• Title/Summary/Keyword: very young patients

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A Case Study on Patients with Hematologic Malignancies Receiving OrthoCellular Nutrition Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 혈액암 환자 사례 연구)

  • Young-ro Kim
    • CELLMED
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    • v.13 no.5
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    • pp.20.1-20.3
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    • 2023
  • Objective: A case report on the improvement of patients with hematologic malignancies by Ortho-Cellular Nutrition Therapy (OCNT). Methods: A 69-year-old Korean female diagnosed with Stage 4 ACUTE LYMPHOBLASTIC Leukemia (ALL) had a very low platelet count of 8000/µl. Results: The platelet count improved to its normal level after Ortho-Cellular Nutrition Therapy (OCNT). Conclusion: Ortho-Cellular Nutrition Therapy (OCNT) is effective in relieving the symptoms of acute lymphoblastic leukemia patients with thrombocytopenia.

The Usefulness of Electromagnetic Neuronavigation in the Pediatric Neuroendoscopic Surgery

  • Choi, Ki Young;Seo, Bo Ra;Kim, Jae Hyoo;Kim, Soo Han;Kim, Tae Sun;Lee, Jung Kil
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.161-166
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    • 2013
  • Objective : Neuroendoscopy is applied to various intracranial pathologic conditions. But this technique needs informations for the anatomy, critically. Neuronavigation makes the operation more safe, exact and lesser invasive procedures. But classical neuronavigation systems with rigid pinning fixations were difficult to apply to pediatric populations because of their thin and immature skull. Electromagnetic neuronavigation has used in the very young patients because it does not need rigid pinning fixations. The usefulness of electromagnetic neuronavigation is described through our experiences of neuroendoscopy for pediatric groups and reviews for several literatures. Methods : Between January 2007 and July 2011, nine pediatric patients were managed with endoscopic surgery using electromagnetic neuronavigation (AxiEM, Medtronics, USA). The patients were 4.0 years of mean age (4 months-12 years) and consisted of 8 boys and 1 girl. Totally, 11 endoscopic procedures were performed. The cases involving surgical outcomes were reviewed. Results : The goal of surgery was achieved successfully at the time of surgery, as confirmed by postoperative imaging. In 2 patients, each patient underwent re-operations due to the aggravation of the previous lesion. And one had transient mild third nerve palsy due to intraoperative manipulation and the others had no surgery related complication. Conclusion : By using electromagnetic neuronavigation, neuroendoscopy was found to be a safe and effective technique. In conclusion, electromagnetic neuronavigation is a useful adjunct to neuroendoscopy in very young pediatric patients and an alternative to classical optical neuronavigation.

Ethnography on Isolation Unit for Hematopoietic Stem Cell Transplantation: Focusing on Patients (조혈모세포이식 병동에 관한 문화기술지: 환자를 중심으로)

  • Kang, Young-Ah;Yi, Myung-Sun
    • Asian Oncology Nursing
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    • v.9 no.1
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    • pp.31-42
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    • 2009
  • Purpose: The purpose of the study was to understand how patients experience everyday life in an isolation unit for hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 25 patients with HSCT at the isolation unit from January to March in 2008 in one general hospital in Korea. The data were collected by participant observations and ethnographic interviews and were analyzed using ethnographic method. Results: Four themes regarding environmental area emerged: 'barrier pulling up the drawbridge', 'very strange world', 'small and restricted space tied by IV and other treatment lines', and 'loud noise in a silent space.' Three themes regarding patients emerged: 'facing fear and anxiety', 'continuation of loneliness and lethargy', and 'compromising with a very long, dull, and boring time'. These themes describe how patients with HSCT suffer from continuous physical and psychosocial problems in a confined space, while endeavoring to control these problems and to search for hope for a new life. Conclusion: The results of the study provide an in-depth understanding of the experience and culture of patients in an isolation unit for HSCT. They would be used in developing practical programs to decrease patient's culture shock including fear and anxiety at isolation unit for HSCT.

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Pain Management of Post-herpetic Neuralgia (대상포진 후 신경통의 통증관리)

  • Bae, Weon-Ho;Whang, Chung-Han;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.9-15
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    • 1988
  • Postherpetic neuralgia, the most feared complication of acute herpes zoster, may agonize the pain clinician because the appropriate management of intractable pain can fail inspite of various and prolonged therapeutic techniques. Of all patients with herpes zoster, approximately 5~10% will develop postherpetic neuralgia. Postherpetic neuralgia is very rare in young patient but very common in patients over 60. In other words, the older, the higher incidence. In our pain clinics, 13 postherpetic neuralgic patients were treated with sympathetic blocks, local infiltration with local anesthetics and steroids, TENS, Laser and various drugs including antiderpressant. The results of management of pain in 13 patents were as follows. 1. Excellent pain control :4(30.8%) 2. Good pain control :3(23.0%) 3. Fair pain control :2(15.4%) 4. No effect :4(30.8%).

