• 제목/요약/키워드: 병원 의학

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Melatonin for Treatment of Delirium in Hospitalized Patients : Retrospective Trial (입원 환자의 섬망 치료에서 멜라토닌의 효과에 관한 후향적 연구)

  • Yang, Jung Woo;Kim, Jong Woo;Kang, Won Sub;Lee, Sang Min;Kim, Young Jong;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.112-118
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    • 2018
  • Objectives : Delirium is one of the most common mental illnesses that can affect cognitive function. Melatonin has been shown to be effective in the treatment of insomnia, and recent studies have shown a protective effect to prevent delirium. This study was conducted to investigate the efficacy of melatonin in delirium patients. Methods : All patients were referred to psychiatric department for insomnia and symptoms of delirium, and were diagnosed delirium by the DSM-5 diagnostic criteria. We compared base line severity of delirium with K-DRS-R-98-R (Korean version of Delirium Rating Scale revised 98) and after taking 2mg of melatonin, retrospectively. The side effects were also identified by referring to the medical records. Results : A total 21 patients had taken melatonin for insomnia and delirious symptoms. The K-DRS-R-98 scores were decreased from $15.24{\pm}2.64$ before treatment to $6.57{\pm}5.42$ after treatment. And CGI-S scores were also decreased from $4.14{\pm}0.48$ before treatment to $2.81{\pm}0.93$ after treatment (p<0.05). Conclusions : This study illustrates the possibility of melatonin as an effective treatment option for delirious symptoms such as disorientation, motor agitation, lability of affect and hallucinations as well as insomnia, with less concerns of drug side effect. Further study with a larger sample and prospective design will be required to confirm these results.

Optimization of MRI Protocol for the Musculoskeletal System (근골격계 자기공명영상 프로토콜의 최적화)

  • Hong Seon Lee;Young Han Lee;Inha Jung;Ok Kyu Song;Sungjun Kim;Ho-Taek Song;Jin-Suck Suh
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.21-40
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    • 2020
  • Magnetic resonance imaging (MRI) is an essential modality for the diagnosis of musculoskeletal system defects because of its higher soft-tissue contrast and spatial resolution. With the recent development of MRI-related technology, faster imaging and various image plane reconstructions are possible, enabling better assessment of three-dimensional musculoskeletal anatomy and lesions. Furthermore, the image quality, diagnostic accuracy, and acquisition time depend on the MRI protocol used. Moreover, the protocol affects the efficiency of the MRI scanner. Therefore, it is important for a radiologist to optimize the MRI protocol. In this review, we will provide guidance on patient positioning; selection of the radiofrequency coil, pulse sequences, and imaging planes; and control of MRI parameters to help optimize the MRI protocol for the six major joints of the musculoskeletal system.

Prevalence of Emotional Distress and Related Factors of Orthopedic Surgical Patients in a Military Hospital : A Cross-sectional Feasibility Study (군 병원 정형외과계 입원환자의 정서문제 유병률과 관련 요인)

  • Oh, In Mok;Hong, Minseok;Lee, Soo Yeon;Yoon, Ga Hee;Lee, Ho;Kim, Myung Jin;Kim, Hyun Mi;Lee, Sang Don
    • Anxiety and mood
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    • v.15 no.2
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    • pp.115-121
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    • 2019
  • Objective : The purpose of this study was to investigate prevalence of psychiatric symptoms and determine predictors of emotional distress of military hospital surgical patients. Methods : This study examined 104 orthopedic patients admitted to the Armed Forces Military Hospital September-November 2018. For the study, every subject completed self-assessment inventories regarding depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), sleep problems (Pittsburgh Sleep Quality Index), problematic alcohol and tobacco use (Cut off, Annoyed, Guilty, Eye-opener screening), and psychiatric history. We performed the Student's t-test and the chi-square test for the collected data to investigate the prevalence of psychiatric symptoms, including emotional distress. Logistic regression analysis was used to examine the risk factors related to emotional distress of hospitalized military personnel. Results : There were no significant differences in socio-demographic and psychiatric symptoms between soldiers and officers. The prevalence of depressive and/or anxiety symptoms (emotional distress) was 21.2% (n=21). In the logistic regression analysis, psychiatric history [Adjusted Odds Ratio (AOR)=18.99 ; 95% Confidence Interval (CI)=1.42-253.57 ; p=0.026] and low military life satisfaction (AOR=15.67; 95% CI=1.46-168.11 ; p=0.023) correlated with emotional distress. Conclusion : Soldiers admitted to the military hospital showed similar prevalence of emotional distress as those at general hospitals. Considering military circumstances, it is necessary to detect and intervene regarding soldiers with a psychiatric history and low military life satisfaction to promote mental health at military hospitals.

