82 results on '"Jeong Min Ryu"'
Search Results
2. Clinical features and use of renal replacement therapy in children who visit the emergency department with benign acute childhood myositis or rhabdomyolysis who visit the emergency department
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Namjin Kim, Jun Sung Park, Dahyun Kim, Min Kyo Chun, Jeeho Han, Jong Seung Lee, and Jeong-Min Ryu
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child ,myositis ,renal replacement therapy ,rhabdomyolysis ,risk factors ,Medicine - Abstract
Purpose This study was performed to analyze clinical features and use of renal replacement therapy (RRT) for children who visit the pediatric emergency department with benign acute childhood myositis (BACM) or rhabdomyolysis. Methods We retrospectively reviewed medical records of 289 children who visited the emergency department with BACM or rhabdomyolysis from January 2013 through December 2022. Clinical features, laboratory and microbiological findings, and outcomes were compared between children with the two diagnoses. Subsequently, multivariable logistic regressions were performed to identify factors associated with applying RRT. Results Of the 289 children, a total of 212 were analyzed, including 93 with BACM and 119 with rhabdomyolysis. Influenza (70 of the 145 children [48.3%]) was the most common cause, followed by exercise (36 of 212 [17.0%]). Compared with the children with BACM, those with rhabdomyolysis showed significantly higher frequencies of being boys and hematuria, and higher concentrations of hemoglobin, creatinine, creatine kinase, and myoglobin. Continuous venovenous hemofiltration, a modality of RRT, was applied to 8 children (6.7%) with rhabdomyolysis, of whom 1 died. Creatine kinase was independently associated with the application of RRT (adjusted odds ratio, 1.06; 95% confidence interval, 1.00-1.12; P = 0.036). Conclusion Rhabdomyolysis in children who require RRT may be associated with a higher concentration of creatine kinase.
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- 2024
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3. Change of utilization of emergency department in children after lifting mask mandates in a single center in Korea
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Chaeho Shin, Jong Seung Lee, Hyung-Rae Cho, Heejin Jang, Jun Sung Park, Dahyun Kim, Min Kyo Chun, Jeeho Han, and Jeong-Min Ryu
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covid-19 ,emergency service, hospital ,masks ,pediatrics ,public health complications ,postoperative hemorrhage ,tonsillectomy ,Medicine - Abstract
Purpose We aimed to investigate changes in visiting patterns after the lifting of mask mandates in a single pediatric emergency medical center in Seoul, Korea. Methods This retrospective study was based on the data of patients’ (≤ 18 years) visits to the emergency department (ED) of the center from January 1, 2022 through June 30, 2023. Clinical characteristics, Korean Triage and Acuity Scale (KTAS) level, ED outcomes, and length of stay were compared between before (March 20-June 30, 2022) and after (March 20-June 30, 2023) the lifting of mask mandates. The comparisons were iterated in the patients with infectious disease. Results During the study period, a total of 18,654 children visited the ED. After the lifting of mask mandates, ED visits increased from 7,146 to 11,508 (61.0%; 95% confidence interval, 59.5-62.6; P < 0.001). The increase was more prominent in the age of 2-5 years (82.9%), infectious diseases (175.3%), KTAS level 3 (127.7%), and length of stay shorter than 3 hours (78.8%-92.6%). The number of patients per hour increased by 151.2% for 5 patients or more and over 3,000% for 10 or more. Median length of stay decreased (2.3 hours [interquartile range, 1.2-4.1] to 1.9 hours [1.1-3.5]; P < 0.001). The patients with infectious disease (n = 7,139) showed similar patterns of increase in the age of 2-5 years, KTAS level 3, and length of stay shorter than 3 hours, with an additional increase in the age of 6-18 years. Conclusion After the lifting of mask mandates, pediatric visits increased by 61%, with the highest increase in children with mild infectious diseases on weekends and at night, and the proportion of more than 10 visits per hour significantly increased. We need urgent and realistic support measures from health authorities.
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- 2023
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4. Changes in pediatric psychiatric emergency during the coronavirus disease 2019 pandemic
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Jung Il Kwak, Jun Sung Park, Seung Jun Choi, Jong Seung Lee, Jeong-Min Ryu, and Jeong-Yong Lee
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covid-19 ,emergencies ,emergency service, hospital ,pediatrics ,psychiatry ,republic of korea ,suicidal ideation ,Medicine - Abstract
Purpose The lifestyle changes during the coronavirus disease 2019 pandemic possibly affected mental health among the pediatric population. We aimed to analyze changes in psychiatric emergency-related visits to the emergency department (ED). Methods We reviewed cases of pediatric patients (≤ 18 years) who visited the ED of a tertiary hospital with psychiatric emergency as a chief complaint from March 2019 through February 2021. The study period was dichotomized by March 2020, starting point of social distancing, into the pandemic and control periods. Clinical data were collected and compared between the 2 periods. Results A total of 246 cases with a mean age of 15.2 years were included. The overall visits to the ED decreased to 43.8% whereas the proportion of psychiatric emergency-related visits increased during the pandemic period, compared to the control period (0.5% vs. 1.0%; P < 0.001). The cases with suicidality, including ideation and attempt, increased in both number and proportion during the pandemic period (51 [38.9%] vs. 63 [54.8%]; P = 0.013). Conclusion Pediatric psychiatric emergency-related visits, particularly suicidality, proportionally increased during the pandemic. This finding may be useful to prepare psychiatric resources in EDs.
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- 2022
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5. Risk factors for acute bronchiolitis-related return visits to the emergency department
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Yunjun Kook, Jong Seung Lee, and Jeong-Min Ryu
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ambulatory care ,bronchiolitis ,child ,emergency service, hospital ,risk factors ,Medicine - Abstract
Purpose Acute bronchiolitis (AB)-related return visits incur overuse of emergency medicine resources, crowding of emergency departments (EDs), and deterioration of rapport with the guardians. The authors aimed to analyze factors associated with the return visits to the ED. Methods This study was conducted based on the medical records of 447 children aged 24 months or younger with AB who visited the ED from January 2019 through December 2020. A return visit was defined as an AB-related visit to the ED within 7 days of index visit. According to the return visit, we compared the clinical features. Multivariable logistic regression was conducted to identify independent factors for the return visit. Results Of the 323 children with AB, 77 (23.8%) made return visits. The returning children showed a younger median age (6 [interquartile range, 2-10] vs. 8 months [3-14]; P < 0.001), a lower mean oxyhemoglobin saturation (92.9 ± 4.3% vs. 97.1 ± 1.8%; P < 0.001), and higher frequencies of congenital heart diseases (22.1% vs. 10.6%; P = 0.009) and bronchopulmonary dysplasia (11.7% vs. 5.7%; P = 0.013), and respiratory syncytial virus infection (57.1% vs. 37.0%; P = 0.002). No other variables, such as the hospitalization rate, differed as per return visits. The factors associated with return visits were respiratory syncytial virus infection (adjusted odds ratio, 9.41; 95% confidence interval, 2.13-41.57), lower oxygen saturation (2.00; 1.64-2.43), and age younger than 3 months (1.25; 1.07-1.24). Conclusion AB-related return visits may be associated with age younger than 3 months, lower oxygen saturation, and respiratory syncytial virus infection.
