RVG. The non-RVG showed even age distribution(P<0.05). In RVG, patients occurred in March frequently and 52% occurred from January to March. In non-RVG, patients occurred highly in February and July(P<0.05). The average of admission period was higher in RVG than non-RVG(P<0.05). The percentage of patient admitted for over 10 days was 8% in the RVG. In dehydration severity, the RVG showed mild(51%), moderate(44%) and severe(5%) respectively, but non-RVG showed only mild dehydration(P<0.05). The laboratory findings' did not have statistic significance between RVG and non-RVG. Conclusion : Compared to the previous studies, seasonal peak prevalence of rotavirus gastroenteritis changed from autumn to spring and patients over 3 years increased. Therefore, we suggest that there are variable serotypes of rotavirus domestically and there is a need for reinvestigation about clinical features and serotypes of rotavirus gastroenteritis.