• Title/Summary/Keyword: 환자의 접근

Search Result 959, Processing Time 0.031 seconds

Relationships of Peripheral Inflammatory Marker With Suicide Attempt History (자살시도력과 말초혈액의 염증 지표 간의 연관성)

  • Su-Hyun Oh;Seung-Jun Kim;Sang-Ho Shin;Hong-Seok Oh;Jae-Chang Lee;Woo-Young Im;Na-Hyun Lee
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.31 no.2
    • /
    • pp.165-172
    • /
    • 2023
  • Objectives : The purpose of this study is to determine whether there is a significant difference in the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio according to the history of suicide attempt in patients with psychiatric diseases. Methods : A medical record review was conducted on patients who had been hospitalized in Konyang University Hospital since 2021-03-01 to 2023-02-28 to collect demographic and clinical characteristics. T-test for continuous variables and Chi-square test for categorical variables were performed to determine demographic differences according to the history of suicide attempt, and the ANCOVA test was performed to compare the average value of peripheral inflammatory marker according to the history of suicide attempt with gender and age as covariates. One-way variance analysis was performed to determine whether the number of suicide attempt causes significant difference of the peripheral inflammatory marker. Results : The final analysis target of this study was 266 patients, 101 had history of suicide attempt, and 165 had no history of suicide attempt. The neutrophil-to-lymphocyte ratio (p<0.001) and platelet-to-lymphocyte ratio (p<0.001) were higher in patients with the history of suicide attempt than patients without the history of suicide attempt, but the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were not significantly increased depending on the serial increase of number of suicide attempts. Conclusions : This study suggests that peripheral inflammatory markers are meaningful and easily accessible indicators for predicting the risk of suicide attempt in psychiatric patients. We expect that prospective follow-up study will be conducted with more subjects and controlled potential confounding variables.

Cause Analysis on Dry of stream flow for the Ui-Cheon (우이천의 건천화 원인분석)

  • Yi, Choong Sung;Choi, Seung An;Kim, Hung Soo;Shim, Myung Pil
    • Proceedings of the Korea Water Resources Association Conference
    • /
    • 2004.05b
    • /
    • pp.753-758
    • /
    • 2004
  • 건천화란 하천이 건천이 되어가는 과정이라고 할 수 있다. 그러나 이의 정량적 접근이 어려운 이유는 건천이 되어가는 과정에 대한 현상을 지속적으로 관찰하기 어렵고, 순수한 자연현상이라기보다 인위적 요소가 간섭한 결과이기 때문이다. 본 연구는 건천이 되어가는 하천 중에서도 도시화에 의한 건천화의 영향이 큰 것으로 보이는 우이천 유역에 대해 건천화의 원인을 분석하여 몇 가지 결론과 대책을 제시하였다. 우이천은 유역면적 $27.67km^2$, 유로연장 11.75km의 비교적 좁은 면적 내에 인구 461,351명이 거주하고 주변 행정구역 총 인구가 604,282명인 지방2급하천이다. 유역 내 북부와 북서부의 산악지역을 통과하는 상류는 대부분 계류(溪流)로서 자연상태를 유지하고 있으나, 중${\cdot}$하류는 양안의 셋방, 복개, 직강화, 보 및 낙차공 등 인공구조물로 인해 하천형상이 크게 왜곡되어 있는 전형적인 도시하천유역이다. 본 연구는 우이천에 대한 건천화 원인분석을 위해 크게 4가지 방봅으로 접근하였는데 반분포형 유출모형인 TOPMODEL에 의한 장기유출분석, 수문${\cdot}$기상자료에 의한 분석, 인문${\cdot}$사회자료의 분석, 지하수위 분석 등이었다. 분석결과 우이천 유역과 같이 장기간에 걸쳐 도시화가 진행된 유역은 수문순환계의 왜곡이 돌이킬 수 없는 수준이므로, 적절한 건천화 방지대책의 방향은 건천화의 원인이 되는 인자를 제거함으로써 줄어든 유량을 회복하는 방안보다는 인위적이고 강제적인 방식으로 추가적인 하천수량을 확보하는 것이 타당하다 사료된다. 하천의 건천화는 하나의 주된 원인이 지배적일 수도 있지만 간접적인 영향이 많고, 하나의 원인이 다른 인자에 영향을 주어 연쇄적인 영향을 미칠 수도 있는 복잡한 현상이다. 따라서 다양한 각도에서 다양할 접근방식으로 방지대책을 수립하여야 할 것이다.적에 따른 임계지속기간과 유출량의 변화를 검토해 보았다.이를 각각의 경우의 해석해 결과와 비교${\cdot}$분석하였다. 후방추적 퍼프모형은 전방추적 퍼프모형에 비하여 사용된 퍼프수와 관계없이 작은 오차를 발생하였으며, 전체적으로 퍼프 모형이 입자모형보다는 훨씬 적은 수의 계산을 통해서도 작은 오차를 나타낼 수 있다는 것을 알 수 있었다. 그러나 Gaussian 분포를 갖는 퍼프모형은 전단흐름에서의 긴 유선형 농도분포를 모의할 수 없었고, 이에 관한 오차는 전단계수가 증가함에 따라 비선형적으로 증가하였다. 향후, 보다 다양한 흐름영역에서 장${\cdot}$단점 분석 및 오차해석을 수행한 후에 각각의 Lagrangian 모형의 장점만을 갖는 모형결합 방법을 제시할 수 있을 것으로 판단된다.mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carria