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- 2021
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6. Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: a retrospective single-center study
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Jun-Sung Park, Young-Hoon Byun, Jeong-Yong Lee, Jong Seung Lee, Jeong-Min Ryu, and Seung Jun Choi
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Febrile infant ,Neonate ,Procalcitonin ,Severe bacterial infection ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Fever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center. Methods We retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018. Results A total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3 and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7 and 92%, respectively, both increased. Conclusion PCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.
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- 2021
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7. Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
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Jeong-Yong Lee, Young-Hoon Byun, Jun-Sung Park, Jong Seung Lee, Jeong-Min Ryu, and Seung Jun Choi
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Child ,Emergency service hospital ,Intussusception ,Lactic acid ,Prognosis ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes. Methods The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 h of reduction or when surgical reduction was required due to air enema failure. Results A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P
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- 2020
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8. Age group characteristics of clinical features and use of epinephrine in children with anaphylaxis who visited the emergency department
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Namsung Baek, Jong Seung Lee, and Jeong-Min Ryu
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age groups ,anaphylaxis ,child ,emergency service, hospital ,epinephrine ,Medicine - Abstract
Purpose Diagnosis of anaphylaxis depends on clinical manifestations and a high index of suspicion, and a misdiagnosis can lead to a preventable death. We aimed to investigate age group characteristics of clinical features and epinephrine use in children with anaphylaxis who visited the emergency department (ED). Methods We performed a retrospective chart review of 138 children who visited a tertiary care hospital ED from January through December 2018, and were discharged with anaphylaxis as the diagnosis. Anaphylaxis was defined according to the National Institutes of Allergy and Infectious Disease criteria. The children were divided into 4 age groups; infants (< 1 year), preschoolers (1-5 years), schoolers (6-11 years), and adolescents (12-18 years). Clinical features and epinephrine use were compared among the age groups. Results Of the 138 children with presumed anaphylaxis, 108 met the criteria. The most common cause was food (74%), followed by drugs (10.2%). Epinephrine was used in 82 children (75.9%). The infants and preschoolers reported less frequent cardiovascular symptoms (0%-3.6% vs. 26.5%, P = 0.020) and epinephrine use (33.3%-70.9% vs. 91.2%, P = 0.037) compared to the adolescents. The former 2 age groups reported food as triggers more frequent, and often reported food-associated and respiratory or gastrointestinal symptoms. Conclusion Infants and preschoolers with anaphylaxis may undergo less frequent cardiovascular symptoms and epinephrine use compared to adolescents. This feature prompts to increased epinephrine use in the former age groups even without age-adjusted hypotension.
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- 2019
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9. The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm
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Taeyeop Lee, Hyunjung Park, Jeong-Min Ryu, Namkug Kim, and Hyo-Won Kim
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Psychiatry and Mental health ,Developmental and Educational Psychology - Published
- 2023
10. Pediatric transport medicine: a yet unknown territory in Korea
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Jeong-Min Ryu
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Pediatrics ,RJ1-570 - Published
- 2020
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11. Neuroblastoma in a 3-year-old boy presenting with pain in the bilateral hip and abdomen
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Jae Hyun Kwon, Jung Heon Kim, In Hye Song, and Jeong-Min Ryu
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child ,diagnosis, differential ,emergencies ,hip ,neuroblastoma ,pain ,Medicine - Abstract
A 3-year-old boy presented to our emergency department with a 3-week history of pain in the bilateral hip and abdomen that had persisted through antibiotic therapy based on diagnosis of acute osteomyelitis. At presentation, he had fever, anemia, and increased concentration of lactate dehydrogenase. After the identification of a left adrenal mass indicating neuroblastoma on computed tomography scan, he was admitted to the hospital by a pediatric oncologist. Subsequently, positron emission tomography and bone scintigraphy showed disseminated metastasis to the bone and bone marrow, and neuroblastoma was pathologically confirmed. This case highlights the importance of differential diagnosis of non-traumatic hip pain in toddlers considering the protean manifestations of neuroblastoma.
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- 2016
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12. A tracheoinnominate artery fistula presenting with massive hemorrhage in a 13-year-old boy
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Jung Heon Kim, Jeong-Yong Lee, Hyung-Rae Cho, Jong Seung Lee, and Jeong-Min Ryu
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tracheostomy ,brachiocephalic trunk ,fistula ,hemorrhage ,child ,Medicine - Abstract
Despite its rarity, a tracheoinnominate artery fistula can result in catastrophic hemorrhage. Here, we describe a case of a 13-year-old boy with such a condition following tracheostomy. After identification of pulsatile bleeding from the tracheostoma, temporary control of hemorrhage was obtained using hyperinflation of the tracheostomy tube cuff. Subsequently, a lesion indicative of a tracheoinnominate artery fistula was found on a computed tomography scan, and the diagnosis was confirmed at surgery. After surgery, he was discharged with no recurrent bleeding. This case highlights the importance of high suspicion and prompt management of tracheoinnominate artery fistula.
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- 2015
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13. Quality of Life in Older Adults with Benign Prostatic Hyperplasia
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Sewon Park, Jeong-min Ryu, and Munjae Lee
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health-related quality of life (HRQOL) ,Benign Prostatic Hyperplasia (BPH) ,older adults ,subjective health status ,physical activity ,Medicine - Abstract
The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.
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- 2020
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14. Pediatricians and Emergency Physicians’ Recognition and Training Regarding Child Abuse
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Hyun Jung Lee, Hye Young Jang, Jong Beon Byeon, Jin Hee Jung, Jeong-Min Ryu, Young Ho Kwak, and June Dong Park
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child abuse ,data collection ,cognition ,Medicine - Abstract
Purpose To explore the recognition levels and educational experiences of child abuse among physicians. Methods We conducted an electronic questionnaire survey of pediatricians and emergency physicians. Results Of the 245 total respondents, 63% remarked that child abuse occurred “frequently” in Korea. One hundred twenty-seven (51.8%) respondents experienced an abused child during their practice, and only 55.9% reported the event. Regarding the knowledge for obligation of report as a medical specialist, 45.7% knew where they should report the case, and 39.2% of the respondents knew the phone number of the “Child Protection Agency”. Most respondents (70.2%) answered that they had never received an education about child abuse. Some respondents answered that they had not reported a suspected abused case because they were not certain that the case was abuse and thereby felt discomfort in making the report. To enhance child abuse reports, respondents thought that an immediate intervention is necessary for the reported case. Also, they answered that their confidentialities have to be assured and that the education about child abuse is needed. Conclusion The survey results show that pediatricians and emergency physicians often do not report suspected abuse despite their suspicion of the seriousness and frequent occurrence of child abuse. Such behaviors are affected by the recognition and knowledge levels about child abuse, the experience of training for child abuse, and discomfort of the reporting process. For medical specialists’ attention and reporting of abuse, repetitive education, appropriate public relations and improvement of the reporting process are needed.
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- 2015
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15. Pheochromocytoma Presenting with Hypertensive Encephalopathy in a 12-Year-Old Boy
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Jung Heon Kim and Jeong-Min Ryu
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pheochromocytoma ,hypertensive encephalopathy ,child ,Medicine - Abstract
Although pheochromocytoma is rare in children, it could result in hypertensive emergency. We describe the case of a 12-year-old boy with pheochromocytoma. His clinical manifestations indicated hypertensive encephalopathy; however, there were no space-occupying lesion in the brain and definitive evidence of secondary cause of hypertension. Knowing that he had extremely high blood pressure, headache, palpitation, and perspiration rendered sympathetic crisis a presumptive diagnosis. Subsequently, pheochromocytoma was diagnosed by computed tomography and catecholamine assay. After stabilizing the blood pressure with antihypertensive medications, such as phenoxybenzamine, laparoscopic adrenalectomy was performed, and he was discharged without residual discomfort. We would like to highlight expeditious diagnosis and proper management of pheochromocytoma with hypertensive encephalopathy.
