• Title/Summary/Keyword: 서울대학교병원

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Evaluation on the Record Completeness of the Nursing Process in Electronic Nursing Record for Patients Undertaken Gastrectomy (전자간호기록에 사용된 간호과정 완성도 분석 - 위절제술 환자를 중심으로 -)

  • Park, Ihn Sook;Yoo, Cheong Suk;Lee, Soon Hyeung;Woo, Kyung Shun;Joo, Young Hee;Choi, Woan Heui;Kang, Hyun Sook;Jung, Mi Ra;Kim, Hee Jin;Park, Mi Ok;Lee, Su Hee;Ahn, Seon Yeong
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.107-116
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    • 2009
  • Purpose: This study was conducted to evaluate the record completeness of the nursing process in the Electronic Nursing Record(ENR) in a university hospital. Methods: We compared nursing statements documented in 2004 with those from the year 2007, given the fact that the ENR system had been utilized since 2004. The ENRs of 35 gastrectomy patients in each year were selected for evaluation. The selected data were 11,822 nursing statements in 2004 and 27,870 in 2007. Results: The number of nursing records which documented the whole nursing process completely was 4,010 (48.3%) in 2007, whereas 513 (5.9%) in 2004 (p<.001). The number of incomplete records in 2004 was 8,142 (94.1%), while 4,300 (51.7%) in 2007 (p<.001). The number of nursing diagnoses was 846 in 2004 and 4,313 in 2007, which increased in number more than 5 times. The most frequently used diagnoses were 'pain', 'risk for infection' and 'risk for ileus' in both years. Conclusion: There was a significant increase in the record completeness on nursing process in 2007 compared to the records in 2004. The reasons for this increase are attributed to nurse training for encouraging to complete recording and nursing record auditing.

Discomfort and Bleeding in Relation to Bedrest Time after Bone Marrow Examination among Hemato-oncology Patients (혈액종양 환자의 골수검사 후 침상안정 시간에 따른 불편감 및 출혈)

  • Lee, Hye Youn;Jung, Jin Young;Park, Se Yeon;Jo, Eun Mi;Jang, Chang Seob;Kim, Hyang Seon;Park, Mi Jeong;Hwang, Yu Min;Suh, Eun Young
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.1
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    • pp.91-97
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    • 2019
  • Purpose: The purpose of this study was to investigate hemato-oncology patients' discomfort and bleeding in relation to the bedrest time after bone marrow examination. Methods: A descriptive correlational study was conducted. The data were collected using self- report questionnaire from total of 131 patients who underwent bone marrow examination from January 2017 to September 2017. Data were analyzed with descriptive statistics, Wilcoxon Signed-rank test, McNemar's test and logistic regression. Results: The level of discomfort after 4 hours of bedrest was significantly higher when compared to 2 hours of bedrest(p<.001). The occurrence of bleeding after 2 hours of bedrest was significantly higher than 4 hours of bedrest(p<.001), however the degree of bleeding was slight. No bleeding occurred in 84% of the patients after 2 hours of bedrest. Conclusion: The results of this study demonstrated that shortening the bed rest time after bone marrow examination was helpful in improving the patient's well-being. Bedrest time could be shortened according to the site of bone marrow examination and patient's condition.

Verification of the Reliability and Validity of the Korean Pediatric Patient Classification System and Estimation of Nursing Time Conversion Index (한국형 소아 환자 분류도구의 신뢰도와 타당도 검증 및 간호시간 환산지수 산출 연구)

