1.Primary Tuberculous Complex at the Site of Intralesional Corticosteroid Injection.
Chull Wan IHM ; Hyuk Cheol KWON ; Seon Pill CHOI
Annals of Dermatology 1989;1(1):37-39
No abstract available.
2.Two Cases of Acral Fibrokeratomas.
Chull Wan IHM ; Jai Il SUH ; Eun Sup SONG ; Seon Pill CHOI
Korean Journal of Dermatology 1984;22(6):675-678
Acral fibrokeratoma, more often called acquired digital fibrokeratoma, is a firm hyperkeratotic horn-like projection of skin surrounded by a slightly elevated epidermial collarette. Most frequently they appear on the finger of adult man. Authors report two cases, one developed on the palm and the other on the ankle. Because of the rarity of these lesions and their even more unusual location, these case were deemed worthy of report.
Adult
;
Ankle
;
Fingers
;
Humans
;
Skin
3.Infectious Complications in the Survivors of Out-of-hospital Cardiac Arrest.
Seon Hee WOO ; Woon Jeong LEE ; Se Min CHOI ; Seung Pill CHOI ; Kyu Nam PARK
The Korean Journal of Critical Care Medicine 2009;24(1):22-27
BACKGROUND: Infectious complications commonly occur in the survivors of out-of-hospital cardiac arrest. The aim of our study was to describe the incidence, associated factors and outcome of infectious complications of the survivors of out-of-hospital cardiac arrest. METHODS: We conducted a retrospective analysis of 75 patients who survived out-of-hospital cardiac arrest. We collected the data on the demographics, the modes of cardiac arrest, the duration of CPR, the dose of epinephrine, the use of hypothermia, new infections, the duration of mechanical ventilation, the length of stay in the intensive care unit (ICU), recovery of consciousness and the mortality. RESULTS: New infections developed in 46.7% of the patients. Asystole was the most common rhythm (70.7%). The most common infectious complication was pneumonia (40.0%) urinary tract infection developed in 10 cases, vascular catheter local infection developed in 6 cases, primary blood stream infection developed in 3 cases, wound infection developed in 2 cases and pseudomembranous colitis developed in 1 case. The most common pathogens of pneumonia were Pseudomonas aeruginosa and Staphylococcus aureus. Blood cultures were obtained in 36 patients during the first 24 hr and the pathogen was isolated in three. The patients with infection had a longer duration of mechanical ventilation and a longer stay in the ICU (p < 0.001, p = 0.001). CONCLUSIONS: Infectious complications are common in survivors of out-of-hospital cardiac arrest and these infections are associated with a longer duration of mechanical ventilation and a longer stay in the ICU. The most common infectious complication was pneumonia and the pathogens of pneumonia were Pseudomonas aeruginosa and Staphylococcus aureus.
Cardiopulmonary Resuscitation
;
Consciousness
;
Demography
;
Enterocolitis, Pseudomembranous
;
Epinephrine
;
Heart Arrest
;
Humans
;
Hypothermia
;
Incidence
;
Intensive Care Units
;
Length of Stay
;
Out-of-Hospital Cardiac Arrest
;
Pneumonia
;
Pseudomonas aeruginosa
;
Respiration, Artificial
;
Retrospective Studies
;
Rivers
;
Staphylococcus
;
Staphylococcus aureus
;
Survivors
;
Urinary Tract Infections
;
Vascular Access Devices
;
Wound Infection
4.Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea.
Hyun Soon KIM ; Dae Hee KIM ; Hai jeon YOON ; Woon Jeong LEE ; Seon Hee WOO ; Seung Pill CHOI
Journal of Korean Medical Science 2018;33(48):e295-
BACKGROUND: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. METHODS: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. RESULTS: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378–46.651), hospital days (4–7 days; aOR: 7.246; 95% CI: 3.229–16.261), duration of antimicrobial exposure (1–3 days; aOR: 1.976; 95% CI: 1.137–3.436), and age (aOR: 1.025; 95% CI: 1.007–1.043). CONCLUSION: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.
Bacterial Infections
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Colon*
;
Cross-Sectional Studies
;
Delivery of Health Care
;
Emergencies*
;
Emergency Service, Hospital*
;
Enterococcus*
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Humans
;
Infection Control
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Korea*
;
Logistic Models
;
Long-Term Care
;
Mass Screening
;
Vancomycin Resistance
;
Vancomycin-Resistant Enterococci
5.Effect of Alcohol Ingestion on Clinical Features of Acute Drug Intoxicated Patients.