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- 2015
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16. Missed clavicle fractures on anterior-posterior views of skull X-rays: a retrospective, observational, and descriptive study
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Jung-Heon Kim, Jeong-Yong Lee, Hyung-Rae Cho, Jong-Seung Lee, and Jeong-Min Ryu
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clavicle ,skull ,x-rays ,infant ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objective The clavicle is almost always seen in skull X-rays of infants. The objectives of this study were to determine how often the clavicle and clavicle fractures are visible but missed on the skull anterior-posterior view (skull AP) of infants and which factors are associated with missing the diagnosis. Methods We retrospectively studied patients aged 1 year or younger who had a skull AP taken for any injury survey at a single urban, academic hospital between April 1999 and July 2012. Outcomes of interest were the numbers and percentages of visible clavicles; clavicle fractures, including missed ones on skull AP; and the factors associated with missing the diagnosis of a clavicle fracture. Results Both clavicles were visible in 734 patients (89.6%). Of these, 10 patients (1.4%) had confirmed clavicle fractures, and 6 patients (0.8%) had fractures that were missed at presentation. Although we tried to determine the factors that might be associated with missed diagnoses, including age
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- 2015
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17. A Case of Toddler with Cellulitis of the Leg due to Insect Bite
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Jung-Heon Kim and Jeong-Min Ryu
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insects ,cellulitis ,fasciitis ,necrotizing ,Medicine - Abstract
Insect bite could cause soft tissue infection. Although most common cause of it is cellulitis, there are broad differential diagnoses from minor hypersensitivity reactions to necrotizing fasciitis. We describe the case of a 3-year-old boy who experienced progressive erythema with bullae on his leg after an insect bite that had happened 5 days ago. His clinical manifestations indicated necrotizing fasciitis as a possible scenario. However, no surgical exploration was performed after orthopedic consultation and magnetic resonance imaging. Empirical antibiotics was administered to him and he was discharged without any complications after 5 days. Although the final diagnosis was cellulitis, we would like highlight the necessity of high index of suspicion and expeditious treatment.
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- 2014
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18. A Case of Infant with Persistent Stridor due to Residual Esophageal Foreign Body
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Jung-Heon Kim and Jeong-Min Ryu
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infant ,esophagus ,foreign bodies ,respiratory sounds ,Medicine - Abstract
Esophageal foreign body could cause stridor. Stridor may be persistent due to residual foreign body even after removal of esophageal foreign body. We describe a case of a 10-month-old boy who experienced persistent stridor after initial removal of esophageal foreign body. He had been brought to the emergency department, and a foreign body had been removed by rigid bronchoscopy. Nevertheless, he had persistent stridor. A computed tomography (CT) scan revealed residual foreign body with associated calcification in the prevertebral soft tissue (C3-C5 level). He has been on surgical observation with foreign body in situ.
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- 2014
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19. What is the Most Appropriate Method for Estimating the Depth for Endotracheal Tubes not to Pass through the Trachea of Korean Children in the Emergency Department?
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Hyung Rae Cho, Jeong-Yong Lee, Jung-Heon Kim, Jong Seung Lee, and Jeong-Min Ryu
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child ,intubation ,airway management ,emergencies ,Medicine - Abstract
Purpose The more younger the child, the more complications of endotracheal intubation are likely, such as deep intubation, extubation, atelectasis, or barotraumas, because of the small diameter and short length of the trachea. Therefore, the exact placement of tube tip in the middle third of trachea is very important; however, normal reference ranges of the length from incisors to middle third of the trachea for Korean children is not prepared yet. Methods A retrospective study was conducted on 48 children, who underwent endotracheal intubation in the emergency department of Asan Medical Center, between February 1997 and October 2007. After correcting the depth in actual tip positions by the difference between the actual intubation depths and calculated or measured depths by various methods, such as PALS guidelines, APLS formula, formula method, Broselow tape, and new formula, a comparison between these various methods was done. Results Most commonly, the tube position was too deep including position in the right main bronchus (71%). Among the children who underwent right main bronchus intubation, more than half were children less than 2 years of age (58%). The highest rate of appropriate tube position was observed when corrected using the PALS guideline (69%), and the lowest rate was observed in formula method (26%). Conclusion Meticulous intubation technique requires not to intubate too deep especially in young children less than 2 years of age. Physicians responsible for acute care of children should be knowledgeable of the PALS guideline for the appropriate depth of tracheal tube. However, it is also important to note the possibility of deep intubation while adhering to this guideline (approximately 40%). The development of methods or devices based on the distance from incisors to mid-portion of the trachea for Korean children is necessary.
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- 2014
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20. Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: a retrospective single-center study
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Jeong-Min Ryu, Seung Jun Choi, Jun Sung Park, Jong Seung Lee, Jeong-Yong Lee, and Young-Hoon Byun
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medicine.medical_specialty ,Multivariate analysis ,Urinalysis ,Fever ,Urinary system ,Single Center ,Procalcitonin ,Severe bacterial infection ,03 medical and health sciences ,Leukocyte Count ,0302 clinical medicine ,Neonate ,Febrile infant ,030225 pediatrics ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Child ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Medical record ,lcsh:RJ1-570 ,Infant ,lcsh:Pediatrics ,Odds ratio ,Bacterial Infections ,C-Reactive Protein ,Pediatrics, Perinatology and Child Health ,Biomarker (medicine) ,business ,Emergency Service, Hospital ,Biomarkers ,Research Article - Abstract
BackgroundFever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center.MethodsWe retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018.ResultsA total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3 and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7 and 92%, respectively, both increased.ConclusionPCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.
