• Title/Summary/Keyword: 급성기

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Current Status of Rehabilitation Services in Long-Term Care Hospitals for Health Promotion of Jeollabuk-do Residents (전라북도민 건강증진을 위한 요양병원 재활서비스 현황)

  • Cho, Seung-Hyun
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.199-206
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    • 2021
  • As the super-aged society is imminent, the number of people with senile diseases is also increasing, resulting in a lack of facilities and policies as a social problem. National Health Insurance Service is being talked about as a realistic alternative to medical coverage. Long-term care hospitals are classified into acute-stage hospitals and long-term care facilities and are acting as an alternative to reducing medical expenses. However, in long-term care hospitals, which are the core of maintenance rehabilitation, the quality of service issues have been raised seriously. Currently, there is a problem of mass production of refugees from rehabilitation due to a problem of the medical system. In particular, in the preceding study in 2015, the status of long-term care hospitals in Jeollabuk-do was the worst. Therefore, using public data, the general status of long-term care hospitals in Jeollabuk-do, status of frequent disease, status of rehabilitation services, and status of occupational therapy services are to be explored.

Symptomatic Mid-Substance Posterior Cruciate Ligament Calcification of the Knee Joint (증상을 동반한 슬관절의 후방십자인대 실질부에 발생한 석회화)

  • Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.93-97
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    • 2021
  • Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.

Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction (급성 심근경색 환자의 Tc-99m Tetrofosmin 심근 관류 지연영상에서 관찰되는 역재분포 현상의 임상적 의의)

  • Park, Soon-Ah;Kim, Dae-Weung;Kim, Chang-Guhn;Jeong, Jin-Won;Kim, Nam-Ho;Yun, Kyeong-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.112-119
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    • 2009
  • Purpose: This study was performed to investigate the clinical significance of reverse redistribution(RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography(SPEG) in patients with acute myocardial infarction after revascularization. Materials and Methods: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography(CAG) were performed 9 months later. Results: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments(31%) and in 43 patients(64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR(p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR(p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. Conclusions: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.

Predictive Values of Early Rest/24 Hour Delay T1-201 Perfusion SPECT for Wall Motion Improvement in Patients with Acute Myocardial Infarction After Reperfusion (급성 심근 경색 환자에서 재관류 후 조기에 시행한 휴식/24시간 지연 T1-201 심근 SPECT의 심근벽 운동 호전 예측능)

  • Hyun, In-Young;Kwan, June
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.259-265
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    • 1998
  • Purpose: We studied early rest/24 hour delay T1-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Materials and Methods: Among 17 patients (male/female= 11/6, age: $59{\pm}13$) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay: 11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct-related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest T1-201 perfusion SPECT less then 6 hours after reperfusion and delay T1-201 perfusion SPECT next day. T1-201 uptake was visually graded as 4 point score from normal (0) to severe defect (3). Rest T1-201 uptake ${\le}2$ or combination of rest T1-201 uptake ${\le}2$ or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement ${\ge} 1$ grade in follow up echo compared with the baseline values. Results: Among 98 segments with wall motion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 51/98 (52%), dyskinesia: 1/98 (1%). The wall motion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest T1-201 uptake were 99%, and 54%. PPV and NPV of rest T1-201 uptake were 100% and 52% respectively. Predictive values of combination of rest T1-201 uptake and late reversibility were not significantly different compared with predictive values of rest T1-201 uptake only. Conclusion: We conclude that early T1-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative predictive values in patients with acute myocardial infarction after reperfusion.

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향후(向後) 질병(疾病) 양태(樣態)의 변화(變化)에 대한 연구(硏究) 대어향후질병양태적변화지연구(對於向後疾病樣態的變化之硏究)

  • Bang, Jeong-Gyun
    • Journal of Korean Medical classics
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    • v.18 no.4 s.31
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    • pp.67-82
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    • 2005
  • 지구온난화(地球溫暖化), 식습관(食習慣), 주거환경여약물지오남용(住居環境與藥物之誤濫用), 공치기습열적체어체내(共致其濕熱積滯於體內), 소이유인음정부족이상화치성적병기(所以有因陰精不足而相火熾盛的病機), 기내용시여하(其內容是如下). 기일원인시지구온난화(其一原因是地球溫暖化), 차부단야기급성열성전염병(此不但惹起急性熱性傳染病), 이차야기음부족적허열성질환(而且惹起陰不足的虛熱 性疾患). 기이원인시식습관(其二原因是食習慣), 차적체습열이유발상화(此積滯濕熱而誘發相火), 차유발과도적양화작용(且誘發過度的陽化作用), 소이야기음부족적병기(所以惹起陰不足的病機). 기삼원인시주거환경(其三原因是住居環境), 차방기기적소통(此防其氣的疏通), 소이습열적체어체내이유발음부족적병기(所以濕熱積滯於體內而誘發陰不足的病機). 기사원인시약물적오남용(其四原因是藥物的誤濫用), 차치기열적잠복(此致其熱的潛伏), 소이유발음부족(所以誘發陰不足). 여차유발상화적현대환경(如此誘發相火的現代環境), 야기허열성질환(惹起虛熱性疾患). 소이증가태열여성인병(所以增加胎熱與成人病), 야취증가인과도적양화작용이불임질환(也就增加因過度的陽化作用而不姙疾患), 이차재정서적면(而且在情緖的面), 증가공격적여폭력적정서(增加攻擊的與暴力的情緖).

