• Title/Summary/Keyword: 중증

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Video-Assisted Thoracoscopic Thymectomy -Report of Two Cases- (흉강내시경을 이용한 흉선 절제술)

  • 조상록;이정상
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.589-592
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    • 1996
  • We report two cases of the thoracoscopic thymectomies for patients of myasthenia gratis with tracheostomy (Osserman's Group-ll-C-1). The Irst case was 47-year-old male wlth generalized myas- thenia gravis who was under the mechani al ventilator therapy with tracheostomy. The second case was 60-year-old male with deteriorating generalized myasthenia gratis after the mechanical ventilator therapy. We decided to resect the thymus by vldeo-assisted thoracoscopy to prevent the ouurrence of postoperative complications, especially mediastinitis because all two cases were under tracheostomy state. We could stop the mechanical ventilator therapy on the postoperati'fe 16th day and 3rd day respect- ively and they were recovered without mediastinitis. So we concluded that video-assisted thoracoscopic thymectomy is a good alternative surgical method for myasthenia gratis patients with tracheostomy.

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Intratracheal Stenting Under the Aid of Transcutaneous Cardiac Pacing in a Dog with Severe Bradycardic Conduction Defect (중증 서맥성 전도장애 개에서 피부경유 심박 조절 하에 기관내 스텐트 장착)

  • Lee, Seung-Keun;Hyun, Chang-Baig;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.400-404
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    • 2008
  • A 10-year-old intact female Yorkshire terrier dog (weighing 3 kg) was referred with the primary complaint of severe dyspnea, cyanosis and occasional syncopal episode. Physical examination revealed irregularly irregular bradycardia with persistent pulse deficits. The 12-lead surface ECG showed high grade atrioventricular blocks. Thoracic radiography revealed severe intrathoracic collapse. The dog was successfully treated with an intraluminal self-expanding stent ($COOK^{(R)}$) under the aid of transcutaneous cardiac pacing.

Influence of Age, Gender, and Severity on Recovery of Patients with Brain Injury (뇌손상 환자의 회복에 대한 연령, 성별 및 중증도 영향 분석)

  • Oh, Hyun-Soo;Seo, Wha-Sook
    • Journal of Korean Academy of Nursing
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    • v.38 no.6
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    • pp.923-932
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    • 2008
  • Purpose: This study was conducted to investigate the individual and cross influences of age, gender, and severity on recovery of patients with brain injury. Methods: For the purpose of the study, traumatic or spontaneous brain injury patients admitted to the intensive care unit (ICU) were conveniently selected. The data regarding outcomes were collected 3 months after admission. Results: Individual influences of the study variables on patients' recovery were significant, except for gender. But while the individual influence of gender on recovery was not significant, cross influence of gender and age was significant, but only for the sub-dimension of 'arousalbility and awareness'. The study results also showed that 3-way cross influence of gender, age, and severity was only significant on the sub-dimension of 'arousalbility and awareness'. Conclusion: The sub-dimension of recovery cross influenced by the demographic factors of gender and age, and severity was 'arousalbility and awareness'. This might indicate that the study variables that cross influencing recovery had more influence on consciousness compared to physical function and psycho-social adaptation.

Estimation of Home-visiting Care Costs for Low-income Elderly with Chronic Disease in a Metropolitan City Using the Severity Classification and ABC(active-based costing) (대도시 저소득층 만성질환 노인을 위한 가정.방문간호 원가산정 - 환자 중증도 및 활동기준원가계산법(ABC) 적용 -)

  • Kang, Sung-Ye
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.2
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    • pp.118-130
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    • 2008
  • Purpose: The purpose of this study was to estimate of home-visiting nursing costs for low-income elderly with chronic disease in a metropolitan city using the severity classification and ABC(active-based costing). Methods: First, the HHC activity pool was established. The performance time of each nursing activity were estimated. Second, nursing resources(labor costs, operating costs, and traffic expenses) were analyzed and nursing cost per minute was calculated. And then the cost of each activity was estimated. Third, 202 visiting cases were classified into three group by their severity. And then nursing cost per visit according to their severity was estimated. Results: 59 nursing activities were included in HHC activity pool. The average working time of 59 nursing activity was 6.7minutes and nursing cost per minute was 489 won. According severity, nursing cost per visit were in class I, 54,296 (won), class II 83,124(won), and class III 93,455(won).