- Published
- 2021
21. 2.105 Media Exposure to Nonsuicidal Self-Injury and Its Impact on Pediatric Emergency Department Visits by Self-Harm
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Taeyeop Lee, Hyunjung Park, Jeong Min Ryu, Namkug Kim, and Hyo-Won Kim
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Psychiatry and Mental health ,Developmental and Educational Psychology - Published
- 2022
22. Age group characteristics of clinical features and use of epinephrine in children with anaphylaxis who visited emergency department
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Jeong Min Ryu, Namsung Baek, and Jong Seung Lee
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medicine.medical_specialty ,Epinephrine ,Age groups ,business.industry ,Emergency medicine ,Medicine ,Emergency department ,business ,medicine.disease ,Anaphylaxis ,medicine.drug - Published
- 2019
23. Clinical Implications of Ketosis in Children with Benign Convulsions with Mild Gastroenteritis
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Jeong Yong Lee, Tae-Sung Ko, Mi-Sun Yum, Jeong Min Ryu, and Jong Seung Lee
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Pediatrics ,medicine.medical_specialty ,child ,ketosis ,emergency department ,business.industry ,Incidence (epidemiology) ,Retrospective cohort study ,Emergency department ,Age and sex ,Seizure recurrence ,medicine.disease ,Pathophysiology ,03 medical and health sciences ,0302 clinical medicine ,Neurology ,medicine ,Original Article ,030212 general & internal medicine ,Neurology (clinical) ,Ketosis ,business ,gastroenteritis ,030217 neurology & neurosurgery ,seizures - Abstract
BACKGROUND AND PURPOSE The pathophysiologic mechanisms underlying benign convulsions with mild gastroenteritis (CwG) in children remain unclear. We investigated the incidence of ketosis in CwG and whether this is related to seizures. METHODS This retrospective study included children aged from 6 months to 6 years who visited our emergency department and were diagnosed as CwG between June 2015 and December 2018. The clinical and laboratory data were analyzed for these cases. Ketosis and severe ketosis were defined as blood β-hydroxybutyrate levels of ≥0.6 and ≥4.5 mmol/L, respectively. RESULTS We enrolled 42 pediatric CwG patients aged 21.0±11.5 months (mean±SD) whose blood β-hydroxybutyrate level was 3.65±1.51 mmol/L. Ketosis was observed in 95.2% of these children, while 35.7% had severe ketosis. Compared to the non-severe-ketosis group (n=27), the severe-ketosis group (n=15) demonstrated significantly lower blood glucose levels (68.8 vs. 82.6 mg/dL, p=0.020) and sodium levels (134.2 vs. 135.6 mEq/L, p=0.018), and included a larger proportion of low-body-weight children (defined as adjusted weight
- Published
- 2019
24. A Generalized Convulsive Attack following Ingestion of a Large Number of Ginkgo Nuts in 12- year-old Male
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Jeong-Min Ryu and Tae Sung Ko
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ginkgo biloba ,poisoning ,child ,seizures ,Medicine - Abstract
Ginkgo nuts are commonly used in Korea for its antitussive and expectorant properties, as well as circulatory boosting effect and nutritive value. However, heir potential toxicities are not well-known. Symptoms of ginkgo nut intoxication include abdominal pain, nausea, vomiting, diarrhea, irritability, headaches, and seizure attacks or fatal status epilepticus. 4-O-methoxypyridoxine (MPN) in ginkgo nuts has been known to cause generalized seizures or status epilepticus. This report describes a case of ginkgo nut intoxication in a 12-year-old male. The patient was presented with vomiting and afebrile convulsion 7 hours after eating a large number of roasted gingko nuts.
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- 2014
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25. Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department
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Jong Seung Lee, Jeong-Min Ryu, Seung Jun Choi, Jun Sung Park, Young-Hoon Byun, and Jeong-Yong Lee
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diagnostic imaging ,Point-of-Care Systems ,specificity ,Pyloric Stenosis, Hypertrophic ,point-of-care system ,Medicine ,Humans ,Hypertrophic Pyloric Stenosis ,Retrospective Studies ,business.industry ,Point of care ultrasound ,Ultrasound ,Infant ,Retrospective cohort study ,General Medicine ,Emergency department ,Original Articles ,ultrasonography ,sensitivity ,Patient flow ,pyloric stenosis ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Cohort ,Emergency Medicine ,Vomiting ,Feasibility Studies ,medicine.symptom ,business ,Emergency Service, Hospital - Abstract
OBJECTIVES This study aimed to investigate the feasibility of point-of-care ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED). METHODS A retrospective study was conducted in infants aged younger than 90 days who were brought to the ED due to vomiting between January 2015 and December 2019. Of these, infants who were clinically suspected of having HPS and underwent ultrasound were included and categorized into 3 groups: POCUS only, POCUS followed by radiologist-performed ultrasound (RADUS), and RADUS only. All confirmative diagnoses of HPS were made by RADUS. The diagnostic performance of POCUS was analyzed, and the ED patient flow was compared between the POCUS-performed (POCUS only or POCUS followed by RADUS) and RADUS-only groups. RESULTS Overall, 171 patients with a median age of 34 days were included. Of these, 79 patients (46.2%) underwent POCUS only, and none had HPS; 50 patients (29.2%) underwent POCUS followed by RADUS; and 42 patients (24.5%) underwent RADUS only. Overall, 41 patients (24.0%) were diagnosed with HPS, and POCUS showed a sensitivity of 96.6% and specificity of 94.0%. In the total cohort, length of stay in the ED (EDLOS) was shorter in the POCUS-performed group than in the RADUS-only group (2.6 vs 3.8 hours, P = 0.015). Among non-HPS patients, time to disposition (1.8 vs 2.7 hours, P = 0.005) and EDLOS (2.0 vs 3.0 hours, P = 0.004) were shorter in the POCUS-performed group than in the RADUS-only group. Performing POCUS followed by RADUS did not significantly delay the treatment among HPS patients. CONCLUSIONS Point-of-care ultrasound is accurate and useful for diagnosing HPS and improved the ED patient flow by reducing EDLOS and door-to-disposition time in non-HPS patients.
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- 2021
26. Innovative Culture and Firm Performance of Medical Device Companies: Mediating Effects of Investment in Education and Training
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Yoonseo Park, Jeongwon Park, Jeong-min Ryu, Munjae Lee, and Se-Won Park
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Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,Organizational performance ,Corporation ,Human capital ,Job Satisfaction ,Article ,Republic of Korea ,Humans ,Marketing ,media_common ,corporate performance ,Organizations ,Variables ,Public Health, Environmental and Occupational Health ,organization ,Investment (macroeconomics) ,Organizational Culture ,innovative culture ,Vocational education ,Medicine ,Job satisfaction ,Business ,education and training ,Panel data - Abstract
This research explored the mediating effect of investment in education and training relating to the innovative culture and organizational performance of medical device companies. We used the Human Capital Corporate Panel data provided by the Korea Vocational Competency Development Institute. In the industrial classification system of panel data, the industries related to medical devices were extracted and conclusively analyzed for 8629 workers and 368 companies. The independent and dependent variables were innovative culture and corporation performance, respectively. Investment in training and education was a mediating variable between the independent and dependent variables. Quantitative data were analyzed using SPSS software. A higher level of organizational satisfaction emerged in an innovative culture. Innovative culture positively affected organizational satisfaction. Further, investment in education and training to promote an innovative culture positively affected organizational satisfaction. Medical device companies should improve their performance by creating an innovative culture.
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- 2021
27. Decreased Cases of Pediatric Intussusception During COVID-19
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Jeong-Min Ryu, Jong Seung Lee, Jeong-Yong Lee, Young-Hoon Byun, Seung Jun Choi, and Jun Sung Park
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medicine.medical_specialty ,Text mining ,Coronavirus disease 2019 (COVID-19) ,business.industry ,General surgery ,Intussusception (medical disorder) ,medicine ,business ,medicine.disease - Abstract
Objectives: Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigated the epidemiologic and clinical changes of intussusception from before to after the COVID-19 outbreak, when communicable diseases other than COVID-19 have dramatically decreased due to social lockdown.Methods: The incidence of intussusception and the total monthly visits, including communicable and non-communicable diseases, aged ≤7 years, were investigated from February 2019 to January 2021 in a single pediatric emergency department of a university-affiliated tertiary hospital. The relationship between the incidence of communicable disease and intussusception was analyzed. The clinical characteristics of patients with intussusception were compared for the one-year periods before (February 2019–January 2020) and after (February 2020–January 2021) social lockdown due to COVID-19.Results: Incidence of communicable disease, non-communicable disease, and intussusception is decreased after COVID-19 outbreak (15,932 to 3,880 [24.4%], 12,994 to 8,050 [62.0%], and 87 to 27 [31.0%], respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, Odds ratio=2.15, 95% CI=1.08–4.26, P=0.029). Compared with non-pandemic period, patients of pandemic period showed higher proportions of pathologic leading point and hospitalization (14.8% vs. 2.3%, 18.5% vs. 4.6%, respectively), lower base excess (-4.8 mmol/L vs. -3.6 mmol/L), and higher lactate concentration (1.7 mmol/L vs. 1.5 mmol/L).Conclusions: The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe disease and PLPs were higher after the COVID-19 pandemic.
