• 제목/요약/키워드: 임상 경과

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3차원 흉부 CT에서 추체 골 전이 병변에 대한 반자동 검출 기법 및 분류 시스템 개발 (Development of a Semi-Automated Detection Method and a Classification System for Bone Metastatic Lesions in Vertebral Body on 3D Chest CT)

  • 김영재;이승현;최자영;선혜영;김광기
    • 한국통신학회논문지
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    • 제38C권10호
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    • pp.887-895
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    • 2013
  • 골 전이 암은 여러 장기에 생긴 암이 질병이 경과함에 따라 뼈로 옮아가는 것으로서, 암 환자에게서 주로 발생하는 합병증 중 하나이다. 골 전이는 골 용해성 전이와 골 형성성 전이로 구분되며, CT에서 골 전이의 진단은 임상적으로 매우 유용할 수 있으나, 많은 판독건수로 인하여 중요한 병변이 간과되는 경우가 많고, 이를 통해 골 전이 암을 조기에 진단하지 못하는 경우가 발생할 수 있다. 이에 본 논문에서는 흉부 CT의 단층 영상들을 3차원 볼륨 데이터로 구성하여 3차원 영상처리 알고리즘을 적용하여 골 전이 병변을 검출하고 3차원 가시화를 수행하였으며, 총 10개 데이터에 대해 민감도를 측정한 결과, 골 형성성 병변이 평균 94.1%, 골 용해성 병변이 평균 90.0%의 값을 나타내어 골 전이 진단에서의 활용에 대한 높은 가능성과 잠재적인 유용성을 확인할 수 있었다.

두개경유도플러초음파를 이용한 성인 여성 무조짐편두통 환자의 식사 상태에 따른 뇌혈관반응성 변화 (Change of Cerebrovascular Reactivity by Prandial State in Women with Migraine without Aura: Transcranial Doppler Ultrasonography (TCD) with Breath-Holding Method)

  • 박정호;박선아;이태경;성기범
    • Annals of Clinical Neurophysiology
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    • 제14권1호
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    • pp.20-24
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    • 2012
  • Background: Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes. Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascular reactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods: Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significant history of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebral artery with better temporal window. Each subject was examined consecutively before and after a standard meal, together with serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI (mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group; postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239, respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serum glucose level of patients showed a tendency of mild positive correlation with BHIs (${\gamma}$=0.448, P=0.032). Conclusions: Although exact mechanisms are unclear, cerebrovascular reactivity of some women with migraine without aura may be influenced by prandial state.

데이컴 기법을 이용한 중앙공급 간호사의 직무분석 (Job Description of Nurses in Central Supply Department using DACUM Technique)

  • 오은실;송순덕;최이정;전현숙;한화순;류성숙;황문숙;이미경
    • 임상간호연구
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    • 제20권3호
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    • pp.303-312
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    • 2014
  • Purpose: This study aimed to use the DACUM analysis technique and identify the job description among nurses of the Central Supply Department, in order to clarify their duty and task descriptions, identify the characteristics of job. Methods: Through a DACUM workshop, job descriptions, and the job duties and tasks were derived. A total of 150 nurses from the Central Supply Departments of medical Institutions over 100 beds were surveyed using drafting and a job analysis table. Individual jobs' frequency, importance and difficulty were measured using a 3-point scale, and the results were analyzed using SPSS. Results: The nurses' job in the Central Supply Department consisted of 13 duties and 64 tasks. Duties with highest importance and difficulty was 'sterilization assurance system', the second was 'employee safety management' and the duty with highest frequency was 'manage packaging before sterilization'. Conclusion: This study clarified the types of nursing jobs in the Central Supply Departments, as well as identified the job characteristics and status in the given setting. Given the sterilization assurance system for preventing hospital infection, and safety management for ensuring work environment safe were found to be important duties, it is suggested for the department to stress those important jobs for managing hospital safety.

