Acute and Critical Care

Won Kim

3 Articles

Clinical Feature and Prognostic Factors of Emphysematous Pyelonephritis: Won Soek Yang, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Won Kim, Kyoung Soo Lim; Korean J Crit Care Med. 2012;27(2):89-93.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.89

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BACKGROUND
Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN.
METHODS
All patients diagnosed with EPN radiologically and treated at the emergency department in the university-affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients' demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively.
RESULTS
Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 +/- 2.7, 2.4 +/- 1.4 mg/dl, and 22.4 +/- 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality.
CONCLUSIONS
Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.

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Analysis of Kidney Computed Tomographic Findings in Patients with Acute Pyelonephritis and Septic Shock
Soonseong Kwon, Sangchan Jin, Wooik Choi, Sungjin Kim
Korean Journal of Critical Care Medicine.2013; 28(4): 272. CrossRef

The Usefulness of a Triage Kit for Detecting Abused Drugs: Myoung Kwan Kwak, Won Young Kim, Hui Dong Kang, Jae Ho Lee, Bum Jin Oh, Won Kim, Kyoung Soo Lim; Korean J Crit Care Med. 2009;24(2):75-79.; DOI: https://doi.org/10.4266/kjccm.2009.24.2.75

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Abstract PDF

BACKGROUND
The recovery and outcome of intoxicated patients depends on the kind of drugs they took and the total time of their initial management. The purpose of this study is to evaluate the usefulness of a Triage drug kit for detecting abused drugs.
METHODS
From 2003 Feb. to 2003 July, we studied the patients who visited the emergency department with suspicious drug intoxication. In this case, we used a Triage drug kit for 134 patients with drug intoxication or who were clinically suspected of taking illegal drugs, with 30 of the patients initially admitting the substance they had used. The kit is an immunoassay kit for qualitative testing drug metabolites in urine. To compare with those cases of the preceding year, we studied 104 patients with drug intoxication that was detected between February 2002 and July 2002.
RESULTS
Overall, 60% of the 30 cases who did not know what substance they abused and tested positive for, and 33% of the 27 cases with suspected intoxication confirmed their substance abuse. The positive rate for benzodiazepine use was the highest (46.7%), and there were no positive results regarding amphetamine, methamphetamine or cocaine. An appropriate antidote was administered significantly more frequently in the group for which we used the kit.
CONCLUSIONS
A Triage drug kit is probably useful for diagnosing acute drug intoxication and for identifying the causative substance. However, the time required to decide whether or not a patient should be admitted is not reduced. If the kit can detect the frequently abused drugs in Korea, it will be helpful for treating drug intoxicated patients.

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Clinical features of adolescents with suicide attempt and the factors associated with their outcomes: poisoning versus non-poisoning
Myoung Hoon Lee, Jae Ho Jang, Jin-Seong Cho, Woo Sung Choi, Jea Yeon Choi
Pediatric Emergency Medicine Journal.2020; 7(2): 85. CrossRef
Evaluation of the Triage TOX Drug Screen Assay for Detection of 11 Drugs of Abuse and Therapeutic Drugs
Hae In Bang, Mi-Ae Jang, Yong-Wha Lee
Annals of Laboratory Medicine.2017; 37(6): 522. CrossRef

Does Adding Somatostatin to Proton Pump Inhibitor Improve the Outcome of Peptic Ulcer Bleeding?: Insung Kim, Yoon Seon Lee, Byuk Sung Koh, Won Kim, Kyoung Soo Lim; Korean J Crit Care Med. 2008;23(2):75-78.; DOI: https://doi.org/10.4266/kjccm.2008.23.2.75

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Abstract PDF

BACKGROUND
Somatostatin has been shown to offer a distinct advantage over antisecretory drugs in the management of peptic ulcer bleeding (PUB). However, rebleeding rates are still high in spite of endoscopic and medical treatment. In this study, we intended to determine whether combined therapy of a proton pump inhibitor (PPI) plus somatostatin is more beneficial than a PPI alone in patients with PUB.
METHODS
We enrolled 90 consecutive patients who presented with PUB between January 2006 and October 2007. All the patients were managed with endoscopic hemostasis and divided into two treatment groups: 1) PPI alone (group A) and 2) PPI plus somatostatin (group B). The primary outcome was rebleeding within 72 hours. The secondary outcomes were rebleeding in 30 days, packed red blood cells (pRBC) transfused, length of hospital stay, need for surgery, and in-hospital mortality.
RESULTS
Forty-five patients in the PPI group (A) and 45 patients in the PPI plus somatostatin group (B) were studied. There was no difference between the two groups with respect to clinical and endoscopic features at admission. After medical treatment, there was no difference between groups A and B in rebleeding at 72 hours (11% vs. 13%, p = NS), rebleeding in 30 days (13% vs. 16%, p = NS), pRBC transfused (mean, 3.2 vs. 4.5 units, p = NS), length of hospital stay (mean, 7.4 vs. 8.4 days, p = NS), and in-hospital mortality (2% vs. 7%, p = NS).
CONCLUSIONS
Combined therapy with PPI and somatostatin did not result in better outcomes than PPI alone.

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The effect of octreotide in acute nonvariceal upper gastrointestinal bleeding: A randomized, double-blind, placebo-controlled trial
Masoud Abrishami, Payam Peymani, Marziyeh Zare, KamranB Lankarani
Journal of Research in Pharmacy Practice.2020; 9(2): 94. CrossRef
Octreotide Added to a Proton Pump Inhibitor Versus a Proton Pump Inhibitor Alone in Nonvariceal Upper-Gastrointestinal Bleeds
Heidi M. Riha, Rachel Wilkinson, Jennifer Twilla, L. Jeff Harris, Lauren A. Kimmons, Mehmet Kocak, Megan A. Van Berkel
Annals of Pharmacotherapy.2019; 53(8): 794. CrossRef

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