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- 2021
28. High Concentration of C-Reactive Protein Is Associated With Serious Bacterial Infection in Previously Healthy Children Aged 3 to 36 Months With Fever and Extreme Leukocytosis
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Jina Lee, Jong Seung Lee, Jeong-Yong Lee, Jung Heon Kim, Jeong-Min Ryu, and Hyung-Rae Cho
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Male ,medicine.medical_specialty ,Fever ,Leukocytosis ,Sensitivity and Specificity ,Gastroenterology ,Leukocyte Count ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,030225 pediatrics ,Internal medicine ,White blood cell ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,biology ,business.industry ,C-reactive protein ,Infant ,Retrospective cohort study ,Bacterial Infections ,General Medicine ,Emergency department ,medicine.disease ,Confidence interval ,Surgery ,C-Reactive Protein ,medicine.anatomical_structure ,Child, Preschool ,Predictive value of tests ,Pediatrics, Perinatology and Child Health ,Lobar pneumonia ,Emergency Medicine ,biology.protein ,Female ,medicine.symptom ,Emergency Service, Hospital ,business ,Biomarkers - Abstract
Objectives The aim of the study was to investigate the diagnostic efficacy of C-reactive protein (CRP) in predicting serious bacterial infection (SBI) in febrile children aged 3 to 36 months with extreme leukocytosis (EL), defined as a peripheral white blood cell count of 25,000 to 49,999/mm. Methods The presence of SBI was reviewed in previously healthy children aged 3 to 36 months with a fever of 39°C or higher and EL, who visited a tertiary care hospital emergency department between September 2010 and August 2015. We measured cutoff values of CRP with corresponding likelihood ratios (LRs) and posttest probabilities (PPs). Results Of 9989 febrile children, 4252 (42.6%) underwent assays for white blood cell and CRP. Of 233 (5.5%) children with EL, 133 (3.1%) were enrolled, of whom 43 (32.3%; 95% confidence interval [CI], 25.0%-40.7%) had SBI, including 33 pyelonephritis, 5 deep abscesses, 3 lobar pneumonia, and 2 soft tissue infections. With the cutoff of 7.8 mg/dL, the sensitivity of CRP in predicting SBI was 81.4% (95% CI, 67.4%-90.3%); the specificity, 80.0% (95% CI, 70.6%-87.0%); the positive predictive value, 66.0% (95% CI, 52.6%-77.3%); the negative predictive value, 90.0% (95% CI, 81.5%-94.9%); the positive LR, 4.1; and the PP, 66.0% (95% CI, 55.6%-75.0%). A CRP concentration of 16.1 mg/dL or higher yielded an LR of 11.2 and a PP of 84.2% (95% CI, 62.1%-94.5%). A CRP concentration of lower than 3.4 mg/dL yielded an LR of 0.05 and a PP of 2.4% (95% CI, 0.3%-14.6%). Conclusions High concentration of CRP is strongly associated with the presence of SBI in febrile children with EL.
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- 2019
29. Clinical features of Mycoplasma pneumoniae coinfection and need for its testing in influenza pneumonia patients
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Kyoung Soo Lim, Won Young Kim, Jung Heon Kim, Jong Seung Lee, Jeong-Min Ryu, Sung-Han Kim, Jae Hyun Kwon, and Jeong-Yong Lee
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Mycoplasma pneumoniae ,medicine.medical_specialty ,biology ,business.industry ,030106 microbiology ,Odds ratio ,Emergency department ,medicine.disease_cause ,medicine.disease ,respiratory tract diseases ,Serology ,03 medical and health sciences ,Pneumonia ,0302 clinical medicine ,medicine.anatomical_structure ,Immunoglobulin M ,White blood cell ,Internal medicine ,biology.protein ,Coinfection ,Medicine ,030212 general & internal medicine ,business - Abstract
Background: To investigate the clinical features of coinfection due to Mycoplasma pneumoniae ( M. pneumoniae ), a common copathogen in influenza, in influenza pneumonia patients. Methods: We reviewed 4,465 patients with influenza who visited a tertiary care hospital emergency department in Seoul (Korea) from 2010 through 2016, and underwent immunoglobulin M (IgM) serology or polymerase chain reaction (PCR) for M. pneumoniae . Influenza pneumonia was defined as laboratory-confirmed influenza plus radiographic pneumonia. Patients with healthcare-associated pneumonia or non-mycoplasma bacterial coinfection were excluded. Clinical, laboratory, and radiographic findings and outcomes of the influenza pneumonia patients with and without M. pneumoniae coinfection were compared. Multivariable logistic regression analysis was performed to identify factors associated with the coinfection. Results: Of 244 influenza pneumonia patients, 41 (16.8%) had M. pneumoniae coinfection. These patients were younger with a higher frequency of age of 5–10 years, and had higher white blood cell (WBC) and lymphocyte counts; lower concentration of C-reactive protein (CRP). The coinfection had no association with specific radiographic findings and poor outcome. Multivariable analysis showed the age of 5–10 years (adjusted odds ratio, 18.83; 95% confidence interval, 5.899–60.08; P
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- 2018
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30. Pediatric Sedation in the Emergency Department: Trends from a Nationwide Population-based Study in Korea, 2007–2018
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Jeong Min Ryu, Jong Seung Lee, Mi-Sun Yum, Jeong Yong Lee, Seung Jun Choi, and Jun Sung Park
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Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Midazolam ,Sedation ,Chloral hydrate ,Population ,Conscious Sedation ,Pediatrics ,Republic of Korea ,medicine ,Humans ,Hypnotics and Sedatives ,Anesthesia ,Ketamine ,Chloral Hydrate ,Child ,education ,Retrospective Studies ,Anesthetics, Dissociative ,education.field_of_study ,business.industry ,Infant ,Retrospective cohort study ,General Medicine ,Emergency department ,Child, Preschool ,Sedative ,Emergency medicine ,Anesthesia, Intravenous ,Original Article ,medicine.symptom ,Emergency Service, Hospital ,business ,medicine.drug - Abstract
Background Pediatric sedation in the emergency department (ED) is widely performed in Korea; thus exploring the trends of its use is necessary. This study aimed to investigate the characteristics of patients and sedatives use in the ED and verify their changes over recent years. Methods A nationwide population-based retrospective study was conducted including pediatric patients aged ≤ 15 years who received sedative medication in the ED and were discharged during 2007–2018, using the Korean Health Insurance Review and Assessment Service database. Patient characteristics (age, sex, level of ED, and diagnosis) and type of sedative used were analyzed. Results Sedation was performed in total 468,221 visits during 2007–2018 (399,320 visits, at least 3.8% of overall ED visits during 2009–2018). Among these, 71.0% were children aged 1–3 years and 93.5% were sedated to support diagnosis of injury. An increase in total sedation was observed in patients aged 4–6 years during the study period (from 13.8% to 21.8%). A gradual decrease in the use of chloral hydrate (CH) compared with an increase in ketamine use was observed (CH, from 70.6% to 28.6%; ketamine, from 23.8% to 60.7%). Therefore, ketamine was the most used sedative since 2014. The most frequently used sedatives over the study period differed according to age groups (CH in, Graphical Abstract
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- 2021
31. Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: A retrospective single-center study
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Jun Sung park, Young-Hoon Byun, Jeong-Yong Lee, Jong Seung Lee, Jeong-Min Ryu, and Seung Jun Choi
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BackgroundFever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center.MethodsWe retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018.ResultsA total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3% and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7% and 92%, respectively, both increased.ConclusionPCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.
