• 제목/요약/키워드: 병원 의학

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Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status (의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성)

  • Rok Lee;Tae Yong Shin;Hyung Jun Moon;Hyun Jung Lee;Dongkil Jeong;Dongwook Lee;Sun In Hong;Hyun Joon Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.135-142
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    • 2023
  • Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

A Case Report on Peripheral Facial Nerve Palsy and Sleep Disorders After Microvascular Decompression (미세혈관 감압술 후 발생한 말초성 안면신경 마비와 수면장애에 대한 한방치험 1례)

  • Min-jin Kwon;Tae-ju Kim;Na-young Kim;Oh-bin Kwon;Do-Hoon Lee;Sang-Joon Yoo;Dong-Hyeob Kang;Seon-Woo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.929-940
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    • 2023
  • Objectives: This study reports on the efficacy of Korean medicine treatments for peripheral facial nerve palsy and sleep disorders that occur after microvascular decompression. Methods: A 57-year-old female patient with right facial palsy was treated with herbal medicines and acupuncture for 36 days. The treatment effect was evaluated using the House Brackmann Grading System (HBGS), Yanagihara's Unweighed Grading System (Yanagihara's score), and the Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ). Results: Following treatment, the patient showed a decrease in HBGS and an improvement in Yanagihara's score and KMLSEQ score. Conclusions: Korean medicine treatments appeared to be effective in reducing facial nerve palsy. Further clinical research on patients with facial nerve palsy is needed.

Case Report: Improvement of 3 Stroke Patients Through Integrative Medicine Based on Scalp Acupuncture (두침치료를 위주로 한 의한협진을 통해 호전된 뇌졸중 환자 3례의 증례보고)

  • Siyoung Song;Esther Jang;Joonyong Noh;Soomin Jo;Eunseo Kim;Geunjeong Kim;Kyungok Kim;Jaeuk Sul;Changsu Na
    • Korean Journal of Acupuncture
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    • v.41 no.3
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    • pp.118-126
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    • 2024
  • A stroke is a condition where an ischemic injury occurs in the brain tissue due to blockage or rupture of cerebral blood vessels. The damage to the brain nerve cells caused by a stroke is irreversible. Significant recovery is generally observed within the first six months after the onset, but the natural recovery rate decreases after six months. Therefore, intensive rehabilitation therapy is necessary within the first six months of the onset. This case report presents three cases of patients in the sequelae phase of stroke, where treatments based on integrative medicine system between traditional Korean medicine and Western medicine were applied. The treatments included scalp acupuncture from traditional Korean medicine and rehabilitation exercises and electrical therapy from Western medicine. In this case report, we evaluated the Manual Muscle Test (MMT), Modified Barthel Index (MBI), and the patients' subjective symptom interviews before and after the implementation of the integrative treatment. As a result, significant improvements in MMT and MBI were observed in acute stroke cases, whereas the improvement was minimal in cases with chronic progression. However, in all cases, the patients expressed high satisfaction with the treatment during the interviews.

Reliability and Validity of the Korean Version of the Hoarding Rating Scale-Self-Report (한국판 저장행동평가척도의 표준화 연구)

  • Lee, Hye Min;Chang, Jhin Goo;Song, Hoo Rim;Lee, Soo Young;Hong, Minha;Kim, Se Joo;Kim, Chan-Hyung
    • Anxiety and mood
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    • v.17 no.2
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    • pp.73-77
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    • 2021
  • Objective : The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that simply assesses the hoarding symptoms. We evaluated the factor structure, reliability, and validity of the Korean version of the HRS-SR (HRS-SR-K). Methods : A total of 144 individuals completed the self-administered questionnaires including HRS-SR-K, Obsessive-Compulsive Inventory-Revised-Korean version (OCI-R-K), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Psychometric properties of the HRS-SR-K were analyzed. Results : The Cronbach's α value for internal consistency of the HRS-SR-K was excellent (Cronbach's α=0.84). The construct validity was analyzed on the basis of principal component analysis and one-factor structure of the original scale was maintained. The HRS-SR-K total score and each item scores were more strongly correlated with the hoarding subscale score in OCI-R-K (convergent validity, r=0.71, p<0.01) than the corresponding scores of nonspecific depression or anxiety measures (discriminant validity). Conclusion : The HRS-SR-K is a simple and reliable self-report scale for examining the severity of hoarding symptoms.

