• The Journal of Korean society of community based occupational therapy
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• v.7 no.1
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• pp.37-47
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• 2017

Objective : The main purpose of this study was to analyze factors affecting a health related quality of life(HRQOL) in the elderly stroke patients with(Group 1) or without(Group 2) sequela. Methods : This survey performed secondary analysis with 'the fifth korea national health and nutrition examination survey', and investigated 91 elderly stroke patients over 65 years. Results : The results were as followed: HRQOL and self rated health had a significantly lower in Group 1(p<.05). In all groups, HRQOL was affected by self rated health(${\beta}=0.39$), mental health, and medical health significantly(p<.05). In group 1, HRQOL was affected by mental health(${\beta}=0.45$), self rated health significantly(p<.05). In group 2, HRQOL was affected by medical health(${\beta}=0.45$), functional health, mental health significantly(p<.05). Conclusion : In order to improve the HRQOL of stroke patients during rehabilitative therapy, it is important that early detection and early intervention of depression and suicide, which affect mental health status, are important in the case of severe aftereffects. If the patient continues to support his/her current status regardless of aftereffects, he/she can improve the HRQOL with functional recovery of the stroke patient, and finally have a positive effect on the independence of the stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.1
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• pp.593-603
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• 2020

This study identified the relationship between academic stress and hopelessness among female high school students. The self-administered questionnaires were given to 334 female high school students located in D-city during the period from August 20, 2018 to September 20, 2018. As a result, the distribution of the level of hopelessness among those surveyed was 61.6% for the normal range group, 23.1% for the mild range group, 12.9% for the moderate range group, and 2.4% for the severe range group. The level of hopelessness, according to the academic stress of the study subjects, was significantly higher in the higher academic stress group than that in the lower academic stress group (p=0.000). Hopelessness also showed significant positive correlation with academic stress (r=0.371, p<0.01). The results of the logistic regression analysis showed that the risk ratio of hopelessness was significantly increased 9.27 times in the higher academic stress group when compared to that in the lower academic stress group. According to the multiple regression analysis, the significant variables affecting hopelessness were satisfaction with school life, conversation with parents, eating regularly, stress due to tests, stress due to studies and stress about career paths. Given the above results, the hopelessness of female high school students is significantly related to academic stress. Therefore, it is necessary to develop and implement programs that can properly control academic stress factors.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.769-774
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• 2001

Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

• Journal of Oriental Neuropsychiatry
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• v.28 no.2
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.210-215
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• 2015

Macrophage activation syndrome (MAS) is a rare complication in systemic lupus erythematosus (SLE) that can be triggered by infections. Due to the fact that MAS may mimic clinical features of underlying rheumatic disease, or be confused with an infectious complication, its detection can prove challenging. This is particularly true when there is an unknown/undiagnosed disease; and could turn into an even greater challenge if MAS and SLE are combined with a viral infection. A-14-year-old female came to the hospital with an ongoing fever for 2 weeks and a painful facial skin rash. Hepatomegaly, pancytopenia, increased aspartate aminotransferase, elevated serum ferritin and lactate dehydrogenase were reported. No hemophagocytic infiltration of bone marrow was reported. The patient was suspected for hemophagocytic lymphohistiocytosis. Her skin rashes were eczema herpeticum, which is usually associated with immune compromised conditions. With the history of oral ulcers and malar rash, positive ANA and low C3, C4 and the evidence of hemolytic anemia, she was diagnosed as SLE. According to the diagnostic guideline for MAS in SLE, she was diagnosed MAS as well, activated by acute HSV infection. After administering steroids and antiviral agent, the fever and skin rash disappeared, and the abnormal laboratory findings normalized. Therefore, we are reporting a rare case of MAS triggered by acute HSV infection as the first manifestation of SLE.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.93-103
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• 2016

This study consisted of descriptive research to determine the prevalence of dry eye disease using the Ocular Surface Disease Index (OSDI) questionnaire targeting workers in hospitals to understand the differences between general and health related characteristics depending on whether people have dry eye disease, and to determine the influencing factors of the disease. The subjects were 502 (Male: 51, Female: 451) general hospital employees in G-city. The data were collected from October 1 to October 31, 2015. Logistic regression was used to analyze the data. The results showed that hospital workers' prevalence of dry eye disease was 76.1%. Factors influencing DED in this population included currently having or adjusting medication (OR: 4.73), among those who felt their eyes dry, those who visited clinics and received medical treatment (artificial tears) (OR: 2.37), those who felt eye dryness (OR: 2.23), and not eating regularly (OR: 0.55). Moreover, 54.0% of those who had dry eye disease reported serious conditions. Accordingly, education to manage the risk factors of the disease and improve lifestyle is needed to prevent and manage dry eye disease.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.536-542
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• 2000