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- 2020
32. Safety and Efficacy of Pediatric Sedation Protocols for Painless Diagnostic Examination in A Pediatric Emergency Room of A Single Tertiary Hospital
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Junsung Park, Young-Hoon Byun, Jeong-Yong Lee, Jong Seung Lee, Jeong-Min Ryu, and Seung Jun Choi
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Background: Pediatric patients undergoing diagnostic tests in the pediatric emergency room are frequently sedated. Although efforts are made to prevent adverse events, no sedation protocol has specified the optimal regimen, dosage, and interval of medication to prevent adverse events. This study analyzed the safety and efficacy of sequential pediatric sedation protocols for pediatric patients undergoing diagnostic tests in the pediatric emergency room of a single tertiary medical center.Methods: The medical records of patients aged Results: Of the 289 included patients, 20 (6.9%) experienced adverse events, none serious, and nine (3.1%) failed to reach the depth of sedation required to complete the test. The regimen (P=0.622) and dosage (P=0.777) of the sedatives were unrelated to the occurrence of adverse events when sedation was performed according to protocol.Conclusion: The sedation protocol used in these patients, consisting of sequential administration of minimum dosages, achieved a sufficient depth of sedation with relatively few adverse events, indicating that this protocol can be used safely and effectively for painless sedation in pediatric patients undergoing diagnostic testing.
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- 2020
33. Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
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Jong Seung Lee, Young-Hoon Byun, Jeong-Min Ryu, Seung Jun Choi, Jun Sung Park, and Jeong-Yong Lee
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Emergency service hospital ,medicine.medical_specialty ,Enema ,030230 surgery ,Logistic regression ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Recurrence ,Outcome predictor ,Internal medicine ,Intussusception (medical disorder) ,Humans ,Medicine ,Air enema ,Child ,Retrospective Studies ,business.industry ,Medical record ,lcsh:RJ1-570 ,Infant ,lcsh:Pediatrics ,Lactic acid ,030208 emergency & critical care medicine ,Emergency department ,Prognosis ,medicine.disease ,Treatment Outcome ,chemistry ,Pediatrics, Perinatology and Child Health ,Emergency Service, Hospital ,business ,Intussusception ,Perfusion ,Research Article - Abstract
Background Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes. Methods The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 h of reduction or when surgical reduction was required due to air enema failure. Results A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P P = .036). Multivariable logistic regression analyses showed that pH and lactic acid levels were the two factors significantly associated with poor outcomes. When the lactic acid level cutoff values were ≥ 1.5, ≥2.0, ≥2.5, and ≥ 3.0 mmol/L, the positive predictive values for poor outcomes were 30.0, 34.6, 50.0, and 88.9%, respectively. Conclusion Lactic acid levels affect outcomes in pediatric patients with intussusception; higher lactic acid levels are associated with higher positive predictive values for poor outcomes.
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- 2020
34. Characteristics and Trends of Suicide Attempt or Non-suicidal Self-injury in Children and Adolescents Visiting Emergency Department
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Harin Kim, Jeong Min Ryu, and Hyo-Won Kim
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Male ,medicine.medical_specialty ,Adolescent ,Attempted Suicide ,Poison control ,Suicide, Attempted ,Suicide prevention ,03 medical and health sciences ,Self-injurious Behavior ,0302 clinical medicine ,Injury prevention ,Republic of Korea ,Odds Ratio ,Medicine ,Humans ,Psychiatry & Psychology ,030212 general & internal medicine ,Psychiatry ,Child ,Children ,Retrospective Studies ,Suicide attempt ,business.industry ,Mental Disorders ,General Medicine ,Emergency department ,Odds ratio ,Emergency Department ,Mental health ,Hospitalization ,Marital status ,Female ,Original Article ,business ,Emergency Service, Hospital - Abstract
Background Non-suicidal self-injury (NSSI) and suicidality are common reasons for child and adolescent psychiatric emergencies. We aimed to investigate the incidence of pediatric emergency department (PED) utilization for psychiatric problems in children and adolescents and to identify demographic and clinical characteristics of youths who visited the PED for suicide attempt (SA) and/or NSSI. Methods The medical records of children and adolescents who visited the PED for psychiatric problems from January 2015 to November 2019 were reviewed retrospectively. Demographic and clinical variables including psychiatric disorders were collected. We compared the characteristics of youths who presented to the PED for SA and/or NSSI with those of youths without SA or NSSI. Student's t-test, χ2 test, and multivariate logistic regression were used for statistical analysis. Results During 59 months of observation, 194 youths visited the PED and the number of total PED visits was 336. Among them, 46 youths (23.7%) visited the PED for SA and/or NSSI at least once, and the number of visits was 91 (27.1% of PED visits). Youths with SA and/or NSSI were older (P = 0.001) and more likely to be a girl (P = 0.005) and to report parental absence (P = 0.023). Bipolar and related disorders (P = 0.032) and depressive disorders (P = 0.004) were more common in youths with SA and/or NSSI, while schizophrenia spectrum and other psychotic disorders (P = 0.030) and somatic symptom and related disorders (P = 0.007) were more common in those without SA and NSSI. After adjusting for age, sex, and parental marital status, bipolar and related disorders (odds ratio [OR], 6.72), depressive disorders (OR, 9.59), and somatic symptom and related disorders (OR, 0.12) were significantly associated with SA and/or NSSI. Youths with SA and/or NSSI also stayed longer in the PED (P = 0.007). Conclusion SA and NSSI are one of the main reasons for child and adolescent admittance to psychiatric services in the PED and are associated with psychiatric comorbidities. An appropriate risk assessment for suicidality and self-injury and proper management and referral to mental health services at the PED are of the utmost importance., Graphical Abstract
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- 2020
35. Quality of Life in Older Adults with Benign Prostatic Hyperplasia
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Munjae Lee, Se-Won Park, and Jeong-min Ryu
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Panel survey ,Gerontology ,Leadership and Management ,Benign Prostatic Hyperplasia (BPH) ,030232 urology & nephrology ,Physical activity ,lcsh:Medicine ,physical activity ,Health Informatics ,Affect (psychology) ,Logistic regression ,urologic and male genital diseases ,Article ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,Quality of life ,Health care ,medicine ,health-related quality of life (HRQOL) ,030212 general & internal medicine ,older adults ,business.industry ,Health Policy ,lcsh:R ,Hyperplasia ,medicine.disease ,subjective health status ,Benign prostatic hyperplasia (BPH) ,business - Abstract
The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.