Woon Jeong LEE ; Chun Song YOUN ; Yeon Young KYONG ; Seon Hee WOO ; Si Kyoung JEONG ; Se Min CHOI ; Seung Pill CHOI ; Kyu Nam PARK
Journal of the Korean Society of Emergency Medicine 2009;20(1):115-121
PURPOSE: This study was conducted to see the effect of alcohol ingestion on clinical features of acute drug intoxicated patients. METHODS: We prospectively investigated drug intoxicated patients who visited the emergency department 6 hours after acute poisoning from January 2004 to December 2007. Patients were classified into two groups according to serum alcohol levels: an alcohol group (serum alcohol level>10 mg/dl) and a non-alcohol group. The type of toxic material, age, sex, duration of time to arrive to the emergency department (ED) after poisoning, mean arterial pressure, respiratory rate, base excess level, AST level, serum creatinine level, cause of poisoning, suicide attempt, past psychiatric history, discharge against medical advice rate, and admission rate were checked. The initial and final Poisoning Severity Score (PSS), the Glasgow coma scale, the length of stay in the intensive care unit (ICU), the usage of a mechanical ventilator, and death rate were also checked. RESULTS: The study enrolled 222 intoxicated patients of which 75 fell into the non-alcohol group and 147 into the alcohol group. Alcohol ingestion of acute poisoning in males was higher than in females. The AST level and discharge against medical advice rates in the alcohol group were higher than the non-alcohol group. The base excess level, length of stay in ICU, past psychiatric history rate, and admission rates in the non-alcohol group were higher than the alcohol group. The PSS were not correlated with alcohol consumption between the two groups. CONCLUSION: Alcohol ingestion is not associated with PSS. However, alcohol ingestion is commonly found in acute drug intoxicated patients. The discharge against medical advice rate in the alcohol group was higher than the non-alcohol group.
Alcohol Drinking
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Arterial Pressure
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Creatinine
;
Eating
;
Emergencies
;
Female
;
Glasgow Coma Scale
;
Humans
;
Intensive Care Units
;
Length of Stay
;
Male
;
Prospective Studies
;
Respiratory Rate
;
Severity of Illness Index
;
Suicide
;
Ventilators, Mechanical
6.Predictive Value of C-reactive Protein and Kidney Computed Tomography in Patients with Acute Pyelonephritis.
Mi Kyung KIM ; Seon Hee WOO ; Woon Jeong LEE ; Si Kyoung JEONG ; Se Min CHOI ; Seung Pill CHOI ; Kyu Nam PARK
Journal of the Korean Society of Emergency Medicine 2009;20(5):555-561
PURPOSE: This study was conducted to determine the predictive value of the C-reactive protein (CRP) and kidney computed tomography (CT) in the emergency department (ED) for predicting the severity of acute pyelonephritis. METHODS: One hundred thirty-nine patients who were diagnosed with acute pyelonephritis between January 2007 and June 2008 were enrolled in this study. The patient underwent a kidney CT in the ED and the CT findings were classified as normal, a focal wedge-shaped lesion, a multi-focal wedge-shaped lesion, a mass-effect lesion, and abscess formation. The symptoms, vital signs, past history, initial laboratory findings, serum CRP in the ED, and the length of the hospital stay based on the kidney CT grade in the ED were compared. RESULTS: Among the 139 patients, 138 were females and the mean age was 48.5+/-17.7 years. We classified the CT grades as follows: grade 1, normal (n=20); grade 2, focal wedge-shaped lesion (n=25); grade 3, multi-focal wedgeshaped lesion (n=45); grade 4, mass-effect lesion (n=42); and grade 5, abscess formation (n=7). Statistically significant differences in leukocyte count, neutrophil ratio, ESR, CRP, and length of hospital stay existed between the CT grades. Patients were classified into two groups based on the CT grade (the mild group [grades 1 and 2], and the severe group [grades 3~5]). The leukocyte count, neutrophil ratio, ESR, CRP, maximal body temperature, duration of fever, duration of pyuria >3 days, and length of hospital stay were greater in the severe group. Based on the results of multivariate logistic regression analysis, the CRP level was shown to be an independent predictor that affected the severe group. The area under the ROC curve for CRP was 0.775 (95% CI, 0.695~0.854). CONCLUSION: The CRP level in the ED was an independent predictor that affected the severe group. Thus, the initial CRP level with the kidney CT grade may be used as a prognostic indicator of acute pyelonephritis in the ED.