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Design of Lung Sound Analyzer Using Adaptive Digital Filter and DSP Chip (적응 디지탈 필터와 DSP 칩을 이용한 폐음 분석기 설계)

  • 김규한;조일준
    • Journal of Biomedical Engineering Research
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    • v.10 no.2
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    • pp.151-156
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    • 1989
  • Lung sound analyer which can provide an objective diagnosis of patients with pulmonary and bronchial disorders is designed. For the purpose of power spectrum analysis, adaptive digital filtering technique and TM - S320C25 DSP chip is used. As a results, adaptive lattice Wiener filter could eliminate heart sounds with a few of 10th order and on the distribution of power spectrum each patterns has shown in normal vescicular breathy from 100 Hz to 200 Hz, in crackle sound from 100 Hz to 400 Hz, in wheeze sound from 150 Hz to 600 Hz.

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Mechanical Obstruction of Right Coronary Artery during Aortic Valve Replacement (대동맥판막 치환술중에 발생한 우관상동맥 폐색증)

  • 정철현;허재학;이택연;이윤석
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.365-367
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    • 2001
  • 매우 드물게 발생하지만 대동맥판막수술중에 우관상동맥의 급성폐색은 우심실부전을 일으켜 매우 치명적인 결과를 초래할 수 있다. 심한 대동맥 판막부전증을 가진 67세 여자 환자에서 19 mm Hancock II 조직판막을 이용하여 대동맥판막치환술을 시행한 후 심폐기에서 이탈하는 과정주에 우심실부전이 발견되었으며, 우관상 동맥의 폐색을 의심하여 우측 내흉동맥을 사용하여 관상동맥 우회수술을 시행하였고 이후에 심폐기에서 순조롭게 이탈할 수 있었다. 수술후 9일째 시행한 관상동맥 조영술에서 우관상동맥 근위부에 색전에 의한 폐색을 확인할 수 있었다. 이에 저자들은 우관상동맥의 폐색으로 인한 우심부전증이 우관상동맥우회수술후에 회복된 증례를 보고하고자 한다.

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High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer (급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술)

  • Hong, Seung Woo;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

Nuclear Factor-κB(NF-κB) Activity and Levels of IL-6, IL-8 and TNF-α in Induced Sputum in the Exacerbation and Recovery of COPD Patients (만성폐쇄성폐질환의 급성악화와 회복기에서 유도객담 내 Nuclear Factor-κB(NF-κB)의 활성도와 IL-6, IL-8 및 TNF-α의 농도 변화)

  • Song, So Hyang;Kim, Chi Hong;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.152-159
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    • 2005
  • Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the $NF-{\kappa}B$ is known to be an indicator of cellular activation and of inflammatory mediator production. This study was undertaken to investigate the change of cytokine characteristics and $NF-{\kappa}B$ activity in induced sputum of COPD patients during exacerbation and recovery of the disease. Methods : Sputum induction was performed in 37 patients with COPD during exacerbation and during recovery and in 15 healthy subjects. Cell counts, levels of IL-6, IL-8 and $TNF-{\alpha}$ in induced sputum and NF-kB activity in macrophage of induced sputum were measured. Results : Patients with COPD showed significantly increased levels of IL-6, IL-8 and $TNF-{\alpha}$(p<0.01) and increased $NF-{\kappa}B$ activity in induced sputum(p<0.05) as compared with control subjects. Level of IL-8 during exacerbation of COPD decreased significantly during recovery(p<0.05). $NF-{\kappa}B$ activity and levels of IL-6 and $TNF-{\alpha}$ tended to be decreased during recovery, but not siginificantly. Conclusion : Activation of $NF-{\kappa}B$ and increased levels of IL-6, IL-8 and $TNF-{\alpha}$ were thought to be associated with pathogenesis and exacerbations of COPD.

Effect of Cytarabine, Melphalan, and Total Body Irradiation as Conditioning for Autologous Stem Cell Transplantation for Patients with AML in First Remission (1차 관해된 급성 골수성 백혈병에서 자가 조혈모세포 이식을 위한 Cytarabine, Melphalan, 전신 방사선치료의 효과)

  • Kang Ki Mun;Choi Byung Ock;Chai Gyu Young;Kang Young Nam;Jang Hong Sek;Kim Hee Jae;Min Wo Sung;Kim Chun Choo;Choi Ihl Bohng
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.192-198
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    • 2003
  • Purpose: Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival In patients with acute myeloid leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. Materials and Methods: Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine ($3.0\;gm/m^2$ for 3 days), melphalan ($100\;gm/m^2$ for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). Results: The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor Influencing disease free survival and relapse rate was the French-American-British (FAB) classification ($M_3$ group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity. Conclusion:: Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous SCT for AML on first remission appears to be safe and effective.