Objective : This study was performed to evaluate the relationships among intracranial pressure(ICP), cerebral perfusion pressure(CPP), and cerebral arteriovenous oxygen difference($AVDO_2$) which were used as parameters of adequacy of cerebral blood flow to support cerebral metabolism after severe head injury and also to examine the association between delayed cerebral infarction and outcome. Material and Method : The authors studied the ICP, CPP and $AVDO_2$ before and after treatment on 34 head-injured patients from June 1996 to December 1997 and examined the association with the change of an ICP, CPP and $AVDO_2$ following treatment and the development of delayed cerebral infarction. Sixteen patients underwent craniotomy for hematoma evacuation and eighteen patients received mannitol to decrease ICP. Results : The development of delayed cerebral infarction was demonstrated in 3(42.9%) out of 7 patients in no improvement group and 13(48.1%) out of 27 patients in improvement group with an increased ICP following treatment. Also, the development of delayed cerebral infarction was demonstrated in 8(50%) out of 16 patients in no improvement group and 8(44.4%) out of 18 patients in improvement group with a decreased CPP following treatment. The association with changes of ICP and CPP following treatment and development of delayed cerebral infarction was not statistically significant(p>0.01). However, 11(78.6%) out of 14 patients who demonstrated an increase in $AVDO_2$ and 5(25%) out of 20 patients who demonstrated a decrease in $AVDO_2$ following treatment developed delayed cerebral infarction. No improvement(reduction) in $AVDO_2$ following treatment was significantly associated with the development of delayed cerebral infarction(p<0.01). All of 16 patients with delayed cerebral infarction showed poor prognosis. Conlcusion : The change of $AVDO_2$ rather than those of ICP and CPP was considered more important factor for the development of the delayed cerebral infarction and poor outcome.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.71-76
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• 2009

