• 제목/요약/키워드: 부산백병원

검색결과 163건 처리시간 0.023초

2018 한국형 공황장애 치료지침서 : 정신사회적 치료전략 (Korean Guidelines for the Treatment of Panic Disorder 2018 : Psychosocial Treatment Strategies)

  • 김민숙;김민경;이재헌;김원;문은수;서호준;구본훈;양종철;이강수;이상혁;김찬형;유범희;서호석
    • 대한불안의학회지
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    • 제15권1호
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    • pp.13-19
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    • 2019
  • Objective : The purpose of this study was to investigate consensus relative to treatment strategies for psychosocial treatment in panic disorder, that represents one subject addressed by the Korean guidelines for treatment of panic disorder 2018. Methods : The executive committee developed questionnaires relative to treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two (61.0%) of 112 experts on a committee reviewing panic disorder responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies), and identified treatment of choice using the Chi-square test and 95% confidence intervals. Results : For psychosocial treatment of panic disorder, individual and group cognitive behavior therapy (CBT) were recommended treatments of choice, and mindfulness based cognitive therapy (MBCT) was recommended as first line strategy. There was statistically significant consensus among experts regarding usefulness of each component of CBT and MBCT, for treatment of patients with panic disorder. Conclusion : Results, that reflect recent studies and clinical experiences, may provide the guideline for psychosocial treatment strategies for panic disorder.

전립선암의 근접치료 시 금 나노입자 밀도에 따른 흡수선량평가 (Evaluation of Absorbed Dose According to the Gold Nanoparticle Density in Prostate Cancer Brachytherapy)

  • 이득희;김정훈
    • 한국방사선학회논문지
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    • 제13권2호
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    • pp.247-252
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    • 2019
  • 국내 남성에게서 지속적으로 발생하는 전립선암을 대상으로, 근접치료 시 금 나노입자 밀도에 따른 흡수선량을 평가하고자 하였다. 흡수선량 평가는 몬테카를로 시뮬레이션을 이용한 MCNPX 프로그램을 이용하였다. 선원은 일시적 삽입선원 $^{192}Ir$과 영구적 삽입선원 $^{103}Pd$을 이용하였으며, 금 나노입자의 밀도는 0 mg, 7 mg, 18 mg, 30 mg으로 하였다. 그 결과 표적장기인 전립선은 $^{192}Ir$이 2.95E-14 Gy/e에서 4.42E-14 Gy/e로 밀도에 비례해서 증가하였으며, $^{103}Pd$도 동일한 경향성을 보였다. 또한 주변장기에 대한 선량은 밀도에 반비례하여 감소하는 것으로 나타났다. 따라서 근접치료 시 나노입자의 사용은 치료가능비를 상승시킬 수 있을 것으로 판단된다.

만성 C형간염 환자에서 간섬유화 등급별 혈청표지자들의 Cut-off값에 대한 고찰 (Consideration of Cut-off Value for Fibrosis Serum Marker by Liver Fibrosis Stage in Chronic Hepatitis C Patients)

  • 남지희;김정훈
    • 한국방사선학회논문지
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    • 제13권4호
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    • pp.539-546
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    • 2019
  • 간조직 생검은 침습적이며, 합병증의 위험을 동반함에도 불구하고 간섬유화의 정도를 예측하는 표준 진단법으로 적용된다. 이러한 단점을 보완하기 위해 본 연구에서는 만성 C형간염 환자 200명을 대상으로 Fibroscan(R)을 이용하여 간섬유화 등급을 나누고, ROC 곡선을 측정하여 혈청학적검사로 계산되는 FIB-4, APRI, AAR의 유용성과 실질적인 Cut-off value를 알아보고자 하였다. 그 결과 간섬유화 평가를 위해 AAR을 적용하는 것보다는 APRI, FIB-4를 이용하는 것이 적절할 것으로 생각되며, 경한 섬유화 등급을 예측하기 위해서는 APRI, 간경변군인 F4등급에는 FIB-4를 사용하는 것이 유용하다고 판단된다. 혈청학적 간섬유화 표지자의 간편하고 반복 측정이 가능하다는 장점을 이용해 간 섬유화의 경과 관찰 기간을 줄일 수 있으므로 나아가 간경변과 간암의 유병률을 감소시킬 수 있을 것으로 사료된다.