Bilateral Triple Negative Invasive Ductal Breast Carcinoma in a BRCA1 Mutation Carrier with Discrepant Pathologic Response to Neoadjuvant Chemotherapy (BRCA 유전자 변형 환자의 양측 삼중음성 유방암의 선행화학요법에 대한 상이한 반응)

  • Gi Won Shin;Young Mi Park;Tae Hyun Kim;Anbok Lee;Ha Young Park;Hye Kyoung Yoon;Young Jin Heo;Jin Wook Baek;Yoo Jin Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.428-435
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    • 2020
  • Herein, we report a case of synchronous bilateral triple negative invasive ductal breast carcinoma in a patient with discrepant pathologic response to neoadjuvant chemotherapy. Right and left breast cancer stages at the initial diagnosis were T1cN0M0 and T4dN3aM0, respectively. The patient was identified as a BRCA1 mutation carrier and treated with four cycles of adriamycin and cyclophosphamide, followed by four cycles of docetaxel. Bilateral breast cancer stages decreased with the first regimen. However, the bilateral breast cancers showed discrepant responses to chemotherapy with docetaxel. The right breast cancer showed a continuous tumor volume reduction while the left breast cancer showed marked progression. Finally, the tumor size was 0.3 cm and 12 cm in the right and left mastectomy specimens, respectively. As bilateral breast cancers of the same subtype may show discrepant responses to neoadjuvant chemotherapy, close monitoring and follow-up imaging are required to avoid delayed surgery.

Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Radiologic Review of Small Bowel Malignancies and Their Mimicking Lesions (소장의 악성 종양과 악성 종양으로 오인할 수 있는 소장 병변에 대한 영상의학적 검토)

  • Jong Soo Lee;So Hyun Park;Seung Joon Choi
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.110-126
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    • 2023
  • Because of their small size, small bowel malignancies are often easily missed when radiologists read CT images, which can lead to errors in the normal small bowel due to their similar enhancement to the small bowel or non-specific enhancement. In addition, small bowel malignancies are sometimes mistaken for masses of other origins, such as the uterus, rectum, or omentum. In this article, we describe various small-bowel malignancies, their mimicking lesions and the typical and atypical features on CT imaging along with their clinical manifestations.

Complex Korean Medicine Treatment for Posterior Ankle Impingement Syndrome: Case Report (후방 발목 충돌 증후군 환자의 복합 한의진료 경과: 증례보고)

  • Park, Ji-won;Kyung, Da-hyun;Koo, Ji-eun;Bae, Jun-Hyo;Kim, Su-jin;Bae, Ji-eun
    • Korean Journal of Acupuncture
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    • v.39 no.3
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    • pp.100-106
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    • 2022
  • Posterior ankle impingement syndrome is one of the impingement syndromes characterized by posterior ankle pain that occurs during forced plantar flexion. This report presents a case of a 48-year-old PAIS patient with os trigonum syndrome accompanied by tenosynovitis of flexor hallucis longus. She was treated with complex Korean medicine to a good effect. The Numeric Rating Scale and the EuroQol 5-Dimension 5-Level were used to measure the impact of Korean medicine on the patient's pain and quality of life. Decreased NRS and increased EQ-5D-5L scores reflected improvement in her symptoms within 25 days. This study suggests complex Korean medicine treatment for PAIS may be beneficial for alleviating pain and improving quality of life.

Study for Safety of Oriental Medical Therapy and Continuous Intravenous Urokinase combined Therapy in Acute Cerebral Infarction. (급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰)

  • Kim, Sung-keun;Lim, Chang-sun;Yim, Jun-hyok;Yang, Dong-ho;Shin, Hyon-seung;Park, Joon-ha;Jeong, Seung-cheol
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.1-7
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    • 2009
  • Objectives : This Study was prepared for investigating the safety of oriental medicine and continuous intravenous urokinase combined therapy in acute cerebral infarction. Methods : We prospectively estimate safety of hemorrhagic transformation occurred in oriental medical therapy and continuous intravenous urokinase combined therapy. We estimate National Institute of Health Stroke Scale Score and Modified Barthel Index. Results : Hemorrhagic transformation was not noted. and Others are not fatal complication. Conclusions : oriental medical therapy and continuous intravenous urokinase combined therapy are safety method in treatment of acute cerebral infarction. We think this can be a good model of Oriental and western cooperative therapy.

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산업보건기관 탐방기 - 가톨릭대학교 서울성모병원 직업환경의학센터

  • Hong, A-Reum
    • 월간산업보건
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    • s.362
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    • pp.52-55
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    • 2018
  • 직업병을 홀대하던 시절이 있었다. 일을 하면서 그 일로 인해 병이 걸렸음에도 불구하고 그 누구 하나 대책을 마련하기 힘들었던 시절. '직업병'이라는 개념이 서서히 사회 표면으로 꺼내기 시작해 지금까지 산업보건의 역사를 함께하는 곳, 가톨릭대학교 서울성모병원 직업환경의학센터에는 건강하게 일하고 싶은 근로자들의 바람이 담겨있다.

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중국의 의료사정과 "병원관리"에 관하여

  • Nam, Eun-U
    • Journal of the Korean hospital association
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    • v.21 no.5 s.194
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    • pp.54-61
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    • 1992
  • 중국의 문호가 개방되면서 보건.의료계에도 한국과 중국과의 교류가 증대되고 있다. 이 시점에서 중국의 의료사정과 병원관리에 대한 글을 소개하는 것은 의미있는 일일 것이다. 이 글은 일본 동북대학 의학부 병원관리학교실의 교수등 4명의 연구진이 일본병원회잡지(1991년 11월호)에 게재한 것을 번역한것이다. -역자주-

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