• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.207-212
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• 2015

Background: The ideal alternative airway device should be intuitive to use, yielding proficiency after only a few trials. The Clarus Video System (CVS) is a novel optical stylet with a semi-rigid tip; however, the learning curve and associated orodental trauma are poorly understood. Methods: Two novice practitioners with no CVS experience performed 30 intubations each. Each trial was divided into learning (first 10 intubations) and standard phases (remaining 20 intubations). Total time to achieve successful intubation, number of intubation attempts, ease of use, and orodental trauma were recorded. Results: Intubation was successful in all patients. In 51 patients (85%), intubation was accomplished in the first attempt. Nine patients required two or three intubation attempts; six were with the first 10 patients. Learning and standard phases differed significantly in terms of success at first attempt, number of attempts, and intubation time (70% vs. 93%, $1.4 {\pm}0.7$ vs. $1.1{\pm}0.3$, and $71.4{\pm}92.3s$ vs. $24.6{\pm}21.9s$, respectively). The first five patients required longer intubation times than the subsequent five patients ($106.8{\pm}120.3s$ vs. $36.0{\pm}26.8s$); however, the number of attempts was similar. Sequential subgroups of five patients in the standard phase did not differ in the number of attempts or intubation time. Dental trauma, lip laceration, or mucosal bleeding were absent. Conclusions: Ten intubations are sufficient to learn CVS utilization properly without causing any orodental trauma. A relatively small number of experiences are required in the learning curve compared with other devices.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.75-85
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• 2018

Purpose: This study examined the Poisoning Severity Score (PSS) from acute poisoning patients, to determine the relationships among the PSS, PSSsum, the primary outcome (prolonged stay at the ER over 24 hours, general ward and ICU admission and the application of intubation and mechanical ventilator, and the administration of inotropes). Methods: A retrospective study was conducted through the EMR for 15 months. The PSS grade was classified according to the evidence of symptoms and signs. The differences in the primary outcomes between the PSS of when a single organ was damaged, and the PSS, PSSsum combined with the grade of when multiple organs were damaged, were studied. The cutoff value was calculated using the receiving operating characteristics (ROC) curve. Results: Of the 284 patients; 85 (29.9%) were men with a mean age of 48.8 years, and their average arrival time to the ER was $4.4{\pm}6.7\;hours$. The most frequently used drug was hypnotics. The number of patients with PSS grade 0, 1, 2, 3, and 4 was 17, 129, 122, 24, and one, respectively. No ICU admissions, application of intubation and mechanical ventilators, administration of inotropes were observed among the patients with PSS grades 0 and 1 but only on patients with PSS grades 2 to 4. At PSS, when separating the patients according to the number of damaged organs, 17 had no symptoms, 133 had one organ damaged, 75 had two organs damaged, 36 had three organs damaged, and 23 had four organs damaged. Significant differences were observed between increasing number of damaged organs and the primary outcome. Conclusion: Among the acute poisoning patients, the PSS was higher in severity when the grade was higher. The number of damaged organs and the primary outcome showed meaningful statistical differences. This study confirmed that when the patients' PSS>2 and PSSsum>5, the frequency of ICU admission was higher, and they were considered to be severe with an increased prescription risk of application of intubation and mechanical ventilator, and the administration of inotropes.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.107-121
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• 2020

Objectives: The purpose of this study was to identify the characteristics of patients who visited the emergency room (ER) of a Korean medicine (KM) hospital and to provide basic data for further research. Methods: We conducted a retrospective analysis using electronic medical records of 263 patients who visited the ER of OO University Oriental Hospital from January 1 to December 31, 2019. Results: Of the 263 patients' medical records, 245 were included in this analysis. The male-to-female ratio was 1.09:1. The average age was 52 years, with patients in their 40s having the largest distribution. The district where the hospital was located had the largest number of patients. The distribution by visit time was the lowest in the early morning. Most patients visited on Sunday, in September, and on the day of onset. The admission rate was 39.18%, and largest number of patients was admitted to the Department of Acupuncture and Moxibustion. The percentage of patients who revisited the KM hospital as an outpatient were 26.17%. The diagnosis for most patients was musculoskeletal disease. Acupuncture was the most common treatment, accounting for 62.45% of the cases, followed by herbal medicines, accounting for 54.69% of the cases. National health insurance was the most common type of insurance registered. Most patients visited the ER of the KM hospital via the ER of the hospital. Conclusions: This clinical analysis helped us identify the characteristics of patients visiting the ER of a KM hospital. Continuous data accumulation is required in relation to this for further studies.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.58-75
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• 1998

Background : In Korea, the rational use of antibiotics are rarely controlled, and their patterns of utilization are not understood. In order to reduce the excessive use and to improve the appropriate use of antibiotics, it is necessary to accurately determine present uses of antibiotics in hospitals. Methods : Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. A stratified sampling by types of hospitals, departments, and diseases was obtained from 1994 August data. Patients with secondary diseases were excluded. In this study, 2,697 adults with URI, 6,397 children with URI, 704 adults with bronchitis, and 1,838 children with bronchitis were included. Results : Most patients were prescribed medication (95.2-99.6%). Of the patients prescribed medication, more than 85% of URI patients and more than 91% of bronchitis patients were prescribed antibiotics. Antibiotics expenses accounted for 14% of total medical expenses in adults and 9% of total medical expenses in children. In adults with URI, antibiotics expenses accounted for 52% of drug expenses. Of the patients prescribed antibiotics, average number of antibiotics used was 1.6-1.7. For patients who are prescribed antibiotics, drug expenses were 62-97% greater than patients not prescribed antibiotics. When children were prescribed antibiotics, the highest price of drugs prescribed were 3.4-fold greater. In addition, the number of drugs prescribed also increased by more than one. Elderly patients, more than 60 years, were prescribed antibiotics less frequently. Children less than 10 years and elderly patients greater than 60 years old were prescribed fewer antibiotics than other patients. And they were prescribed medications for longer days than other patients. Conclusion : This study demonstrated that the average rate of prescribing antibiotics was higher in Korea than other countries. Measures to reduce overuse of antibiotics and to improve the appropriate prescription of antibiotics must be considered for cost effective treatment and overall health of people.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.38-44
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• 2018

Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.688-693
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• 2010

An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type natriuretic peptide (BNP) or N-terminal-proBNP must be conducted in the BPD patients with greater than moderate degree to prevent PH and to ensure early treatment if PH is present. In the BPD patients with significant PH, multi-modality treatment, including treatment for correcting an underlying disease, oxygen supply, use of diverse selective pulmonary vasodilators (inhaled nitric oxide, inhaled prostacyclins, sildenafil, and endothelin-receptor antagonist) and other methods, is mandatory.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.500-506
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• 2018

This study analyzed current prehospital emergency care for severe trauma patients administered by different number of 119 EMS (emergency medical services) teams. Out of 1,067 severe trauma patients transferred by 119 EMS teams in J province from January 1st to December 31st 2015, 438 were evaluated in this study. IBM SPSS Statistics 21.0 was used to analyze collected data. The number of patients with severe trauma during the period of study was higher in male with two and three ambulance crews of 119 EMS teams with 242 patients (70.6%) and 66 patients (69.5%) respectively. The percentage of transfers made to local emergency medical centers was highest in those two groups, being 44.0% (151 patients) and 49.5% (47 patients), respectively. Total time spent at the scene did not differ between ambulance crews of two and three, nor did the frequency of practicing advanced airway management and IV (intravenous) cannulation, or the success rate of IV cannulation (p=0.253, p=0.362, p=1.000). Overall, the results indicated that merely increasing the number of paramedics does not improve the quality of prehospital care for severe trauma patients. Measures such as securing professional paramedics, simplifying direct medical oversights, activating indirect medical oversights, and expanding the legally allowed work scope are required.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4959-4962
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• 2012

The objective of this retrospective study was to investigate prognostic factors associated with survival of patients with extensive stage small cell lung cancer (ES-SCLC). Included were 200 patients admitted to the Liberation Army General Hospital with a diagnosis of ES-SCLC. The demographics of patients, disease characteristics, pre-treatment biochemical parameters and therapeutic plan were assessed or evaluated. Univariate analysis found that second-line chemotherapy, radiotherapy, and no liver metastasis were associated with improved survival. Tumor response to first-line chemotherapy and normal initial hemoglobin levels were also associated with a survival benefit (all P-values ${\leq}$ 0.0369). Multivariate Cox regression analysis indicated that liver metastasis and the total number of all chemotherapy cycles were independent prognostic factors of survival. The morbidity risk in patients with liver metastasis was 2.52-fold higher than that in patients without liver metastasis (hazard ratio (HR)=2.52 (1.69-3.76); P<0.0001). However, one unit increase in the total number of chemotherapy cycles decreased the risk of death by 0.86-fold (HR=0.86 (0.80-0.92); P<0.0001). Absence of liver metastasis and ability of a patient to receive and tolerate multiple lines of chemotherapy were associated with longer survival.

• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.76-89
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• 2019

Purpose: The purpose of this study was to evaluate the prognostic effect of patient compliance with supportive periodontal treatment (PC-SPT). Chronic periodontitis patients were classified based on their compliance level, and factors affecting PC-SPT and the prognosis of PC-SPT were investigated. Methods: This study selected 206 patients who started SPT after receiving periodontal treatment between 2010 and 2012. Patients who continued SPT through February 2016 were included. The patients were classified according to whether they exhibited complete compliance (100% of visits), excellent compliance (${\geq}70%$ of visits), incomplete compliance (<70% of visits), or non-compliance (only 2 visits). Patient characteristics that could affect PC-SPT, such as age, sex, distance of the clinic from their residence, implantation, and periodontal treatment, were investigated. The number of newly decayed and extracted teeth, alveolar bone level changes around the teeth and implants, and implant removal were examined to evaluate the prognosis of PC-SPT. Results: Sex and the presence of an implant significantly affected PC-SPT. Additionally, the number of newly decayed and extracted teeth and changes in alveolar bone levels around the teeth and implants were significant prognostic factors related to PC-SPT. Conclusions: PC-SPT in chronic periodontitis patients will help maintain periodontal health and prevent further periodontal disease.

• Physical Therapy Korea
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• v.8 no.1
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• pp.89-96
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• 2001

This study addresses the effects of treadmill training on hyperextended knee and cadence in patients with hemiplegia. A single subject research design with multiple baselines across individuals was used for the study. Two patients with hemiplegia participated in the experiment. The experiment consisted of interventions where the patients were asked to ambulate for 15 minutes at a comfortable walking speed on the treadmill with 11% slope grade and were allowed to rest for 10 minutes. Patients, then, were asked to ambulated 20 meters at walkway. The number of occurrences of knee hyperextension and the total number of steps were recorded. The results showed that the occurrence of knee hyperextension decreased by approximately 30% after the first session of the treadmill training and continued to gradually decrease during the following sets of treadmill training. Meanwhile, there was a slight increase in the cadence to a negligible extent. These results suggest that the gait training on the sloped treadmill may be helpful for correcting the knee hyperextension in patients with hemiplegia.