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Correction of Congenital Auricular Deformities Using the Ear-Molding Technique

  • Woo, Taeyong;Kim, Young Seok;Roh, Tai Suk;Lew, Dae Hyun;Yun, In Sik
    • Archives of Plastic Surgery
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    • v.43 no.6
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    • pp.512-517
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    • 2016
  • Background Studies of the ear-molding technique have emphasized the importance of initiating molding early to achieve the best results. In the present study, we describe the immediate effects and long-term outcomes of this technique, focusing on children who were older than the ideal age of treatment initiation. Methods Patients who visited our institution from July 2014 to November 2015 were included. Medical charts were reviewed to collect data on demographics, the duration of treatment, the types of deformities, and the manner of recognition of the deformity and referral to our institution. Parents were surveyed to assess the degree of improvement, the level of procedural discomfort at the end of treatment, any changes in the shape of the molded auricle, and overall satisfaction 12 months after their last follow-up visits. Results A review of 28 ears in 18 patients was conducted, including the following types of deformities: constricted ear (64.2%), Stahl ear (21.4%), prominent ear (7.1%), and cryptotia (7.1%). The average score for the degree of improvement, rated on a 5-point scale (1, very poor; 5, excellent), was 3.5 at the end of treatment, with a score of 2.6 for procedural discomfort (1, very mild; 5, very severe). After 12 months, the shapes of all ears were well maintained. The average overall satisfaction score was 3.6 (1, very dissatisfied; 5, very satisfied). Conclusions We had reasonable outcomes in older patients. After 1 year of follow-up, these outcomes were well maintained. Patients past the ideal age at presentation can still be candidates for the molding technique.

Recent Advance in Very Early Onset Inflammatory Bowel Disease

  • Shim, Jung Ok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.41-49
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    • 2019
  • Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Several genetic defects that disturb intestinal epithelial barrier function or affect immune function have been noted in these patients from the young age groups. In incidence of pediatric IBD in Korea has been increasing since the early 2000s. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with "neonatal IBD" or "infantile-onset IBD" have higher rates of affected first-degree relatives, severe disease course, and a high rate of resistance to immunosuppressive treatment. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.

Optimal Dose of Edoxaban for Very Elderly Atrial Fibrillation Patients at High Risk of Bleeding: The LEDIOS Registry

  • Ju Youn Kim;Juwon Kim;Seung-Jung Park;Kyoung-Min Park;Sang-Jin Han;Dae Kyeong Kim;Yae Min Park;Sung Ho Lee;Jong Sung Park;Young Keun On
    • Korean Circulation Journal
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    • v.54 no.7
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    • pp.398-406
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    • 2024
  • Background and Objectives: Optimal anticoagulation in very elderly patients is challenging due to the high risk of anticoagulant-induced bleeding. The aim of this study was to assess outcomes of on-label reduced-dose edoxaban (30 mg) in very elderly patients who had additional risk factors for bleeding. Methods: This was a multi-center, prospective, non-interventional observational study to evaluate the efficacy and safety of on-label reduced-dose edoxaban in atrial fibrillation (AF) patients 80 years of age or older and who had more than 1 risk factor for bleeding. Results: A total of 2448 patients (mean age 75.0±8.3 years, 801 [32.7%] males) was included in the present study, and 586 (23.9%) were 80 years of age or older with additional risk factors for bleeding. Major bleeding events occurred frequently among very elderly AF patients who had additional bleeding risk factors compared to other patients (unadjusted hazard ratio [HR], 2.16; 95% confidence interval [CI], 1.16-4.02); however, there were no significant differences in stroke incidence (HR, 1.86; 95% CI, 0.98-3.55). There were no significant differences for either factor after adjusting for age and sex (adjusted HR, 1.65; 95% CI, 0.75-3.62 for major bleeding; adjusted HR, 1.13; 95% CI, 0.51-2.50 for stroke). Conclusions: In very elderly AF patients with comorbidities associated with greater risk of bleeding, the incidence of major bleeding events was significantly increased. In addition, risk of stroke showed tendency to increase in same population. Effective anticoagulation therapy might be important in these high-risk population, and close observation of bleeding events might also be required.

