• Title/Summary/Keyword: 수술 후

Search Result 5,372, Processing Time 0.035 seconds

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
    • /
    • v.13 no.3
    • /
    • pp.153-160
    • /
    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Effects of Intracavitary Urokinase Instillation in Complicated Pleural Effusion (합병성 흉막 삼출에 대한 국소적 Urokinase 주입치료 효과에 관한 연구)

  • Sohn, Dong-Hyun;Yoon, Su-Mi;Kim, Chung-Mi;Park, Ik-Soo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.3
    • /
    • pp.357-364
    • /
    • 2000
  • Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

  • PDF

Observation on The Frequency of Chromosomal Aberration and Changes in Number of Peripheral Lymphocytes in Radioactive Iodine Treatment (방사성옥소 투여에 따른 말초혈액 림프구 수의 변화 및 염색체이상 빈도의 관찰)

  • Koo, Chun-Hee;Shin, Min-Ho;Park, Young-Ju;Lee, Jung-Yim;Park, Tae-Yong;Lee, Jae-Yong;Kim, Chong-Soon;Han, Seung-Soo;Kim, Kwang-Hoe;Kim, Hee-Geun;Kang, Duck-Won;Song, Myung-Jae
    • The Korean Journal of Nuclear Medicine
    • /
    • v.29 no.3
    • /
    • pp.343-349
    • /
    • 1995
  • Background : For biological dosimetry of radiation exposure, both observing hematologic change and calculating Ydr by chromosomal analysis as biological indicators are widely used. However, due to the lack of studies on biological dosimetry of radiation dose absorbed in the body such as in the cases of radioactive iodine therapy, the maximal and safe dose is not well known, nor is the extent to which the body can safely endure radiation exposure. Purpose : To investegate the practical applicability of hematologic changes and Ydr as an indicator for estimating radiation exposure, to patients with thyroid diseases after doses of radioactive iodine. Material and Methods : 5 patients with hyperthyroidism and 35 patients who have had thyroid cancer operation were under treatment with radioactive iodine, changes in number of lymphocytes were tracked and Ydr was calculated for more than 2 months by chromosomal analysis in peripheral lymphocytes. Results ; 1) The number of lymphocytes began to decrease 2 weeks after doses of radioactive iodine, and reached the nadir after 6 and 8 weeks, then gradually recovered. 2) The nadir count of lymphocytes was reversely correlated with the administered dosage of radioactive iodine. 3) Ydr was generally stable between 2 and 8 weeks. 4) The maximal value of Ydr was correlated with the administered dosage of radioactive iodine. 5) Ydr value at the 2nd week increased with augmented dosage of radioactive iodine. 6) Ydr value at the 2nd week was correlated with fall of lymphocyte count. Conclusion : Patients must be closely observed, because temporary bone marrow suppression and slight chromosomal aberration can be produced by even generally used dosages of radioactive iodine for diagnosis and therapy. Maximal percent fall of lymphocyte count, Ydr at the 2 week interval and maximal Ydr can be used as the biological predictor of administered dosage of radioactive iodine.

  • PDF

Clinical Significance of Lymph Node Micrometastasis in Patients with Stage 1 Non-Small Cell Lung Cancer (제1기 비소세포폐암 환자에서 임파절 미세전이와 예후와의 상관관계)

  • 최필조;노미숙;이재익
    • Journal of Chest Surgery
    • /
    • v.36 no.5
    • /
    • pp.348-355
    • /
    • 2003
  • Background: The prognostic significance of lymph node micrometastasis in non-small cell lung cancer remains controversial. We therefore investigated the clinicopathologic factors related to lymph node micrometastsis and evaluated the clinical relevance of micrometastasis with regard to recurrence. Material and Method: Five hundred six lymph nodes were obtained from 41 patients with stage 1 non-small ceil lung cancer who underwent curative resection between 1994 and 1998. Immunohistochemical staining using anti-cytokeratin Ab was used to detect micrometastasis in these lymph nodes. Result: Micrometastatic tumor cells were identified in pN0 lymph nodes in 14 (34.1%) of 41 patients. The presence of lymph node micrometastasis was not related to any clinicopathoiogic factor (p) 0.05). The recurrence rate was higher in patients with micrometastasis (57.1%) than in those without (37.0%), but the difference was not significant (p=0.22). Patients with micrometastasis had a lower 5-year recurrence-free survival rate (48.2%) than those without micrometastasis (64.1%), with a borderline significance (p=0.11), The S-year recurrence-free survival rate (25.0%) in the patients with 2 or more micrometastatic lymph nodes was significantly lower than that in the patients with no or single micrometastasis (p=0.02). In multivariate analysis, multiple lymph node micromestasis us was a significant independent predictor of recurrence (p=0.028, Risk ratio=3.568). Conclusion: Immunehistochemical anti-cytokeratin staining was a rapid, sensitive, and easy way of detecting lymph node micrometastasis. The presence of lymph node micrometastasis was not significantly associated with the recurrence, but had a tendency toward a poor prognosis in stage 1 non-small cell lung cancer. Especially, the presence of multiple micrometastatic lymph nodes was a significant and independent predictor of recurrence.