  • Sim, Mi Young;Park, Ji Sun;Kwon, Mi Kyung;Song, Suk Hee;Kim, Ye Seul;Kang, Min Seo;Lee, Shin Ae;Choi, Eun Seok;Ha, Eun Ju
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.185-197
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    • 2022
  • Purpose: This study was performed to verify reliability and validity of the Korean Pediatric Patient Classification System (KPPCS) and estimate nursing time conversion index. Methods: The study was conducted in 9 children's hospital which included various areas and size of bed settings. To verify intraclass correlation reliability and construct validity, staff nurses and nurse managers of 21 wards classified 575 patients according to KPPCS comparing differences by age, days of stay, type of stay and medical department. Direct and indirect nursing time of 575 patients were measured by 284 nursing staffs by stopwatch observation and self reports for 24 hours. Results: KPPCS has 12 categories, 55 nursing activities and 80 criterions. High agreement among nurses (r=.91, p<.001) suggested substantial reliability. Construct validity was verified by comparing differences in age, days of stay, type of stay and medical department (p<.05). The correlation of nursing time and classification score was also statistically significant (r=.59, p<.001). The nursing time conversion index was 10.78 minutes per 1 classification score. The entire patient group were classified to four groups using KPPCS. Conclusion: The findings suggest that KPPCS would be a useful tool for estimating nursing demands related to the complexity of pediatric patients.

Pneumocystis Pneumonia Developing during Treatment of Recurrent Renal Cell Cancer with Nivolumab (니볼루맙 치료 도중 발생한 폐포자충 폐렴 1예)

  • Kim, Hak Ro;Keam, Bhumsuk;Park, Young Sik;Kim, Miso;Kim, Tae Min;Kim, Dong-Wan;Heo, Dae Seog
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.571-574
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    • 2018
  • Nivolumab is an immune checkpoint inhibitor approved for the treatment of metastatic cancers. Here, we report the case of a 65-year-old male with recurrent renal cell carcinoma. After six cycles of nivolumab treatment, positron emission tomography/computed tomography (PET/CT) was performed to evaluate the response. PET/CT revealed diffuse ground glass opacities in both lungs. He developed a cough, sputum, chills, and a febrile sense. After bronchoscopic bronchoalveolar lavage, pneumocystis pneumonia was finally diagnosed.

A Pilot Study on Automatic Diagnosis of Cancer Cells Metastasis in Frozen Section Using Convolutional Neural Network (합성곱 신경망을 이용한 동결절편의 암세포 전이 여부 자동진단에 관한 예비연구)

  • Jung, Dae-Il;Kang, Jae-Ku;Jeon, Hye-Lynn;Oh, Se-Jong;Kim, Sungchul;Kim, Young-Gon;Gong, Gyungyub;Song, In Hye;Park, So Yeon;Ahn, Soomin;Lee, Hyunna;Yang, Dong Hyun;You, Wonsang
    • Proceedings of the Korea Information Processing Society Conference
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    • 2020.05a
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    • pp.480-482
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    • 2020
  • 동결절편검사는 수술과 연계하여 암 전이 여부를 판단하기 위한 응급한 병리검사가 필요할 때 이용된다. 합성곱 신경망은 이미지 분류에 뛰어난 성능을 보이는 딥러닝 기법으로 본 논문에서는 이를 이용하여 유방암 전이 여부를 자동적으로 진단하는 방법을 제안한다. 실험과정은 전처리, 학습, 후처리의 과정으로 구성되어 있으며, 합성곱 신경망으로는 Resnet-18 모델을 사용하였다. 실험결과 예측 정확도 및 종양의 최대 길이 정합 여부를 점수로 환산하여 약 0.514 의 결과를 보였다.

Rituximab Treatment for Polyneuropathy Induced by an Immune Checkpoint Inhibitor (Immune Checkpoint Inhibitor에 의한 다발신경병의 Rituximab 치료)

  • Shin, Hye-Rim;Kang, Dong-Wan;Kim, Eun Young;Kim, Tae Min;Lee, Soon-Tae
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.329-332
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    • 2018
  • Immune checkpoint inhibitor is associated with variety of immune-related adverse events. We present a case of polyneuropathy induced by immune checkpoint inhibitor, which was refractory to steroid and immunoglobulin. While high-dose steroid and immunoglobulin were not effective, we tried rituximab which is effective in other immune-mediated polyneuropathy. After rituximab treatment, patient's clinical symptom and nerve conduction study finding was markedly improved. We suggest rituximab might be effective in polyneuropathy induced by immune checkpoint inhibitor.