Detection of Hepatitis B Virus and Mycobacterium tuberculosis in Korean Dental Patients

  • Lee, Sun-A;Yoo, So Young;Kay, Kee-Sung;Kook, Joong-Ki
    • Journal of Microbiology
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    • v.42 no.3
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    • pp.239-242
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    • 2004
  • This study examined the detection rate of the hepatitis B virus (HBV) and Mycobacterium tuberculosis (Mtb) in serum and saliva samples, respectively, from 120 dental patients who were unaware if they have or had either hepatitis or tuberculosis. The frequencies of HBsAg and anti-HBs were determined using an immunochromatic assay. Mtb positivity was determined by the PCR method. Of the 120 patients, 7 (5.8%) were HBV positive and 30 (25.0%) were Mtb positive. This highlights the fact that dental health care workers (DHCWs) can be exposed to the risk of infection from blood- or saliva-borne pathogens as a consequence of their work. Therefore, it is very important to prevent cross infection between patients and dental personnel. Accordingly, laboratory tests prior to surgical treatment are needed to determine the infectious state of dental patients in order to prevent the transmission of infectious diseases in dental clinics.

Retrospective Analysis of Long-Term Survival in Very Elderly (Age ≥80) Critically Ill Patients of a Medical Intensive Care Unit at a Tertiary Care Hospital in Korea

  • Lee, Seung Hun;Kim, Ju-Young;Kim, Tae Hoon;Ju, Sun Mi;Yoo, Jung-Wan;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.242-247
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    • 2020
  • Background: The purpose of this study was to evaluate the long-term survival rates of very elderly (age ≥80) critically ill patients admitted to a medical intensive care unit (MICU) at a regional tertiary-care hospital in Korea. Methods: We retrospectively analyzed data from patients who survived after discharged from the MICU of our hospital. Survival rates at 90 days, 1 year, 2 years, and 3 years were assessed between patients age ≥80 and those age <80. Survival status was evaluated using the National Health Insurance Service data. Results: A total of 468 patients were admitted, 286 (179 males, 97 females; mean age, 70.18±13.2) of whom survived and were discharged soon after their treatment. Among these patients, 69 (24.1%) were age ≥80 and 217 (75.9%) were age <80. The 90-day, 1-year, 2-year, and 3-year survival rates of patients age ≥80 were significantly lower than those in patients age <80 (50.7%, 31.9%, 15.9% and 14.5% vs. 68.3%, 54.4%, 45.6%, and 40.1%, respectively) (p<0.01). The Kaplan-Meier survival curves showed significantly lower survival rates in patients age ≥80 than in those age <80 (p=0.001). Conclusion: The poor rates of long-term survival in very elderly (age ≥80) and critically ill patients admitted to an ICU should be considered while managing and treating them.

Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease (히르슈슈프룽병 환자에서 미성숙 신경절 세포의 빈도 및 그 의의)

  • Yang, Hee-Beom;Kim, Hyun-Young;Kim, Soo-Hong;Jung, Sung-Eun;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.122-129
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    • 2013
  • Immature ganglion cell (IGC) is known for its relationship with intestinal motility and its impact on postoperative functional outcomes of Hirschsprung's disease (HD). There are few studies on the relationship between intestinal dysmotility and IGC in HD patients. 67 patients pathologically diagnosed with HD and who received definitive operation in Seoul National University Children's Hospital from 2010 to 2011 were included. 10 patients were excluded due to inadequate immunohistochemical staining results. The proximal end of resected ganglionic segment was evaluated with immunohistochemistry examination with MAP-2, a marker of ganglionic cells and bcl-2, a marker of IGCs The median age at operation was 155 (15-4678) day-old. 55 (96.5%) patients positive for bcl-2, were regarded as having IGC, and 2 (3.5%) patients positive for MAP-2 but negative for bcl-2, were regarded as having only mature ganglion cells. In the bcl-2 positive group, there were 7 patients (12.7%) with constipation, 15 patients (27.3%) with soiling, 3 patients (5.5%) with perianal excoriation and 6 patients (10.9%) with medication use. In bcl-2 negative group, intestinal dysmotility was not seen. There was no statistical significance in the two groups. Considering that HD is diagnosed at a young age, the rate of IGC present is very high and it might be inappropriate to relate IGC to functional outcome at young ages.