Abscess
;
Body Temperature
;
C-Reactive Protein
;
Emergencies
;
Female
;
Fever
;
Humans
;
Kidney
;
Length of Stay
;
Leukocyte Count
;
Logistic Models
;
Neutrophils
;
Pyelonephritis
;
Pyuria
;
ROC Curve
;
Tomography, Spiral Computed
;
Vital Signs
7.The Prognostic Value of Alveolar-arterial Oxygen Gradient for Community-Acquired Pneumonia in the ED.
Jae Bok SHIN ; Woon Jeong LEE ; Jeong Ho PARK ; Seung Pill CHOI ; Si Kyung JUNG ; Seon Hee WOO
Journal of the Korean Society of Emergency Medicine 2013;24(5):571-578
PURPOSE: The purpose of this study was to investigate the value of the alveolar-arterial (A-a) oxygen gradient for patients with community-acquired pneumonia (CAP) in the emergency department (ED). METHODS: A prospective study of patients with CAP in the ED was performed. Patients with clinical and a radiographic diagnosis of CAP were enrolled. Inflammatory biomarkers, such as WBC (white blood cell) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and A-a oxygen gradient were measured. The severity of CAP was assessed by three prediction rules: The Pneumonia Severity Index (PSI), CURB65 (confusion, blood urea nitrogen, respiratory rate, blood pressure and age> or =65 yrs), and the Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) rules. The value of each biomarker (WBC, CRP, ESR) and A-a oxygen gradient for the prediction of mortality and CAP severity were assessed. RESULTS: A total of 126 patients with CAP were included. Sixteen patients, older and in the high-risk group, died within 30 days. Non-survivors had a significantly increased A-a oxygen gradient compared to survivors (91.20 vs. 46.71 mmHg, respectively; p<.01) and a high-sensitivity to C-reactive protein (158.57 vs. 91.28 mg/dL, respectively; p<.01). The median A-a oxygen gradient was significantly higher with severe disease based on the three prediction rules. In regression logistic analyses, the area under the receiver operating characteristic curve of the alveolar-arterial oxygen gradient was 0.807(95% confidence interval, 0.727-0.872). The addition of A-a oxygen gradient to the three prediction rules significantly increased the area under the receiver operating characteristic curve. CONCLUSION: These results suggest that A-a oxygen gradient is useful for the prediction of mortality and disease severity among CAP patients in the ED. The A-a oxygen gradient, as an adjunct to CAP prediction rules, may be worth while for the assessment of prognosis and severity.
Americas
;
Biomarkers
;
Blood Pressure
;
Blood Sedimentation
;
Blood Urea Nitrogen
;
C-Reactive Protein
;
Communicable Diseases
;
Diagnosis
;
Emergencies
;
Humans
;
Mortality
;
Oxygen*
;
Pneumonia*
;
Prognosis
;
Prospective Studies
;
Respiratory Rate
;
ROC Curve
;
Survivors
8.The Prognostic Value of Alveolar-arterial Oxygen Gradient for Community-Acquired Pneumonia in the ED.
Jae Bok SHIN ; Woon Jeong LEE ; Jeong Ho PARK ; Seung Pill CHOI ; Si Kyung JUNG ; Seon Hee WOO
Journal of the Korean Society of Emergency Medicine 2013;24(5):571-578
PURPOSE: The purpose of this study was to investigate the value of the alveolar-arterial (A-a) oxygen gradient for patients with community-acquired pneumonia (CAP) in the emergency department (ED). METHODS: A prospective study of patients with CAP in the ED was performed. Patients with clinical and a radiographic diagnosis of CAP were enrolled. Inflammatory biomarkers, such as WBC (white blood cell) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and A-a oxygen gradient were measured. The severity of CAP was assessed by three prediction rules: The Pneumonia Severity Index (PSI), CURB65 (confusion, blood urea nitrogen, respiratory rate, blood pressure and age> or =65 yrs), and the Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) rules. The value of each biomarker (WBC, CRP, ESR) and A-a oxygen gradient for the prediction of mortality and CAP severity were assessed. RESULTS: A total of 126 patients with CAP were included. Sixteen patients, older and in the high-risk group, died within 30 days. Non-survivors had a significantly increased A-a oxygen gradient compared to survivors (91.20 vs. 46.71 mmHg, respectively; p<.01) and a high-sensitivity to C-reactive protein (158.57 vs. 91.28 mg/dL, respectively; p<.01). The median A-a oxygen gradient was significantly higher with severe disease based on the three prediction rules. In regression logistic analyses, the area under the receiver operating characteristic curve of the alveolar-arterial oxygen gradient was 0.807(95% confidence interval, 0.727-0.872). The addition of A-a oxygen gradient to the three prediction rules significantly increased the area under the receiver operating characteristic curve. CONCLUSION: These results suggest that A-a oxygen gradient is useful for the prediction of mortality and disease severity among CAP patients in the ED. The A-a oxygen gradient, as an adjunct to CAP prediction rules, may be worth while for the assessment of prognosis and severity.