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Thyroid Carcinoma Coexisting with Myasthenia Gravis : Report of 2 Cases (중증 근무력증과 동반된 유두상 갑상선암 2예)

  • Lim Chi-Young;Lee Jan-Dee;Nam Kee-Hyun;Jang Hang-Seok;Kim Hae-Ryoung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.32-34
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    • 2005
  • Myasthenia gravis with thymoma is associated with an increased risk of second malignancy, but concurrence of myasthenia gravis and thyroid carcinoma is rarely seen. In the treatment, it is emphasized to operate in two stage to avoid myasthenic crisis after surgery. In general, a thyroid cancer surgery is performed after controlling yasthenia gravis by means of thymectomy or medical treatment with steroids and anticholine esterase. We experienced two cases of thyroid carcinoma coexisting with myasthenia gravis, which is thought to be true first report in Korea.

Development of medical image quantification software in the abdominal diseases (복부질환 의료영상 분석 소프트웨어 개발)

  • Kim, Ji-Eon;Kim, Seung-Jin;No, Si-Hyeong;Jun, Hong-Yong;Lee, Chung Sub;Ryu, Jong-Hyun;Kim, Tae-Hoon;Jeong, Chang-Won
    • Annual Conference of KIPS
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    • 2019.05a
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    • pp.348-349
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    • 2019
  • 의료영상은 진단을 목적으로 환자의 질환 부위별로 정밀하게 촬영하여 수집된 영상이다. 수집된 의료영상을 판독하여 진단하기 어려운 경우에는 조직검사를 통해 확진검사를 실시한다. 하지만 조직검사의 경우 환자에게 신체적, 경제적 부담을 줄 수 있다. 따라서 의료영상을 기반으로 정밀 진단하는데 도움을 줄 수 있는 정량분석 소프트웨어 개발이 중요하다. 현재 복부 간 질환의 경우 MELD(Model For End-Stage Liver Disease) 점수를 이용하여 간 질환의 중증도나 예후를 예측하는데 이용되고 있다. 하지만 MELD점수 산출에 있어서 의료영상 정보를 사용하지 않았기 때문에 질환 여부를 가늠하는데 에만 이용될 뿐 병변부위의 위치를 확인하는데 에는 어려움이 있다. 그러므로 본 논문은 다양한 의료영상장비에서 획득한 복부영상을 이용하여 복부질환의 중증도를 예측 및 분석함으로서 실제 임상진단에 도움을 줄 수 있는 시스템을 제안하고자 한다.

Related Factors of Severity Rated by Korean Triage and Acuity Scale (KTAS) among Older Adults at the Emergency Departments (일개 지역 응급의료센터 방문 노인의 중증도 영향 요인)

  • Shin, Dong-Soo;Kim, Mi Sook
    • Journal of East-West Nursing Research
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    • v.24 no.2
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    • pp.146-153
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    • 2018
  • Purpose: This study aimed to identify characteristics and severity assessed by Korean Triage and Acuity Scale (KTAS) among 2,496 older adults aged 65 and over who visited an emergency department (ED) located in Chuncheon city. Methods: Data were collected via electronic medical records from two hospitals from January to December of 2016. Chi square test and logistic regression were applied using SPSS 22.0. Results: 53.5% of the participants were women and 17.6% of visits were done by aged 85 and older. ED visits by ambulance were 33.9%. More than two-third of older adults' ED visits were emergent status. Severity of the ED visits of older adults were rated by KTAS. Commonly reported chief complaints of the ED visits were dizziness, dyspnea, chest pain, abdominal pain, and hypoalbuminemia. Among them, dizziness, chest pain, dyspnea, and hypoalbuminemia were related factors for being-emergent condition. Conclusion: Strategies for older adults' chief complaints are needed in order to reduce unexpected ED visits.