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- 2020
36. Risk Factors for Recurrent Intussusception After Fluoroscopy-Guided Air Enema
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Jeong Min Ryu, Won Young Kim, Jong Seung Lee, Jung Heon Kim, and Kyoung Soo Lim
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Male ,medicine.medical_specialty ,Pediatrics ,Enema ,Logistic regression ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Risk Factors ,030225 pediatrics ,Intussusception (medical disorder) ,Humans ,Medicine ,Child ,Retrospective Studies ,business.industry ,Medical record ,Infant ,Retrospective cohort study ,General Medicine ,Odds ratio ,Emergency department ,medicine.disease ,Confidence interval ,Surgery ,Treatment Outcome ,Child, Preschool ,Fluoroscopy ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Emergency Medicine ,Female ,business ,Intussusception ,Cohort study - Abstract
Objectives The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence. Methods Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction. Symptom-to-door time was defined as the time from symptom onset to emergency department arrival. Door-to-reduction time was defined as the time from emergency department arrival to reduction. Time-to-recurrence was defined as the time required for recurrence from the first ultrasound diagnosis. Results Of the 360 eligible children, 32 had recurrent intussusceptions (8.9%). Multivariable logistic regression showed that age 2 years or older is an independent predictor of recurrent intussusception (odds ratio, 2.39; 95% confidence interval, 1.13-5.02; P = 0.02). Median time to recurrence was 25 hours (18.0-36.0 hours). Although symptom-to-door and door-to-reduction times tended to be longer in the recurrence group, these differences were not significant (12.5 vs 7.0 hours, P = 0.18; 154.0 vs 143.0 minutes, P = 0.67, respectively). Conclusions Our data suggest that provision for early recurrence and extended observation may be beneficial for children 2 years or older. Delayed reduction was not associated with recurrent intussusception, but further studies with larger sample sizes are needed to explain this issue.
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- 2018
37. A Study on the Improvement of the Separation Phenomenon of Coolant Hose in the Tracked Combat Vehicle
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Hun-kee Lee, Tae-Woo Kang, Hun-Yong Shin, Jae-Kyu Kim, Kyung-Chul Park, and Jeong-Min Ryu
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010407 polymers ,0209 industrial biotechnology ,020901 industrial engineering & automation ,Nuclear engineering ,Separation (aeronautics) ,Environmental science ,02 engineering and technology ,01 natural sciences ,0104 chemical sciences ,Coolant - Published
- 2018
38. Decreased Incidence of Pediatric Intussusception during COVID-19
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Jong Seung Lee, Seung Jun Choi, Young-Hoon Byun, Jun Sung Park, Jeong-Min Ryu, and Jeong-Yong Lee
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intussusception ,medicine.medical_specialty ,Communicable disease ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Transmission (medicine) ,Incidence (epidemiology) ,COVID-19 ,Outbreak ,Odds ratio ,communicable disease ,epidemiology ,medicine.disease ,Pediatrics ,Article ,RJ1-570 ,Internal medicine ,Intussusception (medical disorder) ,Pediatrics, Perinatology and Child Health ,Epidemiology ,medicine ,business - Abstract
Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (−4.8 mmol/L vs. −3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic.
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- 2021
39. A Study on the Structural Design for Safety Improvement of the Winch Mount of an Armored Recovery Vehicle
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Kyung-Chul Park, Jeong-Min Ryu, and Tae-Woo Kang
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Engineering ,business.industry ,Forensic engineering ,business ,Winch ,Mount ,Construction engineering - Published
- 2017
40. Decreased Incidence of Pediatric Intussusception during COVID-19.
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Jun Sung Park, Young-Hoon Byun, Seung Jun Choi, Jong Seung Lee, Jeong-Min Ryu, and Jeong-Yong Lee
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INTUSSUSCEPTION in children ,COVID-19 pandemic ,DISEASE incidence ,PEDIATRIC epidemiology ,INFECTIOUS disease transmission - Abstract
Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020– January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (–4.8 mmol/L vs. –3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]
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- 2021
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41. Neuroblastoma in a 3-year-old boy presenting with pain in the bilateral hip and abdomen
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Jung Heon Kim, In Hye Song, Jae Hyun Kwon, and Jeong Min Ryu
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medicine.medical_specialty ,business.industry ,medicine.disease ,030218 nuclear medicine & medical imaging ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030225 pediatrics ,Neuroblastoma ,medicine ,Abdomen ,Differential diagnosis ,business - Published
- 2016
42. Pediatric transport medicine: a yet unknown territory in Korea
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Jeong-Min Ryu
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medicine.medical_specialty ,Editorial ,business.industry ,Family medicine ,Pediatrics, Perinatology and Child Health ,Transport medicine ,MEDLINE ,lcsh:RJ1-570 ,Emergency Medicine ,Medicine ,lcsh:Pediatrics ,business ,Pediatrics - Published
- 2019
43. Clinical features of
- Author
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Jung Heon, Kim, Jae Hyun, Kwon, Jeong-Yong, Lee, Jong Seung, Lee, Jeong-Min, Ryu, Sung-Han, Kim, Kyoung Soo, Lim, and Won Young, Kim
- Subjects
Original Article - Abstract
To investigate the clinical features of coinfection due toWe reviewed 4,465 patients with influenza who visited a tertiary care hospital emergency department in Seoul (Korea) from 2010 through 2016, and underwent immunoglobulin M (IgM) serology or polymerase chain reaction (PCR) forOf 244 influenza pneumonia patients, 41 (16.8%) had
- Published
- 2019
44. Current Status of Pediatric Critical Care in Korea: Results of 2015 National Survey
- Author
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Jae Hee Chung, Seong Jong Park, Kyung Won Kim, Jeong Min Ryu, Jong-Seo Yoon, Young Yoo, Bongjin Lee, June Dong Park, Jin-Tae Kim, Yu Hyeon Choi, June Huh, Hwa Jin Cho, Yoon Hee Kim, Byung Wook Eun, Won Kyoung Jhang, Hong Ju Shin, and Joongbum Cho
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Critical Care ,030106 microbiology ,Staffing ,Economic shortage ,Hospitals, General ,Intensive Care Units, Pediatric ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Surveys and Questionnaires ,Republic of Korea ,medicine ,Risk of mortality ,Humans ,Child ,Survey ,Pediatric ,business.industry ,Questionnaire ,Infant, Newborn ,Infant ,030208 emergency & critical care medicine ,Mean age ,General Medicine ,Length of Stay ,Child, Preschool ,Emergency medicine ,Female ,Original Article ,Pediatric critical care ,business ,Developed country - Abstract
Background The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was 9.4 ± 9.3 (range, 2–30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of 5.7 ± 7.2 (range, 0–22) on the survey day. The mean age of the patients was 3.4 ± 5.6 years. The mean length of hospital stay was 82 ± 271 days. The mean Pediatric Risk of Mortality score III was 9.4 ± 7.8 at the time of admission to the PICUs. Conclusion There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries., Graphical Abstract
- Published
- 2018
45. A Study on Business Model of Fintech - Focus on the Business model canvas
- Author
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Yong-Mo Seo, Jeong-Min Ryu, and Han-Jin Cho
- Subjects
030506 rehabilitation ,03 medical and health sciences ,Focus (computing) ,Knowledge management ,business.industry ,0502 economics and business ,05 social sciences ,Business ,Business Model Canvas ,Business model ,0305 other medical science ,050203 business & management - Published
- 2016
46. A tracheoinnominate artery fistula presenting with massive hemorrhage in a 13-year-old boy
