PURPOSE: Non-blood transfusion is of increasing interest as more patients are refusing a blood transfusion because of religious belief, infection, or fear of a blood-transmitted disease such as AIDS. This study analyzed clinical findings to help the treatment and management of patients who want a non-blood transfusion. METHODS: Of the 83 patients who visited the non-blood transfusion center in Chosun University Hospital from June 2001 to December 2003, 59 patients had a sufficient clinical record, and these were reviewed retrospectively. We investigated sex, age, the reason for the visit, the reason for refusing a blood transfusion, the degree of anemia, the necessity of the blood transfusion, the histories of transfusion and attempted non-blood transfusion, and the histories of visits to emergency departments and the outcomes. RESULTS: The male-to-female ratio was 1:2.93, and the most prevalent ages of the patients were in the forties (26 patients) and thirties (10 patients). The reasons for refusing a blood transfusion were religion (48 patients, 81.4%), risk of infection (1 patients, 1.7%), and other (10 patients, 16.9%). Among the specialty departments, the proportions of patients from the departments of obstetrics and gynecology, internal medicine, general surgery and orthopedics were 40.7% (24 patients), 25.4%, 11.9%, and 6.8%, respectively. Of the patients, 28 patients (47.5%) were admitted directly to the emergency department, and 39 patients (66.1%) were operated on. A blood transfusion was considered to be necessary for 16 patients (27.1%), but only a 2 patients (3.4%) actually received a blood transfusion. Of those 14 patients, 3patients (21.4%) died. After admission, 17 patients (29.8%) received a non-blood transfusion. CONCLUSIONS: Most of the patients visited the non-blood transfusion center for religious reasons, and the majority of the patients were admitted from the Department of Obstetrics and Gynecology. Many of the patients medically should have received blood transfusion, but only a few actually did.
Anemia ; Blood Transfusion* ; Emergency Service, Hospital ; Gynecology ; Humans ; Internal Medicine ; Obstetrics ; Orthopedics ; Religion ; Retrospective Studies

PURPOSE: In response to a growing threat of violence in hospitals, we examined a specific educational effort to reduce emergency department (ED) violence in the shortterm. METHODS: Cross-sectional prospective surveys were conducted at Chosun University Hospital Emergency Center during a baseline period from May 26 to Jul. 9. 2003, and during a post-education period from Aug. 7 to Sep. 20. 2003. Questions addressed the degree of violence, the reason for the violence, demographic information about the perpetrator of the violence, the outbreak time of the violence and the response of emergency personnel. RESULTS: After an education program on violence, the rate of violent events in the ED was decreased by 23.5%. A notable change was that ED workers handled the violence more positively during the post-education period by isolating or restraining the aggressor. Almost all of the violence was caused by males, particularly those in their third or fourth decade. The violence occurred mostly on the night shift. Of the violence, 52.4% was caused by the patient while 34.8% was caused by the patient's guardian. The leading causes of violence were drunkenness and delays in laboratory tests and treatment. Verbal abuse and threats were the most concern forms of violence. CONCLUSION: Violent events are frequent in the ED. Education programs may reduce the number of events at least temporarily.
Alcoholic Intoxication ; Education* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Male ; Prospective Studies ; Violence*

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss

PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast(R)) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast(R) alone or combined with ultrasonic lithotripsy. MATERIALS AND METHODS: Thirty-five (group A) and 39 (group B) patients underwent Lithoclast(R) PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. RESULTS: The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181+/-50 vs. 221+/-65 min, respectively, p=0.004), number of hospital days (11.6+/-3.8 vs. 14.2+/-4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12+/-0.61 vs. 1.39+/-1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast(R) probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). CONCLUSIONS: The combination of ultrasonic lithotripter and Lithoclast(R) is more effective than Lithoclast(R) alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast(R) and the ability to aspirate the debris during ultrasonic lithotripsy.
Hemoglobins ; Humans ; Kidney Calculi ; Length of Stay ; Lithotripsy ; Nephrostomy, Percutaneous ; Operative Time ; Suction ; Ultrasonics

