• Journal of Chest Surgery
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• v.34 no.1
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• pp.72-79
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• 2001

배경: 일반적으로 다제내성 폐결핵의 경우 화학요법만으로는 치료성적이 만족스럽지 못하였다. 이에 수술적 치료와 항결핵 화학요법의 병합사용이 높은 균음전율과 장기 생존율을 보여주고 있으므로 이러한 치료전략이 다제내성 폐결핵환자의 일반적인 치료방법으로 정립되리라는 전망을 갖게 하고 있다. 대상 및 방법: 1995년 1월부터 1999년 12월까지 국립마산결핵병원에서 폐결핵에 대한 수술을 시행받은 130례 중 다제내성 폐결핵으로 폐절제수술을 받은 49례를 대상으로 의무기록 및 검사기록 등을 근거로 후향적 조사를 실시하였다. 결과: 대상환자들의 평균연령은 35세였고, 내성약제의 수는 평균 4.5였다. 43례(87.8%)의 환자에서 공동성 병소를 보였으며 31례(63.3%)의 환자에서 술전 객담내 균양성 소견을 보였다. 수술술식은 12례에서 전폐적출술을, 28례에서 폐엽절제술을, 7례에서는 폐엽절제술과 구역절제술 혹은 설상절제술 등을, 그리고 설상절제술과 공동성형술을 각각 1례에서 시행하였다. 술후 지속적인 내과적 약물치료를 병합하여 장기적인 균음전율은 93.5%였고 술후 사망환자는 없었다. 술후 합병증으로는 1주일 이상 지속되는 공기유출 6례와 술후 출혈, 창상분열이 각각 1례씩 있었다. 결론: 다제내성 폐결핵환자에서 폐절제 수술에 대해서는 적절한 적응증, 수술후 처방, 그리고 술후 치료기간 등에 대한 이견이 있지만 적극적으로 고려되어야 하며 술후 내과적 치료와 병행함으로 좋은 치료효과를 얻을 수 있었다.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.390-394
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• 1993

Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

• Journal of Digital Convergence
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• v.15 no.2
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• pp.273-283
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• 2017

This study aims to develop a convergence optimized LOS(Length of Stay) management system that can provide efficient by predicting LOS on outpatient information for inducing the LOS to manage their own activities. web program has been implemented to comput in real-time predicting LOS by using the predicted LOS model of outpatient information. The predict model was derived management targets of long term predicted patient group and intensive care patient group. The optimized LOS(Length of Stay) management system was confirmed efficient for optimizing management of LOS that can provide by the long-term predicting alarm and over LOS alarm service for long term predicted patient group and intensive care patient group. Therefore the trial operating policy alternative on extension of predicted LOS is needed to utilized convergence optimizing system on LOS.

• Therapeutic Science for Rehabilitation
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• v.8 no.1
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• pp.7-25
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• 2019

Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.

• Journal of Gastric Cancer
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• v.7 no.3
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• pp.117-123
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• 2007

Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.164-171
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• 2015

Purpose: To investigate the long-term prognosis of patients with Kawasaki disease in Korea, and discuss the need for long-term follow-up. Methods: The subjects were 48 patients among 354 who had been hospitalized due to Kawasaki disease, and who consented to echocardiography and exercise challenge testing. The mean duration from the onset of disease to follow-up testing after rehospitalization was 11.6 years (8.2-17.0). Patients without coronary artery aneurysms at the initial presentation of the disease were classified in group 1, and patients with small aneurysms were in group 2. Test abnormalities and differences between the two groups were analyzed. Result: There were no significant differences in the results of follow-up echocardiography and exercise challenge testing between the two groups. Although no abnormal findings were noted at follow-up in most patients, a 9-year-old boy in group 2 showed coronary artery dilation. The exercise test indicated normal results in both groups, and echocardiography results were also normal in 100% of cases in group 1 and 93.3% of cases in group 2. Conclusions: As some patients with coronary aneurysms showed coronary artery dilation, we believe that long-term follow-up may be selectively required in patients with coronary artery complications.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.871-875
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• 2002