- Author
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Jeong-Yong Lee, Jung Heon Kim, Jeong-Min Ryu, Jong Seung Lee, and Hyung-Rae Cho
- Subjects
medicine.medical_specialty ,business.industry ,Fistula ,Artery fistula ,medicine ,business ,medicine.disease ,Surgery - Published
- 2015
47. Initial Characteristics and Clinical Severity of Hemophagocytic Lymphohistiocytosis in Pediatric Patients Admitted in the Emergency Department
- Author
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Jong Jin Seo, Jung Heon Kim, Jeong-Min Ryu, Ho Joon Im, Jong Seung Lee, and Jeong-Yong Lee
- Subjects
medicine.medical_specialty ,Adolescent ,Lymphohistiocytosis, Hemophagocytic ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Interquartile range ,Internal medicine ,medicine ,Coagulopathy ,Humans ,Child ,Retrospective Studies ,Prothrombin time ,Hemophagocytic lymphohistiocytosis ,medicine.diagnostic_test ,business.industry ,Infant ,Retrospective cohort study ,General Medicine ,Emergency department ,Odds ratio ,medicine.disease ,Hospitalization ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Emergency Medicine ,Absolute neutrophil count ,Emergency Service, Hospital ,business ,030215 immunology - Abstract
OBJECTIVES The diagnosis and management of children with hemophagocytic lymphohistiocytosis (HLH) admitted in the emergency department (ED) are challenging. The present study aimed at describing the initial characteristics of pediatric patients with HLH upon admission in the ED. Moreover, the clinical severity of the condition was assessed. METHODS We performed a retrospective study of patients who visited the pediatric ED and were newly diagnosed with HLH during hospitalization between February 2012 and January 2017. The patients were classified in the clinically unstable group if at least 1 of the following conditions was observed upon admission in the ED: hypoxia requiring oxygen supplementation, hypotension requiring inotropic support, coagulopathy with prothrombin time (international normalized ratio, ≥1.5), and seizures or altered consciousness. RESULTS We enrolled 31 pediatric patients with HLH, with a median age of 6.53 years (interquartile range, 1.35-13.24 years). Abdominal discomfort along with fever (74.2%) was the most common presenting symptom in patients admitted in the ED. Based on the HLH-2004 diagnostic criteria, fever (96.8%), hyperferritinemia (96.8%), splenomegaly (74.2%), hypertriglyceridemia and/or hypofibrinogenemia (67.7%), and bicytopenia (41.9%) were observed in the patients. However, only 8 patients (25.8%) met the criteria. Nineteen patients (61.3%) were included in the clinically unstable group. This group had lower albumin (2.3 vs 3.3 g/dL, P = 0.002) and fibrinogen levels and higher ferritin level and neutrophil count than the clinically stable group. Meanwhile, the number of clinical findings that met the diagnostic criteria was not different between the 2 groups. Lower albumin level was a significant risk factor in the clinically unstable group (odds ratio, 0.040; P = 0.004). CONCLUSIONS Pediatric patients with HLH often have clinically unstable conditions upon admission in the ED. However, only few patients meet the HLH-2004 diagnostic criteria. Lower albumin level may be useful in assessing clinically unstable patients and preparing for possible deterioration.
- Published
- 2018
48. Requirement for Head Magnetic Resonance Imaging in Children Who Present to the Emergency Department With Acute Nontraumatic Visual Disturbance
- Author
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Tae-Sung Ko, Hyung-Rae Cho, Jong-Seung Lee, Jeong-Yong Lee, Jung-Heon Kim, Mi-Sun Yum, and Jeong-Min Ryu
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Head (linguistics) ,Vision Disorders ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,Child ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Infant ,030208 emergency & critical care medicine ,Magnetic resonance imaging ,General Medicine ,Emergency department ,Magnetic Resonance Imaging ,Visual Disturbance ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Acute Disease ,Emergency Medicine ,Female ,Radiology ,business ,Emergency Service, Hospital - Abstract
This study aimed to investigate the clinical features and head magnetic resonance imaging (MRI) findings in children who presented to the emergency department with acute nontraumatic visual disturbance and to study related clinical factors for discovering positive lesions on head MRI.We performed a retrospective study of 1-month to 15-year-old children who underwent head MRI as an evaluation for acute nontraumatic visual disturbance as a chief complaint in our pediatric emergency department between March 2010 and March 2015. The symptoms of visual disturbance were blurred vision, diplopia, loss of vision, and visual hallucination. Head MRI findings were considered positive when lesions could explain the symptoms.We identified 39 patients (25 with blurred vision, 9 with diplopia, 3 with loss of vision, and 2 with visual hallucination) with a mean age of 8.35 ± 4.06 years. Positive head MRI findings were identified in 13 patients (33.3%). Brain tumors were most common (53.8%), followed by optic nerve inflammations (23.1%), congenital brain lesions (15.4%), and hypertensive encephalopathy (7.7%). Compared with the negative head MRI group, the positive head MRI group showed significantly less transient visual disturbance (duration1 hour to complete recovery) (P = 0.001), more limited eye movement (P = 0.003), and more pupillary abnormalities (P = 0.030).We suggest performing urgent head MRI in children with acute nontraumatic visual disturbance if the symptoms last longer than 1 hour without complete recovery and are accompanied by limited eye movement or pupillary abnormality.
- Published
- 2018
49. Children Experiencing First-Time or Prolonged Febrile Seizure Are Prone to Stress Hyperglycemia
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Jung-Heon Kim, Tae-Sung Ko, Jeong-Yong Lee, Mi-Sun Yum, Hyung-Rae Cho, Jeong-Min Ryu, and Jong-Seung Lee
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Male ,medicine.medical_specialty ,endocrine system diseases ,Stress hyperglycemia ,Severity of Illness Index ,Seizures, Febrile ,Tertiary Care Centers ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Stress, Physiological ,Internal medicine ,Febrile seizure ,Severity of illness ,Prevalence ,medicine ,Humans ,Lactic Acid ,Significant risk ,Risk factor ,Retrospective Studies ,business.industry ,Infant ,nutritional and metabolic diseases ,030208 emergency & critical care medicine ,Retrospective cohort study ,Emergency department ,Hydrogen-Ion Concentration ,medicine.disease ,Child, Preschool ,Hyperglycemia ,Anesthesia ,Multivariate Analysis ,Pediatrics, Perinatology and Child Health ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The risk factors and clinical implications of stress hyperglycemia in children with febrile seizure remain uncertain. Among 479 children with febrile seizure, the prevalence of the stress hyperglycemia (blood glucose concentration ≥ 150 mg/dL) was 10.0%. Stress hyperglycemia group included larger proportion of first-time febrile seizure, prolonged febrile seizure, and smaller proportion of short febrile seizure in comparison with the non–stress hyperglycemia group. Stress hyperglycemia group demonstrated a lower pH and higher lactate levels than the non–stress hyperglycemia group. Multivariate analysis revealed that first-time febrile seizure (aOR = 3.741, P = .004) and prolonged febrile seizure (aOR = 12.855, P < .001) were significant risk factors for stress hyperglycemia. The rate of early febrile seizure recurrence in the emergency department was not different between the groups. These findings suggest that children experiencing first-time or prolonged febrile seizure are prone to stress hyperglycemia, and this can be related to febrile seizure severity. However, stress hyperglycemia is not predictive of early febrile seizure recurrence in the emergency department.
- Published
- 2015
50. Pheochromocytoma Presenting with Hypertensive Encephalopathy in a 12-Year-Old Boy
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Jeong-Min Ryu and Jung Heon Kim
- Subjects
Pheochromocytoma ,Hypertensive encephalopathy ,Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,medicine.disease ,business - Published
- 2015
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