Predictive Factors for Improvement of Atrophic Gastritis and Intestinal Metaplasia: A Long-term Prospective Clinical Study (위축성 위염과 장상피화생의 호전에 영향을 미치는 인자에 대한 전향적 연구)

  • Hwang, Young-Jae;Kim, Nayoung;Yun, Chang Yong;Kwon, Min Gu;Baek, Sung Min;Kwon, Yeong Jae;Lee, Hye Seung;Lee, Jae Bong;Choi, Yoon Jin;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Lee, Dong Ho
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.186-197
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    • 2018
  • Background/Aims: To investigate the predictive factors for improvement of atrophic gastritis (AG) and intestinal metaplasia (IM). Materials and Methods: A total of 778 subjects were prospectively enrolled and followed up for 10 years. Histological analysis of AG and IM was performed by using the updated Sydney system. To find the predictive factors for reversibility of AG and IM, 24 factors including genetic polymorphisms and bacterial and environmental factors were analyzed. Results: In all subjects, the predictive factor by multivariate analysis for improvement of both antral and corpus AG was successful eradication. The predictive factors for improvement of antral IM were age and successful eradication. The predictive factor for improvement of corpus IM was successful eradication. In patients with Helicobacter pylori infection, age and cagA were predictive factors for improvement of AG and IM. In patients with H. pylori eradication, monthly income and cagA were predictive factors for improvement of AG and IM. Conclusions: H. pylori eradication is an important predictive factor of regression of AG and IM and would be beneficial for the prevention of intestinal-type gastric cancer. Young age, high income, and cagA are additional predictive factors for improving AG and IM status. Thus, various factors affect the improvement of AG and IM.

Cervical lymph node metastasis form non-head & neck sites: below diaphragm (횡격막 아래 장기에서 발생한 악성 종양의 경부림프절 전이 사례 분석)

  • KIM, Jinil;SONG, Seulki;SEOK, Jungirl;LEE, Minhyung;HAN, Sung Jun;JUNG, Young Ho;AHN, Soon Hyun;JEONG, Woo-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.17-21
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    • 2018
  • Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

Cerebrovascular Reservoir and Arterial Transit Time Changes Assessed by Acetazolamide-Challenged Multi-Phase Arterial Spin Labeling Perfusion MRI in Chronic Cerebrovascular Steno-Occlusive Disease (만성 뇌혈관 협착폐색증에서 아세타졸아미드 부하 다상 동맥스핀표지 자기공명관류영상으로 평가한 뇌혈류 예비능과 동맥 통과 시간의 변화)

  • Inpyeong Hwang;Chul-Ho Sohn;Keun-Hwa Jung;Eung Koo Yeon;Ji Ye Lee;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Seung Hong Choi;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.626-637
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    • 2021
  • Purpose To explore cerebrovascular reservoir (CVR) and arterial transit time (ATT) changes using acetazolamide-challenged multi-phase arterial spin labeling (MP-ASL) perfusion-weighted MRI in chronic cerebrovascular steno-occlusive disease. Materials and Methods This retrospective study enrolled patients with chronic steno-occlusion who underwent acetazolamide-challenged MP-ASL between June 2019 and October 2020. Cerebral blood flow, CVR, basal ATT, and ATT changes associated with severe stenosis, total occlusion, and chronic infarction lesions were compared. Results There were 32 patients (5 with bilateral steno-occlusion) in our study sample. The CVR was significantly reduced during total occlusion compared with severe stenosis (26.2% ± 28.8% vs. 41.4% ± 34.1%, respectively, p = 0.004). The ATT changes were not significantly different (p = 0.717). The CVR was marginally lower in patients with chronic infarction (29.6% ± 39.1% vs. 38.9% ± 28.7%, respectively, p = 0.076). However, the ATT was less shortened in patients with chronic infarction (-54 ± 135 vs. -117 ± 128 ms, respectively, p = 0.013). Conclusion Acetazolamide-challenged MP-ASL provides an MRI-based CVR evaluation tool for chronic steno-occlusive disease.