Americas
;
Biomarkers
;
Blood Pressure
;
Blood Sedimentation
;
Blood Urea Nitrogen
;
C-Reactive Protein
;
Communicable Diseases
;
Diagnosis
;
Emergencies
;
Humans
;
Mortality
;
Oxygen*
;
Pneumonia*
;
Prognosis
;
Prospective Studies
;
Respiratory Rate
;
ROC Curve
;
Survivors
9.Ipsilateral Parotitis Due to Organopho - sphate Intoxication: A case report.
Seon Hee WOO ; Woon Jeong LEE ; Yeon Young KYONG ; Seung Pill CHOI ; Kyu Nam PARK ; Mi Jin LEE
Journal of the Korean Society of Emergency Medicine 2008;19(1):139-141
Acute pancreatitis due to organophosphate intoxication is a known risk, but acute parotitis due to organophosphate intoxication is rare. We describe the case of a 74-year-old man who had acute organophosphate intoxication-induced ipsilateral parotitis. He developed ipsilateral parotid gland swelling and elevated serum amylase on the second day of the poisoning. However, serum lipase did not elevate and amylase isoenzyme predominated over S-type. Thus, we suggest that acute parotitis can develop due to organophosphate intoxication, and that this possibility should be checked by serial serum amylase, serum lipase, and amylase isoenzyme testing.
Aged
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Amylases
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Humans
;
Lipase
;
Pancreatitis
;
Parotid Gland
;
Parotitis
10.Predictive Value of Multimodal Evoked Potentials in Comatose Survivors after Cardiac Arrest..
Yo Seon SONG ; Young Min OH ; Byung Hak SO ; Tae Yong HONG ; Kyu Nam PARK ; Seung Pill CHOI
Journal of the Korean Society of Emergency Medicine 2008;19(1):94-101
PURPOSE: To evaluate the prognostic value of multimodal evoked potentials in predicting both awakening and failure to awake from coma due to cardiac arrest. METHODS: Multimodal evoked potentials composed of somatosensory evoked potentials (SEPs), visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) were recorded for 46 patients with anoxicischemic encephalopathy who had coma duration>24 h. Patients with trauma, stroke, malignancy, or age<14 y were excluded. Outcomes were categorized as awakening (GOS 3-5) vs. vegetative state or death (GOS 1-2). RESULTS: Forty-one percent of patients regained consciousness, and 59% died or remained vegetative. Bilaterally absent SEP N20 peaks predicted non-awakening with a sensitivity of 52% and a specificity of 100%. Unilaterally or bilaterally absent BAEP III-V predicted non-awakening with a sensitivity of 12% and a specificity of 100%. Using bilaterally absent SEP N20 peaks, unilaterally or bilaterally absent BAEP III-V, or both of the above predicted non-awakening with a sensitivity of 56% and a specificity of 100%. Bilaterally present SEP N20 peaks predicted awakening with a sensitivity of 100% and a specificity of 63%. However, the combination of bilateral presence of SEP N20 and VEP P100 in predicting awakening increased the specificity to 74%, reaching a sensitivity of 89%, a PPV of 71% and a NPV of 91%. CONCLUSION: Non-awakening in postanoxic coma can be reliably predicted with SEPs and BAEPs. Bilaterally preserved SEPs and VEPs predicted awakening with an accuracy of 80% at 1~4 days after cardiopulmonary resuscitation.
Coma
;
Consciousness
;
Evoked Potentials
;
Evoked Potentials, Auditory, Brain Stem
;
Evoked Potentials, Somatosensory
;
Evoked Potentials, Visual
;
Heart Arrest
;
Humans
;
Persistent Vegetative State
;
Prognosis
;
Sensitivity and Specificity
;
Stroke
;
Survivors