Effect of Chitosan-Trimer on the Prevention of Postoperative Intraperitoneal Adhesion Formation in Rats (랫트에서 Chitosan-Trimer가 복강유착에 미치는 영향)

  • Kwon, Eun-ju;Jang, Kwang-ho;Jang, In-ho
    • Journal of Veterinary Clinics
    • /
    • v.18 no.3
    • /
    • pp.257-264
    • /
    • 2001
  • This study was performed to investigate the effects of chitosan-trimer (CT) on the prevention of postoperative adhesion formation in the rate model. All animals divided into PBS (control), 1% CT, 3% CT, and chitin treated group. The mean adhesion score in 1% CT group (1.03$\pm$0.63), 3% CT group (0.64$\pm$0.53) and chitin group (1.67$\pm$0.71) was found to be lower than that in control group (2.07$\pm$0.81). More favorable adhesion prevention was achieved in 3% CT group (0.64$\pm$0.53) in comparison with the control group, 1% CT group, and chitin group without any hemorrhagic complications. A statistically significant difference was observed in adhesion formation between control group and 3% CT group (p<0.001). In control group, 44 of 45 sites (97.7%) formed adhesions between the intestine defects. In contrast, 3% CT was effective in reducing the incidence of adhesion formation to 17 to 45 sites (62.2%) (p<0.05). The locations of adhesions were observed in serosa-serosa (60%), serosa-mesentery (13.3%), serosa-connective tissue of testis (10%), omentum-liver (10%), serosa-omentum (3.3%), serosa-cecum (3.3%), and serosa-incision (0%). On the results of histological analysis, grade of inflammation and fibrosis at the sites of postoperative peritoneal adhesion formation were not significantly different in all groups. But, 3% CT showed the lowest score of inflammation and fibrosis. In 3% CT group, the rate of increase of plasma fibrinogen was significantly lower compared with that in control group from pre-operation to 10 days later (p<0.05). There were no appreciable difference in the CBC, leukocyte differential counts and total protein concentrations among four groups. In conclusion, our data suggested that CT should be effective on reducing adhesion formation in experimental rat models. The results also showed that 3% CT does not adversely affect normal wound healing and healthy recovery after operation.

  • PDF

Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.3 no.1
    • /
    • pp.60-65
    • /
    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

  • PDF

Ultrasonographic Utility for Arthroscopic Examination of Knee (슬관절 관절경 검사 시 초음파 검사의 유용성)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Kim, Kyung-Cheon;Kim, Dong-Kyu;Kim, Bo-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
    • /
    • v.2 no.1
    • /
    • pp.18-23
    • /
    • 2009
  • Purpose: To evaluate the relationship between the real pathology & abnormal finding found by ultrasonography. Without an MRI test being done beforehand, an arthroscopy is done after an ultrasonography to show abnormal lesions during a knee abnormality. Materials and Methods: The subjects were 42 patients out of 49 cases, excluding those with rheumatoid arthritis, septic arthritis and patients suspected with a ligament tear, which were examined by ultrasonography alone before receiving a knee arthroscopy in our hospital from July 2007 to July 2008. In every case, a physical examination, simple X-ray and knee ultrasonography was done. An arthroscopy was performed when there was ultrasonographic abnormal finding. Before the procedure, a MRI test was not performed and when abnormal findings were found by an arthroscopy, an appropriate surgery was done. Results: During the ultrasonographic examination, there were various sized effusions in the suprapatellar pouch. Also, in addition there were eleven cases of medial meniscus abnormalities, sixteen cases of lateral meniscus abnormalities, and two cases of cystic lesions. Throughout the arthroscopic examination, there were 14 cases of medial meniscus abnormalities, 20 cases of lateral meniscus abnormalities, 15 cases of cartilage damages, 9 cases of medial pathologic plica, 2 cases of intra-articular loose bodies, 5 cases of chondromalacia, 2 cases of cyst, and 2 cases of synovitis. When an effusion abnormality was found by the ultrasonography in a suprapatellar pouch, there was a 100% probability of knee pathology. When a medial meniscus abnormality was found with an ultrasonography, there was a 90.9% probability of a real pathology. When a lateral meniscus abnormality was found there was 81.2% probability of a real pathology. Ultrasonography was 100% accurate when it came to cystic lesions. Conclusion: Knee ultrasonography performed before an arthroscopy seems to be a very useful examination method when suspecting intra-articular lesions.