서론(Introduction) : 의학 시뮬레이션(medical simulation)은 교육생 학습과정에서 내재된 위험이 환자에게 가해짐 없이 교육생이 실제적인 환자 상황을 경험할 수 있게 하고 여러 다양한 임상내용이 포함한 상황에 적용될 수 있다. 시뮬레이션 기술의 사용은 의학교육(medical education), 인증서(certification), 면허교부(Licensure)와 의료의 질 형성에 큰 잠재력을 가지고 있다. 복강경 수술, 내시경검사, 전문심장구조술, 응급기도관리와 외상소생을 포함한 다양한 임상시술의 수행에서 시뮬레이션이 교육생의 술기를 달성하고, 측정하고, 유지하는 유효성을 증명하였다 컴퓨터로 조절되는 시뮬레이터는 맥박, 혈압, 호흡, 대화가 가능하고, 중증질환 또는 외상환자의 치료에 필요한 같은 인명구조 시술을 수행할 수 있다. 의학 시뮬레이션은 의사, 간호사, 응급구조사와 응급 진료를 필요로 하는 환자를 치료하는 사람에게 필요하다. 최신 전문심장구조술 과정수업은 전통적인 강의와 제한된 팀 상호작용이 포함된 이틀 과정이다. 우리는 비 영어권 국제 응급구조학생의 전문심장구조술 술기능력을 알아보고, 그것을 미국 응급구조학생과 비교하고자 한다. 목적(Objective) : 이 연구의 목적은 다양한 전문심장구조술 증례 시나리오를 가진 의학 시뮬레이터를 이용하여 미국과 한국의 응급구조 학생의 능력을 비교하는 것이다. 시행 장소(Site Location) : 이 연구는 한국 제주도에 위치한 제주한라대학 스토니브룩 응급의료교육원에서 진행되었다. 학생들의 평가는 스토니브룩에 위치한 스토니브룩 대학 의료원의 한 명의 평가자(Dr. lee)에 의해 수행되었다. 방법(Methods) : 15명의 한국 응급구조학생들은 세 팀으로 무작위로 선정하였다. 5명이 한 팀이 되어 같은 증례의 시나리오를 받았다. 세 가지 시나리오는 : 첫째, 천식지속상태(Status asthmaticus), 둘째, 긴장기흉을 동반한 만성폐쇄성폐질환(COPD with tension penumothorax) 그리고 마지막으로 메가코드(megacode)를 가진 심정지 이다. 세 팀을 각각 그리고 기본인명구조술(BLS)과 전문심장구조술(ACLS)과정을 마친 미국 응급구조학생들과 비교하였다. 15명의 미국 응급구조학생들 또한 세 팀으로 무작위로 선정하였다. 이 응급구조 학생들은 플러싱병원 의료원 소속으로 그곳에서 이 연구에 참여할 뿐만 아니라 지속적인 의학교육(CME)이수를 받았다. 이들에게도 같은 세 가지 증례의 시나리오가 주어졌고 Dr lee는 총 여섯 팀을 평가하였다(한국 세 팀과 미국 세팀). 결과(Results) : 양 국가의 모든 15명의 학생이 의학시뮬레이터를 사용하여 전문심장구조술 메가코드시험을 포함한 시험에 모두 통과하였다. 비록 학생들을 무작위로 세 팀으로 나누었지만 한 팀이 이 모든 세 증례에서 다른 팀보다 뛰어났다. 제주한라대학 2번 팀은 더 나은 기도관리, 리듬인식과 임상술기를 가진 모든 중요한 활동을 얻기에서 우수했다. 그들은 핵심요구사항을 90% 이상 충족시겼다. 한국의 2번팀(G2K)은 메가코드에서 기도개방, 호흡평가, 순환징후 그리고 흉부압박수와 같은 신체검진 술기에서도 탁월했다. 게다가 다른 팀과 비교 시 리듬인식, 약물지식과 임상술기에서도 높은 점수를 받았으며 2번팀(G2K)이 6팀 중에 가장 뛰어나게 역활수행을 하였다. 결론(Conclusion) : 이 비교 연구에서 한국학생과 미국학생간에 전문심장구조술 메가코드 시험의 통과율에는 차이가 없었다. 그러나 미국학생은 세 팀 사이에 더 적은 변이로 더 일괄된 점수를 받았다. 한국학생들도 모든 세 가지 증례를 통과하였지만 이 세 팀은 미국학생 팀보다 점수에서 더 큰 변이를 보였다.

• Journal of dental hygiene science
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• v.16 no.2
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• pp.127-133
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• 2016

The aim of this study was to examine the geriatric status, oral health, and oral health related quality of life of stroke patients hospitalized at a rehabilitatio ward and assess the relationships among these factors. A total of 78 stroke patients participated in this cross-sectional study. The following oral examinations were performed by a dentist and dental hygienist: Decayed, Missing, Filled Teeth, gingival, debris, calculus, and community periodontal index (CPI). The patients' sociodemographic and geriatric status were evaluated using the Barthel index and a mini-mental state examine (MMSE) according to their medical record and a questionnaire survey. Oral health related quality of life was assessed using the Oral Health Impact Profile (OHIP)-14 questionnaire. Except for three participants, most stroke patients had a gingival index of 2 or more, which means probing results in bleeding gums. Additionally, 53.8% of participants had a CPI code of 3 or 4, which indicates a probing depth of 4 mm or more. CPI index was significantly related to debris, calculus, and gingival index. The OHIP-14 score significantly related to the Barthel index and MMSE (p<0.05). The oral health of stroke patients in the rehabilitation ward was relatively poor and related to poor oral hygiene. Oral health related quality of life was related not to oral health but to geriatric status significantly.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.31-56
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• 2013

The purpose of this study was to investigate the changes that family caregivers have experienced since using the Korean Long-Term Care Insurance(LTCI) system. In-depth interviews were conducted to determine how the services offered within the LTCI program had affected family caregiving and what changes they had incurred. Results from the qualitative content analysis show that the LTCI program significantly reduced the caregiving burden among family caregivers although burdens that family caregiver perceived varied greatly depending on the types of service that the family selected, and assigned family caregivers different identities and diverse roles(i.e., service user, family caregiver, certified care provider) depending on the service they use. The phenomenon of 'certified family care provider', which was not an intention of LTCI, demonstrates the practical need of elderly persons who require both care and the comfort of family and economic status of the family. Despite the positive impact of the LTCI policy on the family caregivers' burden and family relationship, the current LTCI system should be modified in order to better meet the needs of beneficiaries and their family caregivers.