Triage Nurses' Work Experiences in Emergency Department: A Qualitative Research (응급실 중증도 분류 간호사의 업무 경험: 질적 연구)

  • Park, Yu Jin;Kong, Eun-Hi;Park, Young A
    • Journal of muscle and joint health
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    • v.25 no.3
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    • pp.176-186
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    • 2018
  • Purpose: The purpose of the study was to describe work experiences of triage nurses working at emergency departments in Korea. Methods: A qualitative descriptive research method was used. Twenty-one nurses of emergency department participated in the first interview and 16 of them participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis was utilized to analyze the data. Results: Forty-eight codes, 12 categories, and six themes emerged from the data analysis: caring on the frontline, burden as an initial evaluator, handling things alone, lack of others' understanding, becoming an expert, and needs for improvement. Participating triage nurses faced many challenges and difficult situations in emergency departments. They felt burden and loneliness as initial evaluator. Also, they felt pride in their work and struggled to become a professional. Conclusion: This study is the first qualitative study that has focused on exploring the experiences of triage nurses in emergency departments in Korea. The results provide description and in-depth understanding of working experiences of triage nurses. The results provide valuable fundamental data for regulation, clinical practice, education, and research for triage nurses in Korean emergency departments.

Analysis of Influence Factors on Ventilator-Associated Pneumonia in Severe Trauma Patients (중증 외상환자의 인공호흡기 관련 폐렴 영향 요인 분석)

  • Park, Bit Na;Kim, Eun Joo
    • Journal of Home Health Care Nursing
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    • v.25 no.3
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    • pp.224-231
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    • 2018
  • Purpose: This study was to analyze the factors affecting ventilator-associated pneumonia with severe trauma patients. Methods: This study conducted from May 1, 2018 to May 31, 2018 based on the medical records of the intensive care unit of a university hospital from May 1, 2017 to April 30, 2018 in Gangwon province. The inclusion criteria were 1) Trauma intensive care unit patient, 2) older than 19 years 3) without pneumonia at the time of admission. The collected data were analyzed using descriptive, correlation analysis, ANOVA, t-tests, $x^2$-tests and regression. Results: The severe trauma patients had a total of 2,877 days receiving ventilator, and nine VAP cases. The overall infection rate was 4.0%, and the VAP incidence rate was 3.13 per 1000 ventilator days. VAP in severe trauma patient affected ICU stay(OR=1.03), mechanical ventilator applied day(OR=1.04). Conclusion: Therefore, the development of an individualized VAP prevention bundle and nursing intervention for patients with trauma will be needed and further studies. In addition, there were no findings regarding the relationship between VAP occurrence and the severity of multiple traumatic injuries, so further studies of these factors should be performed.

Therapeutics in the Treatment of COVID-19 for Children and Adolescents (소아청소년 코로나바이러스감염증-19의 치료: 치료 약제를 중심으로)

  • Choi, Soo-Han;Choi, Jae Hong;Yun, Ki Wook
    • Pediatric Infection and Vaccine
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    • v.29 no.1
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    • pp.1-15
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    • 2022
  • Coronavirus disease 2019 (COVID-19) presents as a mild-to-moderate respiratory illness in most children. However, a small proportion of children with COVID-19 develop severe or critical illnesses. Although pediatric clinical trials for the treatment of COVID-19 are sparse, some drugs are available for children and adolescents with severe COVID-19. This review summarizes clinical data focusing on antiviral agents and immunomodulators for use in treating COVID-19. In addition, current recommendations for therapeutics for children and adolescents with COVID-19 are discussed.