  • PDF

The attrition pattern in Angle Class III malocclusion with facial astmmetry (안면비대칭을 동반한 Angle III급 부정교합자의 교모양상)

  • Son, Woo-Sung;Jeon, Eun-Ye;Kim, Sung-Jo
    • The korean journal of orthodontics
    • /
    • v.27 no.4 s.63
    • /
    • pp.549-557
    • /
    • 1997
  • This study was designed to investigate the attrition pattern in Angle Class III malocclusion with facial asymmetry. The sample consisted of three groups, the 20 subjects of normal occlusion group(Group I), the 12 subjects of class III malocclusion without facial asymmetry group(Group II) and 17 subjects of Class III malocclusion with facial asymmetry group(Group III). Attrition areas from canine to second molar on both sides in upper and lower arch, totally twenty, was marked by pencil and mesured by computer system(INTERGRAPH CO. USA) 2 times and the average value was used for date processing. Attrition areas from canine to second molar on both sides in upper and lower arch, totally twenty, was marked by pencil and mesured by computer system(INTERGRAPH CO. USA) 2 times and the average value was used for date Processing. All attrition areas were measured 2 times and the average value was used for data processing The data were statistically analyzed by SAS program. The results of this study were as follows. 1. Total attrition area in Group I was larger than in Group II and III. 2. There was no significant difference in attrition area between right and left side in each group, but attrition area in Group III was larger than in Group I and II. 3. In Group I, Maxillary attrition area was larger than mandibular attrition area, but in Group ll and III, there was no significant difference in attrition area between maxilla and mandible. 4. In Group III, the attrition area of deviated side was target than undeviated side 5. There was no significant difference in attrition area between chewing side and non-chewing side in each group. 6. The total attrition area was unaffected by gender.

  • PDF

Effect of Agaricus blazei β-Glucan and Egg Shell Calcium Complex on Bone Metabolism in Ovariectomized Rats (난소절제 흰쥐에서 신령버섯의 β-Glucan과 난각 Ca 복합체가 골 대사에 미치는 효과)

  • Noh, Kyung-Hee;Jang, Ji-Hyun;Kim, Jin-Ju;Park, Cherl-Woo;Kim, Jeong-Ok;Kim, Jae-Cherl;Song, Young-Sun
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.35 no.10
    • /
    • pp.1363-1370
    • /
    • 2006
  • This study was designed to evaluate the effect of Agaricus blazei $\beta-glucan$ and egg shell calcium complex on bone metabolism in ovariectomized (OVX) rats. Forty Sprague-Dewley female rats, 10 weeks of age $(248{\pm}1.7g)$, were divided into 4 groups and fed on the experimental diets for 6 weeks: sham operated control treated with normal diet containing 0.5% calcium (Sham-C), OVX-control treated with normal diet containing 0.5% calcium (OVX-C), $OVX-\beta-glucan$ group treated with $\beta-glucan$ diet containing 0.5% calcium (OVX-G), and $OVX-\beta-glucan$ egg shell calcium complex treated with $OVX-\beta-glucan$ egg shell calcium complex containing 0.5% calcium (OVX-GE). Bone weight of femur was higher in the OVX-GE group than in the other OVX groups. Bone mineral density of femur was significantly different (p<0.05) among the experimental groups and showed the highest level in the OVX-GE group. Calcium absorption rate and retention were higher in the $\beta-glucan$ supplement groups than in the other groups (p<0.05). Alkaline phosphatase activities and osteocalcin levels of serum showed lower in the $\beta-glucan$ supplement groups than in the OVX-C group. Deoxypyridinoline crosslink values of urine, indicator of bone absorption, showed the lowest in the OVX-GE group. The $\beta-glucan$ supplemented groups had a lower bone resorption ratio than in the OVX-C group. We concluded that bioavailability of calcium is higher in $\beta-glucan$ supplement groups compared to those in OVX rats. From the above results, these findings suggest the possibility of using $\beta-glucan$ egg shell calcium complex as a functional food material related to bone metabolism, even though there is no significant difference between the groups of $\beta-glucan$ and $\beta-glucan-egg$ shell calcium complex supplementation.

NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY (외상성 뇌손상 아동의 신경정신과적 후유증 평가)

  • Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.10 no.2
    • /
    • pp.212-219
    • /
    • 1999
  • Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

  • PDF