구속 스트레스 모델에서 석결명의 간손상 및 우울증 관련 인자에 미치는 영향 (Effect of Nardotidis seu Sulculii Concha water extract (NSCE) on liver damage and depression in restraint-induced stress model)

  • 김민정;오태우;도현주;김광연;양주혜;손재동;양예진;유영주;김우현;강승호;이동호;기승희;김영우;박광일
    • 대한한의학방제학회지
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    • 제30권2호
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    • pp.85-93
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    • 2022
  • Objectives : This study investigated anti-inflammatory effects of Nardotidis seu Sulculii Concha water extract (NSCE) against restraint-induced stress. Methods : In vivo, NSCE was orally administered to male white mice at concentrations of 250 mg/kg and 500 mg/kg for 3 days, and then restraint-induced stress was induced for 6 hours. The level of liver damage was measured by serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH). The stress-related hormones such as cortisol and corticosterone were measured by ELISA assay. Also, western blot analysis was performed to detect expression of mitogen-activated protein kinase (MAPK) and cyclooxygenase-2 (COX-2) proteins. Pathological changes were observed by hematoxylin and eosin (H&E) staining of the liver tissue, and Immunohistochemical (IHC) staining was performed to examine liver inflammation through macrophage infiltration. Results : The AST, ALT, LDH and the stress related hormones such as cortisol and corticosterone were significantly decreased in the NSCE treated group compared with stress group. In histological analysis, H&E staining of liver tissues did not detect the hepatic injury or damage in all groups. As a result of IHC staining, it was confirmed that infiltration of macrophages was increased in the stress-induced group, but decreased in the group treated with NSCE. The COX-2 and MAPK proteins expression was significantly increased by restraint-induced stress, but these proteins were decreased in the NSCE treated group. Conclusions : These results suggest that NSCE has the anti-inflammatory activity in restraint-induced stress model, and it is believed that NSCE can be used for the prevention of liver inflammation.

유도객담검사의 시행과 해석: 전문가 의견서 (KAAACI Standardization Committee report on the procedure and application of induced sputum examination)

  • 김민혜;김미영;임경환;양민석;송우정;이정민;서동인;신유섭;권재우;김세훈;김상헌;이병재;조상헌;정재우;대한천식알레르기학회 표준화위원회
    • Allergy, Asthma & Respiratory Disease
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    • 제5권6호
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    • pp.307-311
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    • 2017
  • Induced sputum and sputum cell count analysis is a test for the diagnosis of various respiratory diseases. In particular, it has long been used as an important biomarker in the diagnosis or characterization of asthma or eosinophilic bronchitis. Despite a relatively long history of this test, there has been no consensus report for conducting and interpreting the analyses in Korea. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature and to develop a consensus report on the diagnostic procedure and interpretation of the sputum induction test.

스마트 인솔의 족저압 측정 결과에 대한 타당도 및 신뢰도 평가 (Assessment of Validity and Reliability of Plantar Pressure in Smart Insole)

  • 강호원;안예린;김대유;이동오;박길영;이동연
    • 대한족부족관절학회지
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    • 제26권3호
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    • pp.130-135
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    • 2022
  • Purpose: Smart insoles are wearable devices that are inserted into shoes. Smart insoles with built-in pressure and acceleration sensors can measure the plantar pressure, stride length, and walking speed. This study evaluated the validity and reliability of the plantar pressure measurements of smart insoles during walking on flat ground. Materials and Methods: Twenty one subjects were included in this study. After wearing smart insoles, I-SOL® (Gilon, Seongnam, Korea), the subjects walked a 10 m corridor six times at a rate of 100 steps/min, and the middle three steps, free from direction changes, were chosen for data analysis. The same protocol was repeated after wearing Pedar-X (Novel Corporation, Munich, Germany), an insoletype plantar pressure measurement equipment with proven validity. The average maximum pressure (Ppeak, kPa) and the time at which Ppeak appeared (Ptime, %stride) were calculated for each device. The validity of smart insoles was evaluated by using the interclass correlation coefficient (ICC) of Ppeak and Ptime between the two instruments, and Cronbach's alpha was obtained from the Ppeak values to evaluate the reliability. Results: The ICC of Ppeak was 0.651 (good) in the hallux, 0.744 (good) in the medial forefoot, 0.839 (excellent) in the lateral forefoot, and 0.854 (excellent) in the hindfoot. The ICC of Ptime showed 0.868 (excellent) in the hallux, 0.892 (excellent) in the medial forefoot, 0.721 (good) in the lateral forefoot, and 0.832 (excellent) in the hindfoot. All ICC values showed good or excellent results. The Cronbach's alpha of Ppeak measured in the smart insoles was 0.990 in the hallux, 0.961 in the medial forefoot, 0.973 in the lateral forefoot, and 0.995 in the hindfoot; all indicated excellent reliability in all areas. Conclusion: The plantar pressure measurements of smart insoles during walking on a flat ground showed validity compared to Pedar-X, and high reliability after repeated measurements.

