• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.183-190
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• 1997

Tocolytics are agents widely used in the treatment of premature labor to inhibit uterine contractions. Ritodrine is most commonly used tocolytic agent and acts by increasing intracellular cyclic adenosine monophosphate, which decreases the activity of myosin light-chain kinase, the rate-limiting enzyme in the signal network leading to contraction. Physiologic effects associated with the use of ritodrine are due to their effect on bera-l as well as beta-2 receptors. Some of maternal complications of therapy are rachycardia, hyperglycemia, hypokalemia, lactic acidosis, myocardial ischemia, and pulmonary edema. Tocolytics induced pulmonary edema is a serious complication that can lead to marternal death, although infrequent, The incidence varies from 0.5% to 5% of those receiving these agents. Predisposing factors include the concommitant use of corticosteroid, twin gestation, fluid overload (particularly with saline), and anemia. Several mechanisms have been postulated, but the pathogenesis is uncertain. It is suggested that both types of mechanism, hydrostatic and permeability induced, might be involved. The association of tocolytic therapy with pulmonary edema appears to be unique to the pregnant state, because this complication has never been reported in asthmatic patients exposed to high dosages. We report a case of tocolytic induced pulmonary edema developed in 24 hours after delivery.

• Korean Journal of Adult Nursing
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• v.13 no.3
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• pp.397-408
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• 2001

Currently, breast cancer ranks third among women' s cancers, and as its incidence is increasing, the incidence age is also becoming lower. Therefore it is necessary to address breast cancer for women in their twenties. As there is no way presently to prevent breast cancer, it is imperative that women take available interventions against predisposing factors. It is thus advisable that women acquire the necessary skills to recognize their own health status. The purposes of this study were to identify the effects of education on breast self-examination (BSE) through supportive education among college women during the period from August 2000 to February 2001, and to attempt to design an effective BSE educational program. The first class was implemented through lectures, pamphlets, videotapes, breast palpation on cloths, demonstration and practice for identification of breast masses through palpation using breast model. Supportive education was implemented bimonthly to the experimental group, and effects of the education between experimental and control groups were compared 6 months later. The results of this study are summarized as follows: 1. The effects on supportive education of college women in BSE 1) The mean score of retained knowledge about breast cancer and BSE was 30.88 in the experimental group, and 29.66 in the control group and significantly greater in the experimental group than in the control group (t= -2.062, p= 0.041). 2) Frequency of BSE practice was significantly greater in the experimental group than in the control group($\chi^2=0.045$, p=0,012). 3) The mean accuracy score in BSE practice was 19.10 in the experimental group, and 18.29 in the control group; accuracy was higher in the experimental group than in the control(t= -2.035, p= 0.444). 4) The mean score of self-efficacy was 35.05 in the experimental group, and 31.22 in the control group. The experimental group mean score was higher(t=-3.016, p=0.003). 2. There was a statistically significant correlation between self-efficacy and accuracy of BSE(r=0.447, p=0.000), knowledge of breast cancer and BSE(r= 0.306, p=0.000) and frequency of BSE(r=0,259, p=0,002) but no significant correlation between knowledge of breast cancer and BSE and frequency of BSE (r=0.071, p=0.403). On the basis of this study, periodic supportive education can increase knowledge of breast cancer and BSE, frequency of BSE, accuracy of BSE and self-efficacy. Suggestions: 1. There is a need to compare the effects of individual programs to acquire BSE behaviors in the young. 2. Further research is needed to test the continuity of the effects of BSE education.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.105-110
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• 2011

Purpose: Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU). Methods: Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support. Results: Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support. Conclusion: Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.87-94
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• 1986

Empyema thoracis following pneumonia, intra-abdominal pathology, trauma, and surgical procedure continues to be a source of major morbidity and mortality. Thirty seven adult and eleven pediatric patients with empyema thoracis were treated at the University of Yeungnam Medical Center from May 1983 to November 1986. Age distribution ranged from 6 months to 72 years and showed a double-peaked curve with the highest incidence between 36 and 65 years and below 15 years of age. There were male predominence in patients above 16 years of age. The most common predisposing factors was impaired consciousness due to either alcoholism or head injury. The causes of empyema were as follows: pneumonia 64.6%, lung abscess 6.4%, intraabdominal pathology 6.4%, and surgical procedure 6.4%. The cardinal symptoms were fever, cough, chest pain, dyspnea, sputum, weight loss, anorexia, and night sweat in orders. Culture of empyema fluid were positive in 50% of patients. The isolated organisms were Gram-negative bacilli 33.3%, staphylococcus aureus 25%, and streptococcus 25%. The patients received antibiotics in conjunction with various invasive procedures : chest tube drainage 77.1%, decortication 6.3%, and repeated thoracentesis 10.3%. There were 4 deaths, 1 child and 3 adults, with a overall mortality of 8.3%.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.532-536
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• 2009