Despite early aggressive treatment, post myocardial infarction(MI) ventricular septal defect(VSD) revealed high surgical mortality. We reviewed the 10-year experiences of surgically treated post-MI VSD in Yonsei University. Material and Method: From Jan. 1991 to May 2001, 17 patients underwent surgical repair of post-MI VSD. Ages ranged between 47 and 77 years(mean age＝63.2$\pm$9.1). There were 10 males and 7 females. VSD was located at anterior in 16 patients and at posterior in one. IABP was inserted preoperatively in 12 patients due to cardiogenic shock. Mean interval from MI to occurrence of VSD was 5.6 days. Among patients undergoing early surgical correction(n＝13), mean interval from occurrence of VSD to operation was 2.5 days. In 11 patients, concomitant CABG was performed during repair of VSD. Result: Four patients died within 30 days after the operation(30 day mortality＝23.5%). Among 12 patients with preoperative cardiogenic shock, 4 patients died within 30 days(30-day mortality＝33.3%). During mean follow up period of 52 months, one patient died of unknown cause and 10-year survival of discharged patients was 66.7%. All follow-up patients were in NYHA functional class I or II when their last OPD visit. Conclusion: In the treatment of post-MI VSD, aggressive medical treatment with early surgical correction seems to be very important in terms early and long-term survival of patients.

• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.12
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• pp.147-151
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• 2016

Automatic exposure control (AEC) is frequently used in many hospitals for Standing Whole Spine examination which is able to control radiation dose with respect to the body type such as body mass index (BMI) and we can measure dose area product (DAP) based on respective patient information. However, few studies have been conducted organ absorbed dose evaluation based on location of patient organ. The purpose of this study was to evaluate the relationships between BMI and organ absorbed dose along with location of patient organ. For that purpose, we calculated absorbed dose with selected 5 patient organ (thyroid, breast, heart, kidney, and pancreas) using a PCXMC simulation tool with measured DAP. According to the results, measured DAP increases with BMI and organ absorbed dose decreases with BMI in anterior organs such as thyroid, breast, and heart. On the other hand, there is no correlation between organ absorbed dose and BMI in posterior organs such as kidney and pancreas. In conclusion, our results demonstrated that the radiation effects are different with respect to BMI and location of patient organ in Standing Whole Spine examination.

• Proceedings of the Korea Air Pollution Research Association Conference
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• 2002.11a
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• pp.421-422
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• 2002

병원은 환자가 모여 치료를 받는 곳이지만 이곳에 모인 대부분의 환자 중 맡은 사람이 감염증을 갖고 있거나 다른 환자에 대해 전염원이 될 가능성이 있으며 병에 대한 감수성이 높다(홍영이, 1983). 즉, 백혈병 및 암 환자들이 (특히, 골수암) 수술실에서 수술을 마치고 무균실로 옮기는 과정이나 골수이식을 받을 경우 병원 내에서 이동할 때 저항력이 없는 상태에서 외부 병원균으로부터 신체 내에 감염을 막을 방법이 현재로서는 전혀 없다(산업자원부 2002). (중략)

• 보건세계
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• v.53 no.5 s.597
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• pp.35-39
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• 2006

다제내성 결핵은 치료 성공률이 낮은데 그 원인으로 사용할 수 있는 효과적인 항결핵 약제의 숫자가 제한되어 있고, 약제 부작용이 많고, 장기간의 치료기간으로 인해 환자의 순응도(compliance)가 낮기 때문이다. 치료에 실패한 다제내성 결핵환자는 본인의 고통뿐만 아니라 지속적으로 결핵균을 배출하는 만성배균자가 되어 수 많은 사람들에게 다제내성 결핵균을 퍼뜨리는 전염원이 된다.