PURPOSE: This study attempted to investigate the prevalence and related factors of Clonorchiasis among five major riverside residents in South Korea. METHODS: This study is descriptive research, nationwide survey, and the subjects are 23,492 residents selected by convenience sampling. Data collection was conducted between March 1 and June 30, 2011, and stool collection and questionnaire survey were conducted by affiliated public health centers in 38 cities and Gun's. RESULTS: The prevalence rates of Clonorchiasis in the five major riversides were as follows: the Guem River 15.2%; the Nakdong River 11.9%; the Seomjin River 10.9%; the Han River 5.7%; and the Yeongsan River 3.9%. The prevalence rates were shown to be significantly high among people who had highly frequent experiences of eating and cooking freshwater raw fish, were diagnosed with liver and/or biliary tract diseases, and drank less than once a month. CONCLUSION: These results suggest that it is necessary to improve awareness of Clonorchiasis and provide intensive public health education for the riverside residents. And the target groups should be set up by reflecting the characteristics of at-risk groups, and it is necessary to prepare customized strategies for prevention and management of Clonorchiasis.
Biliary Tract Diseases ; Clonorchiasis* ; Clonorchis sinensis ; Cooking ; Data Collection ; Eating ; Education ; Fresh Water ; Health Behavior ; Korea* ; Liver ; Parasite Egg Count ; Parasites ; Prevalence* ; Public Health ; Rivers

The frequency of intestinal tuberculosis is relatively common; however, primary tuberculosis of the appendix remains a rarity. We report on a case of primary tuberculous appendicitis for which we obtained the MDCT images revealing thickening of the appendix and the surrounding lymphadenopathies.
Appendicitis ; Appendix ; Tuberculosis

Recently, in Korea, the importance of preparation and use of injectable drugs has been emphasized due to successive fatal accidents caused by injection infections. Parenteral nutrition (PN) has also been identified as a cause of infection. Cases of infection due to PN have been reported not only in Korea, but also abroad, and contamination occurs mainly during the preparation of PN. Because sterile preparation and compounding of injections are very important for infection control and patient safety, this article reviews the major guidelines outlined thus far. The Korea Ministry of Food and Drug Safety in 2006 published guidelines and the KSHP (Korean Society of Health-System Pharmacists) recently issued guidelines for the aseptic preparation of injections. In addition, as US guidelines, the ASHP (American Society of Health-System Pharmacists) guidelines and United States Pharmacopeia (USP) < 797 > are also reviewed. The recent guidelines published by the KSHP have significance in that they were adopted in accordance with the domestic reality, even though they conform to foreign guidelines, and are expected to be guidelines for hospital pharmacists performing aseptic preparation work. In addition, the Korea Ministry of Health and Welfare is considering appropriate guidelines for the safe management of medications, training staff for infection prevention and strengthening staff capacity. Furthermore, the gradual expansion of aseptic compounding facilities and human resources, as well as the provision of adequate medical costs are also considered. Based on the establishment and standardization of injectable drugs compounding guidelines for Korean hospitals, it is believed that if human resources and facilities are supported and medical charges are improved, it will be possible to expect the safer preparation and use of injections.
Drug Compounding ; Humans ; Infection Control* ; Korea ; Parenteral Nutrition* ; Patient Safety ; Pharmacists ; United States

The authors revised some errors regarding Table 5 and 6 in the article as the corrigendum. Because it is not official and may be changed in the revision due out in June 2019, Table 5 and 6 should be deleted and do not refer to it.

Purpose: This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. Methods: We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations’ characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. Results: Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. Conclusion A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

Purpose: This study introduces a new machine learning-based auto-merge program (HydraVersion) that automatically combines multiple ocular photographs into single nine-directional ocular photographs. We compared the accuracy and time required to generate ocular photographs between HydraVersion and PowerPoint. Methods: This was a retrospective study of 2,524 sets of 250 nine-directional ocular photographs (134 patients) between March 2016 and June 2022. The test dataset comprised 74 sets of 728 photographs (38 patients). We measured the time taken to generate nine-directional ocular photographs using HydraVersion and PowerPoint, and compared their accuracy. Results: HydraVersion correctly combined 71 (95.95%) of the 74 sets of nine-directional ocular photographs. The average working time for HydraVersion and PowerPoint was 2.40 ± 0.43 and 255.9 ± 26.7 seconds, respectively; HydraVersion was significantly faster than PowerPoint (p < 0.001). Conclusions Strabismus and neuro-ophthalmology centers are often unable to combine and store photographs, except those of clinically significant cases, because of a lack of time and manpower. This study demonstrated that HydraVersion may facilitate treatment and research because it can quickly and conveniently generate nine-directional ocular photographs.