Bypass surgery is performed for insuring continuity of a blood supply that is restricted due to obstruction of the native blood supply. Two types of surgery are commonly carried out: one is anatomic bypass and the other is extraanatomic bypass. Especially, extraanatomic bypass surgery is performed in patients who are a high risk for performing anatomical bypass surgery. The risk factors for anatomical bypass surgery are old age, infection, previous surgery and trauma. A 96-year-old patient underwent extraanatomic bypass surgery from the right femoral artery to the left femoral artery due to total occlusion of the left iliac artery, and 7 years after that operation, a pseudoaneurysm abruptly and spontaneously appeared from the bypass suture site without any predisposing factor. The lesion was revealed to be an organizing thrombus.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.332-340
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• 2011

Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.212-215
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• 2008

Rectus sheath hematoma (RSH) is a rare condition that's caused by a sudden disruption of the deep epigastric vessels or direct damage to the rectus abdominis muscle. This condition is associated with old age, childbirth, abdominal surgery, severe cough, severe sneezing, anticoagulation therapy and/or coagulation disorders. RSH is characterized by abdominal pain and an abdominal mass, so that this is often misdiagnosed as a surgical condition such as appendicitis, intraabdominal abscess, torsion of the ovary and ruptured abdominal aortic aneurysm; this can lead to unnecessary surgery. Thus, we have to be cautious not to miss RSH when a patient with predisposing factors is suffered from abdominal pain and an abdominal mass. We report here on a case of rectus sheath hematoma that was induced by severe cough in a patient who was taking warfarin.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.27-33
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• 2002

Aims: This study was carried out to find the prevalence of human clonorchiasis and to know epidemiological features in a Clonorchis sinensis-endemic area in Korea. Methods and materials: The EHSA was applied for the serodiagnosis of clonorchiasis. A total of 2,591 inhabitants at Soonchang-gun county adjacent to the Sumjin River were screened through the assay. The questionnaire survey was performed for several epidemiological points related to C. sinensis infection. Data from 95 inhabitants were processed for the statistical analysis. Results: The prevalence of human clonorchiasis in Soonchang-gun was 16.1% in average from 33.6% to 7.0% according to the villages of the survey. In the riverside villages to the Sumjin River the prevalences were higher than those in other villages located far from the river. The odd ratio (OR) between men and women was 2.76, indicating that the clonorchiasis was 2.76 times more prevalent in man than woman. The ORs were 2.14 in alcoholic group, 2.40 in the group of raw-eating of fresh-water fishes, 2.44 in the people who thought they were healthy, 5.23 in the people who knew well about the clonorchiasis, and 3.32 in the people who had again raw-eating of the fishes following medication. Conclusions: These results suggested that human clonorchiasis was still highly endemic in riverside area of the Sumjin River and some predisposing factors such as raw-eating of fresh-water fishes were significantly related to the human clonorchiasis.

• Genomics & Informatics
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• v.9 no.3
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• pp.121-126
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• 2011

Osteoarthritis (OA) is the most common degenerative joint disorder in the elderly population. To identify OA-associated genetic variants and candidate genes, we conducted a genome-wide association study (GWAS). A total 3,793 samples (476 cases: wrist + knee and 3317 controls) from a community-based epidemiological study were genotyped using the Affymetrix SNP 5.0. An intronic SNP (rs4789934) in the TIMP2 (tissue inhibitor of metalloproteinase-2) showed the most significance with OA (odd ratio [OR] = 2.06, 95% confidence interval [CI] = 1.52-2.81, p = $4.01{\times}10^{-6}$). Furthermore, a poly-morphism (rs1352677) in the NKAIN2 ($Na^+/K^+$ transporting ATPase interacting 2) was suggestively associated with OA (OR = 1.43, CI = 1.22-1.66, p = $7.01{\times}10^{-6}$). The present study provides new insights into the identification of genetic predisposing factors for OA.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.69-76
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• 2020

Recurrent bacterial meningitis is the reappearance of two or more episodes of meningitis caused by a different or same organism after an intervening period of full convalescence. Predisposing factors for recurrent bacterial meningitis include immunodeficiency and developmental and traumatic anatomical defects. Therefore, careful evaluation of children with recurrent meningitis is essential. We report the case of a patient with a skull base abnormality who had suffered from four events of bacterial meningitis between 8 and 17 years of age. He experienced another event of bacterial meningitis at the age of 21, without undergoing correction for the anatomical defect. Streptococcus agalactiae was identified in the patient's blood and cerebrospinal fluid culture. Afterwards, he underwent surgical treatment for a meningioma; this meningioma was strongly suspected as the cause of the recurrence.