Depression in Schizophrenia Patients with Tardive Dyskinesia (지연성 이상운동이 있는 조현병 환자의 우울증)

  • Cha, Seongjae;Oh, Keun;Kim, Misuk;Park, Seon-Cheol;Kim, Young Hoon
    • Korean Journal of Biological Psychiatry
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    • v.25 no.4
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    • pp.110-117
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    • 2018
  • Objectives This study aimed to investigate the relationship between depressive and anxiety symptoms and tardive dyskinesia (TD) and reveal the association of cognitive function and TD in patients with schizophrenia. Methods We recruited 30 schizophrenia patients with TD and 31 without TD from a national mental hospital in South Korea. To assess depressive and anxiety symptoms, the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) were conducted. Using the five-factor structure of the BDI-II and BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety were assessed. Computerized neurocognitive function test (CNT) was performed to assess levels of cognitive functions. We compared the clinical characteristics, levels of cognitive functions, and depressive and anxiety symptoms between schizophrenia patients with TD and without TD. Chi-square test, Fisher's exact test, independent t-test and Mann Whitney U test were conducted to compare two groups. Pearson correlation analysis was conducted to evaluate relationships among the abnormal involuntary movement scale (AIMS), BDI-II, BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety. Results The subjects with TD had significantly lower score on the cognitive depression than those without TD (t = -2.087, p = 0.041). There were significant correlations between the AIMS score and the BDI-II score (r = -0.386, p = 0.035) and between the AIMS score and cognitive depression score (r = - 0.385, p = 0.035). Conclusions Our findings suggest the inverse relationship between severities in TD and depression and support the assumption that there is an inverse relationship between the pathophysiology of TD and depression.

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The Effects of the Gender Role Identity and Gender Stereotypes on the Prejudice Against Male Nurses of Hospital Workers (병원 종사자의 성 역할 정체감과 성 고정관념이 남자간호사에 대한 편견에 미치는 영향)

  • Cho, Ju-Hee;Chang, Chul-Hun;Kim, Sung-Soo
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.75-91
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    • 2018
  • As more and more males are participating in the female dominated nursing profession in Korea, they are facing a number of discriminations such as department assignment on the job because of male gender stereotype. The purpose of this study is to examine hospital workers's gender role identity, gender stereotype, and the relationship between those attitudes and gender prejudice against male nurses. The results showed that the androgynous group had lower gender stereotypes and lower prejudice against male nurses than those of the other groups. Hospital workers had a strong tendency to believe that male nurses should work mainly in special departments such as emergency rooms, intensive care units, operating rooms and they think that the male nurses are not fit for caring patients because of the patients' unfamiliarity with male nurses. Gender stereotypes were positively correlated to prejudice against male nurses. Therefore, hospitals should consider developing a detailed plan to encourage a culture of gender equality by tackling the existing prejudice against male nurses so that male nurses can get the same opportunities as female counterparts in terms of department assignment and job promotion.