  • PDF

Synergistic Inhibition of Burkitt's Lymphoma with Combined Ibrutinib and Lapatinib Treatment (Ibrutinib과 Lapatinib 병용 치료에 의한 버킷림프종의 상호 작용적 억제)

  • Chae-Eun YANG;Se Been KIM;Yurim JEONG;Jung-Yeon LIM
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.55 no.4
    • /
    • pp.298-305
    • /
    • 2023
  • Burkitt's lymphoma is a distinct subtype of non-Hodgkin's lymphoma originating from B-cells that is notorious for its aggressive growth and association with immune system impairments, potentially resulting in rapid and fatal outcomes if not addressed promptly. Optimizing the use of Food and Drug Administration-approved medications, such as combining known safe drugs, can lead to time and cost savings. This method holds promise in accelerating the progress of novel treatments, ultimately facilitating swifter access for patients. This study explores the potential of a dual-targeted therapeutic strategy, combining the bruton tyrosine kinase-targeting drug Ibrutinib and the epidermal growth factor receptor/human epidermal growth factor receptor-2-targeting drug Lapatinib. Ramos and Daudi cell lines, well-established models of Burkitt's lymphoma, were used to examine the impact of this combination therapy. The combination of Ibrutinib and Lapatinib inhibited cell proliferation more than using each drug individually. A combination treatment induced apoptosis and caused cell cycle arrest at the S and G2/M phases. This approach is multifaceted in its benefits. It enhances the efficiency of the drug development timeline and maximizes the utility of currently available resources, ensuring a more streamlined and resource-effective research process.

Diagnostic Approach to the Solitary Pulmonary Nodule : Reappraisal of the Traditional Clinical Parameters for Differentiating Malignant Nodule from Benign Nodule (고립성 폐결절에 대한 진단적 접근 : 악성결절과 양성결절의 감별 지표에 대한 재검토)

  • Kho, Won Jung;Kim, Cheol Hyeon;Jang, Seung Hun;Lee, Jae Ho;Yoo, Chul Gyu;Chung, Hee Soon;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.43 no.4
    • /
    • pp.500-518
    • /
    • 1996
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

  • PDF

Experience of Life-sustaining Treatment in Patient Care among Intensive Care Unit Nurses: Phenomenological Approach (중환자실 간호사의 연명치료환자 간호 경험: 현상학적 접근)

  • Lee, Su Jeong;Kim, Hye Young
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.23 no.2
    • /
    • pp.172-183
    • /
    • 2016
  • Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.

