• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.298-305
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• 2019

Background: Tuberculosis (TB) causes substantial health burden to the Korean military. This study aims to assess the impact of infectious TB cases on close and casual contacts in the Korean Army settings based on contact investigation data. Methods: Six Army units with infectious TB cases from September 2012 to May 2013 were enrolled in the study. We analyzed the clinical data from close and casual contacts screened using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube to identify latent tuberculosis infection (LTBI) cases. For the control group, 286 military conscripts with no reported TB exposure were tested by TST only. Results: Of the 667 contacts of index cases, LTBI cases identified were as follows: 21.8% of close contacts of smearpositive cases (71/326), 8.5% of casual contacts of smear-positive cases (26/305), and 2.8% of close contacts of smearnegative cases (1/36). In the control group, 16.8% showed positivity in TST. In a multivariate analysis, having stayed in the same room or next room with TB patients was identified as a risk factor of LTBI. Conclusion: Using the data from TB contact investigations in the Korean Army units, we found an overall LTBI rate of 14.7% among the contacts screened. This study demonstrates that contacts living in the same building, especially the same room or next room, with TB patients are at a high risk of acquiring LTBI, serving as additional evidence for defining close and casual contacts of a TB patient with regard to Army barrack settings.

• Journal of Yeungnam Medical Science
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• 제39권3호
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• pp.223-229
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• 2022

Background: The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19-related surgical patients. Methods: We reviewed the medical records of 118 COVID-19-related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19-related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak. Results: One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of -11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19-related patients underwent emergent surgery in the negative-pressure room, including three COVID-19-confirmed patients and five COVID-19-exposed patients. Conclusion: All surgeries of the COVID-19-related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.351-355
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• 2017

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

• Journal of Chest Surgery
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• 제51권1호
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• pp.69-71
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• 2018

A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.

• 한국간호교육학회지
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• 제24권1호
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• pp.5-15
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• 2018

Purpose: The purpose of this study was to investigate the knowledge and practice of patient-controlled analgesia use and management (PCA-UM) among nurses. Methods: Data were collected from 182 nurses employed by four general hospitals having more than 300 beds in Daejeon. The data were collected using self-report questionnaires from November 4 to November 20, 2015. Collected data were analyzed using descriptive statistics, t-test, and ANOVA. Results: The average nurses' knowledge about PCA-UM was 14.8 points out of 20. PCA-UM knowledge was significantly higher for nurses with experience in PCA education (t=3.55, p<.001). Most participants (91.2%) wanted to get PCA training, 86.8% of them provided PCA education to patients after surgery. Approximately 62% of participants regularly evaluated the level of consciousness of patients with PCA. Conclusion: Findings indicate that the knowledge and practice of PCA-UM among nurses were insufficient to provide safe and effective pain management to postoperative patients with PCA. Therefore, it is concluded that it is necessary to develop standardized PCA education programs for nurses to provide safe and effective pain management to postoperative patients with PCA.

• 동의신경정신과학회지
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• 제29권3호
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• pp.197-206
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• 2018

Objectives: Conversion disorder is combination of clinical symptoms and can be promoted until diagnosis is confirmed. In this case, we used Korean medical psychotherapy, M&L therapy, and Korean traditional medicine for treating a conversion disorder patient. Methods: The patient was diagnosed with conversion disorder, and main complaints were lower limb dysesthesia, and anxiety. We used BAI, BDI, HRV, CSEI-S, MMPI, Drawing room of mind for assessment. We treated the patient with Korean medical psychotherapy with M&L therapy, and Korean traditional medicine including acupuncture, moxa and herbal medicine. Results: After treatment, clinical symptoms improved to 40% compared with first visit and the BAI, BDI, HRV, CSEI-S scores decreased, especially scores for anxiety and depression. Conclusions: Korean medical psychotherapy and M&L psychotherapy can be effective for treating conversion disorder.

• Journal of Chest Surgery
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• 제51권3호
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• pp.205-208
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• 2018

A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

• 대한임상독성학회지
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• 제2권1호
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• pp.45-48
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• 2004

Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Many treatment modality has been used, but now paraquat is very fatal drug. Elimination rate of plasma paraquat seems to be a factor for the survival rate. So early diagnosis and early treatment are very important. Plasma paraquat concentration could be measured by radioimmunoassay. But it is impossible that the test was done at Emergency room and the result was checked immediately. There was relation between plasma paraquat concentrations and urine paraquat concentration. Because of its simplicity and low cost, urine paraquat concentration test is complementary to the plasma concentration measurement. If the patient has psychotic problem or unconscious mental state, and is observed unexplained dyspnea and oral ulcer, urine paraquat test is very important to rule out acute paraquat intoxication. We experienced a patient who was presented as unexplained acute renal failure initially and was diagnosed as paraquat intoxication later.

• 호스피스학술지
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• 제5권1호
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• pp.26-32
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• 2005

Purpose: To know for what the medical expenditure had been used and to seek the way how it can be efficiently redistributed, I investigated total medical expenditure according to the time period to death in the expired patients for recent 2 years. Methods: 21patients were enrolled in this study. Total medical expenditure including benefit charge and non-benefit charge charged to patients in in-patient department(IPD) and out-patient department(OPD) was counted according to the period for one year by death. Results: 94.7% of the total medical expenditure had been payed for admission-related expenditure and 89% during period 3 and 4 for 6months before death, which may be due to the more days of admission during those periods. 70.1% of the total expenditure had been charged on the admission-fee, room charge, diet, and administration of the fluid, medicines, and blood etc. Conclusion: Majority of medical expenditure has been used in the affairs being unable to improve the survival or quality of life of patients and during the periods closer to death. Here, it would be needed heartily to look for the best ways in detail how the idea of hospice can come true through nation-wide and social consensus.

• The Korean Journal of Pain
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• 제20권2호
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• pp.235-239
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• 2007

Spontaneous intracranial hypotension (SIH) is believed to be a benign disease. However, numerous studies have reported serious complications related to SIH, including subdural hematoma. In this case report, a 54-year-old male patient visited the emergency room with orthostatic headache. A brain magnetic resonance imaging (MRI) study showed diffuse mild thickening and enhancement of pachymeninges, with a suspicious minimal amount of subdural fluid collected in the left posterior parietal area. His orthostatic headache showed no improvement with conservative treatment; but his pain was almost completely relieved after two trials of cervical epidural blood patch. On the 74th day after the onset of his pain, the patient showed a drowsy mental status and slurred speech when he visited the pain clinic. Brain computerized tomography indicated a left subdural hemorrhage, and he underwent emergency operation to drain the SDH. In conclusion, pain clinicians should pay attention to abrupt changes in mental status as well as continuous headache, for the early diagnosis of SDH in SIH patients.