Longitudinal Trajectories of Mental Health Among North Korean Defectors: A Four-Year Follow-Up Study of Loneliness, Depression, and Life Satisfaction (북한이탈주민 정신건강의 종단적 추세: 외로움, 우울, 삶의 만족도에 대한 4년 추적 연구)

  • Park, So Hee;Hong, Jin Pyo;An, Ji Hyun;Lee, Hye Rin;Kim, Myung Hyun;Chang, Hyein
    • Anxiety and mood
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    • v.17 no.2
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    • pp.49-58
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    • 2021
  • Objective : The purpose of this study was to investigate the longitudinal trajectories of life satisfaction, loneliness, and depression and to identify the factors that influence these trajectories in North Korean Defectors (NKD). Methods : NKD (n=300) who registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea, were recruited into this study. Life satisfaction, loneliness, and depression were assessed with self-report questionnaires over a period of 4 years (7 waves of data). Latent growth modeling was conducted to assess the changes in life satisfaction, loneliness, and depression. Results : Findings from both unconditional and conditional models (with gender, South Korea settlement age, household income, marital status, and PTSD at wave 1) indicated a linear increase in loneliness and depression, and a linear decrease in life satisfaction over the 4-year period. In the conditional model, gender predicted the intercept of life satisfaction and depression. In addition, PTSD predicted the intercept of life satisfaction, loneliness, and depression and slope of depression. Conclusion : Our finding suggests that the mental health of NKD tends to deteriorate over time after settling in South Korea. Therefore, continuous support is necessary for their successful adaptation to the South Korean Society.

Electro-Acupuncture for Cervical Vertigo: A Systematic Review and Meta-analysis (경추성 현훈에 대한 전침 치료: 체계적 문헌고찰 및 메타분석)

  • Kim, Ye-eun;Chung, In-che;Cha, Yun-yeop;Han, In-sik;Park, In-hwa
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.109-118
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    • 2021
  • Objectives The objective of this study was to appraise the effect of electro-acupuncture (EA) for the treatment of cervical vertigo. Methods We performed a literature search using nine electronic databases up to the end of November 2020. We included randomized controlled trials (RCTs) which appraised the effect of EA in the treatment of cervical vertigo. The risk of bias was evaluated from the Cochrane risk of bias tool. Results Thirteen appropriate RCTs were included and analyzed. The efficacy rate of the EA group was statistically higher compared with the control group treated with western medicine (p<0.00001). EA treatment significantly improved efficacy rate when combined with western medicine than western medicine alone (p<0.0001). Also EA used with combined therapy (traction, traditional chinese medicine, injection) significantly improved efficacy rate compared with combined therapy alone (p=0.02). Meta-analysis of thirteen studies demonstrated positive results for using EA for the treatment of cervical vertigo. Conclusions Based on results, EA treatment could be effective in cervical vertigo. However, it should be noted that the studies included in this research are regionally biased and small in number. Further well-designed research should be required.

Use of Aconitum Herbal Medicine for Pain Control in Musculoskeletal Disease (근골격계 질환에서 통증 조절을 위한 부자류 약물의 활용)

  • Park, Hye-Jin;Kim, Hyun-Tae;Lee, Sang-Hyun;Heo, In;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.47-54
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    • 2021
  • Objectives This review was conducted to study use of Aconitum herbal medicine for pain control in musculoskeletal disease. Methods Musculoskeletal disease is a major factor of social cost increase and physical disability. Various drugs, surgery and imaging are being overused regardlessly. Aconitum herbal plants are one of the most toxic Korean traditional herbs. However, they could be utilized effectively on patients with appropriate processing and decocting time. We searched Korean medicine literature to see various features of aconitum herbal plants and tried to find the utilization of the plants in effective way for pain control in musculoskeletal disease. Results Aconitum herbal plants needs to be used carefully because of intoxication which could lead to severe damage to human body. Processing of these toxic plants could minimize the harm and raise the benefits, such as relieving various types of pain and positive inotropic action. Further studies with clearer evidence and discovering aftereffects of processing in more details are needed. Conclusions Aconitum herbal plants could dedicate to controlling pain in musculoskeletal disease with various forms and appropriate processing.

Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder (인지처리치료: 외상후 스트레스 장애의 일차 치료)

  • Jin-Hee, Choi;Hyung-Seok, So;Soonjo, Hwang;Ji-Woo, Suk;Hayun, Choi;Seung-Hoon, Lee;EunYoung, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.80-98
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    • 2022
  • Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.