Performance Improvement of IEEE 802.15.4 MAC For WBAN Environments in Medical (의료 WBAN 환경을 위한 IEEE 802.15.4 MAC 성능 개선)

  • Lee, Jung-Jae;Hong, Jae-Hee
    • The Journal of the Korea institute of electronic communication sciences
    • /
    • v.10 no.1
    • /
    • pp.103-110
    • /
    • 2015
  • WBAN(Wireless Body Area Network) is a Wireless Sensor Network for supporting various applications around body within 2~3m which consists of medical and non-medical device. MAC in WBAN environment should satisfy requirements such as low power consumption, various transmission rate, QoS, and duty-cycle, efficiently distribute frequency band, be strong at traffic load and save energy. This paper proposes AQ(Adaptive Queuing) MAC superframe structure for efficient energy use, considering the increase of traffic load. The simulation result also show that transmission rate and average MAC delay rate is improved comparing IEEE 802.15.4 MAC with AQ MAC.

Surgery-First Orthodontic Approach for the patients (환자를 위한 선수술 교정 접근 방법)

  • Kook, Minsuk
    • The Journal of the Korean dental association
    • /
    • v.55 no.4
    • /
    • pp.296-302
    • /
    • 2017
  • The traditional orthognathic surgery treatment consists of three steps: preoperative orthodontic treatment, orthognathic surgery, and postoperative orthodontic treatment, and the average treatment period is usually two years. Also, patients with Class III malocclusion should spend more time getting their facial features worse during the decompensation process. However, most of the patients who want orthognathic surgery visit the chief complaints of appearance improvement, and resolve this address as soon as possible. The concept of $^{\circ}{\AE}$Surgery - First 'does not cause a facial imbalance caused by decompensation for the pre - operative correction period, and the patient can obtain an improved facial profile immediately after the operation. In addition, the correction period is shortened by Regional Acceleratory Phenomenon (RAP) after surgery. However, it is not applicable to all patients. Patients with severe crowding, severe curve of spee or reverse curve of spee, severe transverse discrepancy of the maxilla and mandibular arch, and severe incisal angles are less likely to apply the technique. Although it is not yet possible to apply this technique to all patients, it has many advantages over the conventional method. Especially, the patients' preference is increasing due to the rapid appearance improvement and the shortening of the total treatment period.

  • PDF

Tricuspid Replacement through Right Thoracotomy in Reoperation - A case report - (재수술 시 우측 개흉을 통한 삼첨판막 치환술 -1예 보고)

  • Kim Hyuck;Han San Woong;Chung Won Sang;Kang Jung Ho;Chon Soon Ho;Lee Chul Bum;Kim Young Hak
    • Journal of Chest Surgery
    • /
    • v.38 no.10 s.255
    • /
    • pp.714-716
    • /
    • 2005
  • In an extremely enlarged right heart, the repeated midline sternotomy was considered to involve the risk of massive hemorrhage. A right thoracotomy provides a convenient and safe way to approach the tricuspid valve in patient who have had previous heart surgery through a midline sternotomy.

A New Method of Approach for Percutaneous Thoracic Vertebroplasty in Vertebral Compression Fracture -Case report- (흉추 압박골절환자를 위한 경피적 척추성형술의 새로운 접근법 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
    • /
    • v.13 no.2
    • /
    • pp.237-241
    • /
    • 2000
  • Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

  • PDF

Development of Education Courseware for Clinical Care Classification System based PC and Smartphone (PC와 스마트 폰 기반 임상간호분류체계 교육 코스웨어 개발)

  • Hong, Hae-Sook;Lee, In-Keun;Cho, Hune;Kim, Hwa-Sun
    • Journal of Internet Computing and Services
    • /
    • v.12 no.3
    • /
    • pp.49-56
    • /
    • 2011
  • It is urgently needed to develop programs supporting lifelong education for nurses and students of nursing, which are not restricted by time or space and use personal computers or smartphone. The purpose of this study is to develop CCC(Clinical Care Classification) System into a education program and provides guideline to support clinical tasks for students of nursing. Comparing the search times of the book guideline and the web guideline developed, this study found that it was over 3.5 times faster. And its error rate was over four times lower. This result shows that it can provide accurate intervention for patients since it approaches to intervention and evaluation guideline fast and precisely in the actual tasks of nursing.