척추마취수술 환자의 수술 후 일상활동이 경막천자 후 두통 발생에 미치는 효과 (Effect of Post Operative Daily Activity on Post-dural Puncture Headache after Spinal Anesthesia)

  • 박지은;정현주;김정화;한복희;신주희;유가경;최현진;강화자
    • 임상간호연구
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    • 제22권3호
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    • pp.336-344
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    • 2016
  • Purpose: The purpose of this study was to compare and analyze differences in effects of postoperative daily activity on headaches in patients who underwent surgery under spinal anesthesia. Methods: The study was conducted with 219 adults, 20 years or older. Official approval (Approval number: KMC IRB 1434-01) was received from K university hospital clinical trials review board. The research design was a nonequivalent control group non-synchronized design with a daily activities group and the bed rest group. Data was collected after receiving written consent from the participants. Results: There were no participants in either group who experienced headaches. Changes in a physiological index were also not significantly different between the daily activities group and the bed rest group. Conclusion: The results indicate that allowing daily activities in the ward, rather than maintaining bed rest for 6 hours, the existing method of nursing care for the prevention of postoperative headaches, in spinal anesthesia patients, is not detrimental to these patients post operatively.

외상성 구안와사 환자 2례에 대한 임상적 고찰 (Clinical Study of Two Patients with Deveation of the Eye and Mouth Caused by Trauma)

  • 이재민;김은미;송형근;고승경;김성래;김정호;김영일;이현;홍권의
    • Journal of Acupuncture Research
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    • 제23권4호
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    • pp.81-89
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    • 2006
  • Objectives : This study is designed in order to evaluate oriental medical treatment of deveation of the eye and mouth caused trauma. Methods : The authors observed patient by Yanagihara's unweighted grading system for operated acupuncture treatment, herbal medicine treatment and physiotherapy. Conclusion : 1. Deveation of the eye and mouth is caused by trauma ; intra cranial trauma, intra temporal bone trauma, extra, temporal bone trauma, etc. Cardinal symptom is palsy of Facial muscle, slobbering, articulation disorder, epiphora, ear pain, hyperacusis, laterality hypogeusia. 2. Deveation of the eye and mouth patient by Lt. temporal bone Fx. is seen evaluate of Yanagihara's total score ; from S to 35. 3. Deveation of the eye and mouth patient by facial nerve inhury is seen evaluate of Yanagihara's total score ; from 10 to 30. 4. Traumatic Deveation of the eye and mouth patient evaluate by oriental medical treatmend ; acupuncture treatment, herbal medicine treatment and physiotherapy. This is based on sil(賞) of stomach channel of foot yangming & larhe intestine channel of hand Yangming.

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여드름 흉터의 한의학 치료에 대한 국내 임상 연구 동향 (Review of Clinical Studies on Korean Medicine for Acne Scar)

  • 제하경;황미리;안재현;정현아
    • 한방안이비인후피부과학회지
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    • 제31권2호
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    • pp.86-103
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    • 2018
  • Objectives : The purpose of this study is to analyze various Korean medical treatments on acne scar and to propose better methods on clinical studies and effective treatments. Methods : Key word 'Acne Scar', published year '2010-2018' were searched on three domestic database systems (RISS, KISS, NDSL). Results : Among 9 studies, 8 studies were case reports and 1 study was comparative study. The treatment used in 9 studies were acupuncture(Subcision, Microneedle Therapy System, laser), pharmacopuncture, external application, dermabrasion, high frequency therapy. 7 out of 9 studies used more than 2 different treatments. The most popular treatment method was 'subcision', followed by 'MTS'. The most popular methods of assessment was QGASC. All studies using assessment methods measuring the severity of acne scar reported improvement, though only 1 study was proved to be statistically different. 1 study reported the side effect, and other 4 studies reported flushing, itching, pain. Conclusions : This study shows the effectiveness of Korean medical treatment on acne scar. It will be expected to use this various treatments and study methods for treating acne scar with Korean medicine, and conducting further clinical studies with higher credibility and reproducibility.

통원 수술환자의 안전한 귀가 결정을 위한 퇴실기준에 관한 연구 (A Study about Discharge Criteria to Determine Patients' Readiness for Safe Return to Home after Ambulatory Surgery)

  • 윤계숙;김은경;정소현;이승주;정미경;이영미
    • 임상간호연구
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    • 제18권3호
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    • pp.435-446
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    • 2012
  • Purpose: This study was conducted to compare three discharge criteria; 1) discharge criteria of S Hospital determined by nurses, 2) discharge readiness determined by patients, and 3) the Modified Post-Anesthetic Discharge Scoring System (MPADSS). The usefulness of MPADSS as a discharge criteria for the patients'safe return to home after ambulatory surgery was also evaluated. Methods: A total of 370 day surgery cases were investigated. The MPADSS was employed in every 30 min. in parallel with discharge readiness assessment by nurses and patients. The percentage of the patients who were categorized as being ready to discharge were compared according to three discharge criteria. Results: The percentage of patients scored to be as MPADSS > 9 in 30 min, 60 min, 90 min were 96.5%, 99.5%, 100%respectively. Whereas 11.1%, 44.3%, 71.1%of patients rated themselves as being ready to discharge and 2.7%, 23.5%, 54.3% of patients actually discharged by nurses according to discharge criteria of S Hospital. Conclusion: Nurses tend to keep patients longer in the hospital when compared to the patient's own assessment about their readiness to home and to that of MPADSS. Faster discharge in the evening than day time suggests patient discharge can be influenced by nursing factors. This brings out the importance of scoring system to determine the safe discharge. The MPADSS could be a useful tool in evaluating patients for safe discharge.