두 족저압 측정장비의 비교 분석 (Comparative Analysis of Two Pedobarography Systems)

  • 강호원;변수민;김대유;조윤재;경민규;이동연
    • 대한족부족관절학회지
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    • 제28권1호
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    • pp.21-26
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    • 2024
  • Purpose: Foot pressure measurement devices are used widely in clinical settings for plantar pressure assessments. Despite the availability of various devices, studies evaluating the inter-device reliability are limited. This study compared plantar pressure measurements obtained from HR Mat (Tekscan Inc.) and EMED-n50 (Novel GmbH). Materials and Methods: The study involved 38 healthy male volunteers. The participants were categorized into two groups based on the Meary's angle in standing foot lateral radiographs: those with normal feet (angles ranging from -4° to 4°) and those with mild flatfeet (angles from -8° to -15°). The static and dynamic plantar pressures of the participants were measured using HR Mat and EMED-n50. The reliability of the contact area and mean force was assessed using the interclass correlation coefficient (ICC). Furthermore, the differences in measurements between the two devices were examined, considering the presence of mild flatfoot. Results: The ICC values for the contact area and mean force ranged from 0.703 to 0.947, indicating good-to-excellent reliability across all areas. EMED-n50 tended to record higher contact areas than HR Mat. The mean force was significantly higher in the forefoot region when measured with EMED-n50, whereas, in the hindfoot region, this difference was observed only during static measurements with HR Mat. Participants with mild flatfeet exhibited significantly higher contact areas in the midfoot region for both devices, with no consistent differences in the other parameters. Conclusion: The contact area and mean force measurements of the HR Mat and EMED-n50 showed high reliability. On the other hand, EMED-n50 tended to record higher contact areas than HR Mat. In cases of mild flatfoot, an increase in contact area within the midfoot region was observed, but no consistent impact on the differences between the two devices was evident.

방사선 근접치료의 디지털 정도관리 가능성 확인을 위한 HgI2 Unit Cell 선량계의 제작 및 평가 (Fabrication and Evaluation of Mercury(II) Iodide Unit Cell Dosimeter to Confirm the Feasibility of Digital Quality Assurance in Intracavitary Radiotherapy)

  • 정재훈;박성광
    • 한국방사선학회논문지
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    • 제16권3호
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    • pp.257-263
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    • 2022
  • 방사선 근접치료에서 잘못된 선원의 위치는 정상조직에 불필요한 선량을 조사하게 되므로, 정도관리 항목에서 방사선원의 위치를 검증하는 것은 필수적이다. 이에 본 연구에서는 디지털 line 선량계의 기초 연구로써 polycrystalline mercury (II) iodide (HgI2)기반의 unit cell 선량계를 제작하고 실리콘다이오드와 재현성, 선형성, 거리의존성에 대한 성능을 비교하였다. 그 결과 재현성은 relative standard deviation (RSD)이 1.21%로 RSD 평가 기준 1.5% 이내를 만족하였다. 선형성 평가는 선형계수 R2가 0.9997로 우수한 결과를 보였다. 거리 의존성은 inverse square value와 비교하였을 때, intensity 50%는 0.035 cm의 차이를 보이며 전체적으로 유사한 경향을 보였다. 본 연구는 HgI2 선량계의 성능 평가함으로써 근접치료 정도관리를 위한 디지털 선량계의 적용 가능성을 제시하고 있으며, 본 연구에 대한 결과는 광도전체 물질의 선량계로써의 특성분석에 대한 연구로, 방사선 및 검출기에 대한 모든 분야의 기초 자료로 활용될 수 있다.

중환자실 조기 재입실 관련 위험요인 (The Risk Factors Related to Early Readmission to the Intensive Care Unit.)

  • 장진녕;이윤미;박효진;이현주
    • 중환자간호학회지
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    • 제12권1호
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    • pp.36-45
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    • 2019
  • Purpose : The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours. Method: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions. Results: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer). Conclusion: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.

중환자실 간호사의 환자안전간호활동 교육요구도 조사 : IPA 활용 (Study on Educational Needs of Patient Safety Nursing Activities in Intensive Care Units: Utilizing Importance-Performance Analysis)

  • 이승희;박남희
    • 중환자간호학회지
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    • 제15권3호
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    • pp.1-11
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    • 2022
  • Purpose : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses' educational needs in this respect. Methods : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance-Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to 'transfer,' 1 to 'infection,' and 1 to 'firefighting surveillance.' As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses' educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.