1.Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score.
Woo Sung CHOI ; Jin Joo KIM ; Hyuk Jun YANG
Korean Journal of Critical Care Medicine 2015;30(4):265-271
BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Basal Ganglia
;
Brain*
;
Cerebellum
;
Cerebral Cortex
;
Emergencies
;
Hand
;
Humans
;
Hypoxia-Ischemia, Brain
;
Intensive Care Units
;
Magnetic Resonance Imaging*
;
Neuroimaging
;
Out-of-Hospital Cardiac Arrest*
;
Putamen
;
Retrospective Studies
;
Survivors
2.A descriptive study on the tuberculosis mortality in a tuberculosis- centered hospital.
Soo Young KIM ; Joo Nam BYUN ; Jin Chol CHOI
Tuberculosis and Respiratory Diseases 1993;40(5):595-601
No abstract available.
Mortality*
;
Tuberculosis*
3.The clinical analysis of choledochal cyst.
Seok Won CHIM ; Young Joo LEE ; Won Jin CHOI
Journal of the Korean Surgical Society 1993;45(4):527-535
No abstract available.
Choledochal Cyst*
4.Caregivers' Burden in patients with acute stroke.
Sue Jin KANG ; Hee Joo LEE ; Choi Kwon SMI
Korean Journal of Rehabilitation Nursing 2002;5(1):27-37
During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress. social isolation. and financial constraints. However. the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Fersonal Resource Questionnaire). Our results showed that the mean burden score was 3,11. indicating high level of burden, Among the sub-domain scores, financial burder was the highest, In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver (p<.001): low cognitive function of the patients(p<.001): low level of ADL(p<.001), the gender of caregiver(p<.001) the current employment status of caregivers(p<.01) the presence of social support for caregiver(p<.001), and the availability of alternative caregivers (p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%). and gender of caregiver (female, 0,4%) were significant explanatory factors of overall burden, The caregivers' burden in acute stages during hospitalization following stroke was high, Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.
Caregivers
;
Cognition
;
Employment
;
Hospitalization
;
Humans
;
Neurology
;
Neurosurgery
;
Nursing
;
Surveys and Questionnaires
;
Social Isolation
;
Stroke*
5.THE VARIOUS ROLE OF LOCAL INJECTION OF BOTULINUM A EXOTOXIN.
Yoon Ho LEE ; Hee Chan CHOI ; Jin Joo HONG
Journal of the Korean Society of Aesthetic Plastic Surgery 1999;5(2):377-389
Botulium toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. Some wrinkle and unsightly facial expressions are due to hyperkinetic muscle. For the past year, the author has injected it for variant purpose, so we describe the our experience with the variant extended use of the toxin including correction for just dynamic wrinkle, used with subperiosteal face lifting or peeling, post-traumatic twitching, and facial paralysis and relevant anatomy are discussed. Also we have another concept about muscle anatomy which have superficial and deep portion. The superficial portion is for harmonious action with SMAS during facial expression, which is also related to fine wrinkle, and the deep portion play role gross movement. Botulium toxin is safe and effective in varient field without complication. Its use is associated with a high degree of patient and physician satisfaction.
Exotoxins*
;
Facial Expression
;
Facial Paralysis
;
Humans
;
Rhytidoplasty
6.Comparison of Case Management between Tele Care Regions and General Care Regions in Korean Medicaid.
Hyun Joo LEE ; Jin Joo OH ; Jeong Myung CHOI
Journal of Korean Academy of Nursing Administration 2010;16(4):381-388
PURPOSE: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. METHOD: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. RESULTS: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. CONCLUSIONS: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.
Case Management
;
Compliance
;
Delivery of Health Care
;
Health Behavior
;
Hospital Costs
;
Humans
;
Medicaid
;
Medication Adherence
;
Outpatients
;
Surveys and Questionnaires
;
Telephone
7.The Effect of Copayment on Medical Aid Beneficiaries in Korea.
Jin Joo OH ; Jeong Myung CHOI ; Hyun Joo LEE
Journal of Korean Academy of Community Health Nursing 2015;26(1):11-17
PURPOSE: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. METHODS: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. RESULTS: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). CONCLUSION: Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.
Cost Sharing
;
Delivery of Health Care
;
Early Detection of Cancer
;
Health Behavior
;
Health Care Costs
;
Health Expenditures
;
Humans
;
Korea
;
Medicaid
;
Medication Adherence
;
National Health Programs
;
Outpatients
;
Quality of Life
;
Statistics as Topic
;
Surveys and Questionnaires
8.Management of Cyanide Intoxication with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.
Jin PARK ; Seung Yeob LEE ; Hyun Sik CHOI ; Yoon Hee CHOI ; Young Joo LEE
Korean Journal of Critical Care Medicine 2015;30(3):218-221
Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with highdose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.
Acidosis
;
Brain Death
;
Brain Stem
;
Coma
;
Cyanides
;
Eating
;
Emergency Service, Hospital
;
Extracorporeal Membrane Oxygenation*
;
Hemodynamics
;
Humans
;
Lactic Acid
;
Male
;
Middle Aged
;
Norepinephrine
;
Organ Transplantation
;
Poisoning
;
Prognosis
;
Reflex
;
Renal Replacement Therapy*
;
Resuscitation
;
Shock
;
Suicide
;
Tissue and Organ Procurement
;
Vital Signs
9.A study for acute pyelonephritis during pregnancy.
Sang Chull PARK ; Young Joo CHOI ; Ki Dong LEE ; Hee Jin KIM ; Kyu Hong CHOI
Korean Journal of Obstetrics and Gynecology 1992;35(6):816-826
No abstract available.
Pregnancy*
;
Pyelonephritis*
10.Three Cases of Primary Adenosquamous Carcinoma of Stomach.
Joon Hyuk CHOI ; Mi Jin KIM ; Hae Joo NAM ; Won Hee CHOI ; Tae Sook LEE
Yeungnam University Journal of Medicine 1988;5(2):189-193
Adenosquamous carcinoma of stomach is a mixed glandular-epidermoid tumor where both components are neoplastic. Its incidence is extremely rare. The five theories on the origin of squamous components are 1) island of ectopic squamous epithelium in the gastric mucosa, 2) squamous metaplasia of gastric epithelium, 3) squamous differentiation in a preexisting adenocarcinoma, 4) endothelial cell differentiated toward squamous elements, and 5) totipotential undifferentiated cells of the gastric mucosa. We experienced three cases of adenosquamous carcinoma. Case 1 was a 71-year-old female patient; an ulcerative lesion was present in the pylorus, measuring 5 cm in diameter. Case 2 was a 57-year-old male patient; an ulcerative lesion is present in the pylorus, measuring 6 cm in diameter. Case 3 was a 58-year-old female patient; an ulcerative lesion was present in the body and fundus, measuring 10 cm in diameter. Microscopic examination revealed a mixed malignant squamous and adenomatous component.
Adenocarcinoma
;
Aged
;
Carcinoma, Adenosquamous*
;
Endothelial Cells
;
Epithelium
;
Female
;
Gastric Mucosa
;
Humans
;
Incidence
;
Male
;
Metaplasia
;
Middle Aged
;
Pylorus
;
Stomach*
;
Ulcer