간호사가 지각한 병원조직의 내부마케팅 수행도, 감정노동, 직장-가정 갈등이 이직의도에 미치는 영향 (Impact of Internal Marketing Activity, Emotional Labor and Work-Family Conflict on Turn-Over of Hospital Nurses)

  • 손연정;박수경;공성숙
    • 임상간호연구
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    • 제18권3호
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    • pp.329-340
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    • 2012
  • Purpose: This study was done to identify internal marketing activity, emotional labor and work-family conflict that influence turn-over in hospital nurses. Methods: Participants were 513 nurses from 2 general hospitals in Chung-nam and Gyeonggi Provinces, South Korea. Data were collected from September 1 to 30, 2011 using self-report questionnaires. Stepwise multiple regression was used to identify association between variables. Results: The mean score for internal marketing activity was $94.7{\pm}14.7$, emotional labor, $31.4{\pm}5.5$, work-family conflict, $19.6{\pm}4.1$, and turn-over, $13.7{\pm}3.4$. After adjusting for general characteristics, stepwise multiple regression showed that work-family conflict (${\beta}=.20$, p<.001), marketing activity (${\beta}=-.21$, p<.001), and emotional labor (${\beta}=.22$, p<.001) were associated with turn-over. These predictors accounted for 33% of variance in turn-over. Conclusion: The results of this study show that work-family conflict was the most influential predictor indicating a need for the development of strategies to reduce work-family conflict and emotional labor. At the same time internal marketing activity should be supported in the hospital by analyzing the needs for nurses. Also career development programs and mentor systems will be useful for effective manpower management and quality improvement of nursing services.

폐문부의 림프절 종대 1예 (A Case of Parahilar Lymph Node Enlargement)

  • 이희정;손지웅;최유진;이원영
    • Tuberculosis and Respiratory Diseases
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    • 제59권2호
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    • pp.209-212
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    • 2005
  • 유육종증은 침범된 기관에 T림프구와 단핵구가 축적되고, 비건락성 상피양세포 육아종이 생기면서 정상 조직의 구조가 파괴되는 원인 불명의 비교적 흔한 만성 질환이다. 저자들은 쉰목소리를 보여 기관지 내시경을 하였으나, 마비된 왼쪽 성대 자체에는 특별한 문제가 없었으며, 컴퓨터 단층촬영과 Gallium-67 스캔에서 비대해진 종격동으로 회귀 후두신경 압박에 의한 임상 양상으로 추측하였고, ACE증가와 피부 병변의 비건락성 육아종을 보였으며 또한 결핵, 진균 등의 침범은 배제할 수 있어 유육종증을 진단하였다. 해외에서는 쉰목소리의 원인으로 유육종증이 진단 된 경우가 종종 보고되고 있으나, 한국에서 드문 것으로 보여 문헌 고찰과 함께 보고하는 바이다.

폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예 (A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient)

  • 김종경;송하도;조동일;유남수
    • Tuberculosis and Respiratory Diseases
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    • 제63권4호
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    • pp.372-377
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    • 2007
  • 척추결핵은 경과가 느리고 서서히 진행하며 특이한 증상이 없으므로 임상적으로 의심하지 않으면 병이 상당히 진행된 후에야 진단되기 쉽다. 또한 침범된 부위가 척추결핵이 흔하지 않은 상부흉추, 경추, 천추부라면 진단은 더욱 늦어질 수 있다. 저자들은 국립의료원 결핵과에서 발열과 약 5개월간 지속된 상부 배부 통증으로 입원한 폐결핵환자에서 MRI 촬영으로 T5-6의 압박골절까지 초래한 상부흉추결핵을 진단하고 신경학적 이상이 생기기 전에 수술을 시행하고 항결핵약제의 치료로 좋은 결과를 얻었기에 이에 보고하는 바이다.