• Title/Summary/Keyword: 환자의 편의성

Search Result 235, Processing Time 0.033 seconds

The Use of Greater Saphenous Vein In Situ Graft in Arterial Occlusive Disease of Lower Extremity (하지동맥 폐쇄성 질환에서 자가 대복재정맥 정위 이식편의 이용)

  • Shin Yong-Chul;Kim Mi-Jung;Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Kim Byung-Yul
    • Journal of Chest Surgery
    • /
    • v.39 no.6 s.263
    • /
    • pp.456-461
    • /
    • 2006
  • Background: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. Material and Method: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. Result: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. Conclusion: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.

Review of the Research in China on Music Interventions for Adult Patients With Brain Injuries (중국 내 성인 뇌손상 환자 대상 음악중재 연구 고찰)

  • Yu, Huiyan
    • Journal of Music and Human Behavior
    • /
    • v.18 no.2
    • /
    • pp.67-85
    • /
    • 2021
  • This study reviewed the research in China on music interventions for adult brain injury patients. Eighty-three studies that met the inclusion criteria were included for analysis. Our review revealed that the number of intervention studies using music with adult brain injury patients has been on the rise since 2012, and random control research design methods have been dominant. Studies focused on the physical domain and emotional domain together were most common. Researchers in fields outside of music therapy conducted 43 of the studies, and music therapists carried out 14 of the studies as intervention providers. Most of the studies carried out by experts in fields other than music therapy used listening activities involving preexisting recorded music. However, most of the studies conducted by music therapists adopted reconstructed music and played it live during their intervention. The specificity of the described content of the interventions and level and relevance of stated rationale to the target goal of the intervention suggests that high quality of intervention was conducted with a therapist/investigator who has completed adequate professional education/training, which would emphasize the importance of music therapy professionalism. This study provides the baseline data for how music intervention research has been implemented in China and presents implications for future clinical practice and research.

The Clinical Outcomes of Off-Pump Coronary Artery Bypass Grafting in the Octogenarians (80세 이상 고령 환자에서 심폐바이패스 없이 시행한 관상동맥우회술의 중단기 성적)

  • Kim Do-Kyun;Lee Chang Young;Lee Kyo Joon;Joo Hyun Chul;Yoo Kyung-Jong
    • Journal of Chest Surgery
    • /
    • v.38 no.10 s.255
    • /
    • pp.680-684
    • /
    • 2005
  • Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

A Study about the efficient Control against the sexual violence in medical area (의사의 성범죄에 대한 최근 의료법 개정법률안 검토)

  • Jeong, Baekeun
    • The Korean Society of Law and Medicine
    • /
    • v.20 no.2
    • /
    • pp.207-229
    • /
    • 2019
  • It is a general recognition that more serious criminal acts in a certain area of society should be given more serious condemation than the same general crimnal act. In particular, considering the purpose of the medical treatment and the trust relationship between the doctor and the patient, the sexual violence by doctor in medical field can not be placed on the same line as that of the general public. But the special legislation to solve this through criminal legal sanctions is not desirable. The basic principle of criminal law ist ultima ratio, so the principle of supplementality. It means to try to solve by all possible means and finally to enter with punishment. A flat and hasty Reaction without the considering of the speciality of medical treatment will cause serious cracking in that area. In addition, it will not be able to expect desirable results in legal practice by breaking down the legal system. Rather, administrative regulation is more efficient than punishment sanctions. But the best way is autonomous control by members of the medical area. Penalties in criminal law must make an enterance at the last, and administrative regulation should be timely intervene in specific situations through diversification. In conclusion, state interventions should be farthest in order to proceed to autonomous control of medical area.

Endoscopic Radial Artery Harvest: Techniques & Results (내시경을 이용한 요골동맥 수확법의 수술 방법과 결과)

  • Jeong, Young-Kyun;Lee, Jong-Tae;Cho, Jun-Yong;Kim, Kyu-Tae;Chang, Bong-Hyun
    • Journal of Chest Surgery
    • /
    • v.39 no.1 s.258
    • /
    • pp.35-41
    • /
    • 2006
  • Background: The radial arteries are being used more often for coronary artery bypass grafting, We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. Material and Method: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. Result: The 23 patients complained of neuralgias on territory of superficial raidal none but no one complained of neuralgias on territory of lateral antebrachial cutaneous none. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9$\pm$3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. Conclusion: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

Is Skeletonized Internal Mammary Artery Harvesting better than Pedicled Harvesting in Respect of the Sternal Blood Flow\ulcorner: An Estimation Using Bone Scan (내유동맥의 골격화 채취는 흉골로의 혈류 감소 측면에서 과연 유리한가 \ulcorner: 골주사를 이용한 평가)

  • 손국희;김영삼;김정택;윤용한;김광호;최원식;백완기
    • Journal of Chest Surgery
    • /
    • v.37 no.6
    • /
    • pp.511-516
    • /
    • 2004
  • Background: One of the theoretical advantages of skeletonized internal mammary artery harvesting in coronary artery bypass surgery is to minimize the interruption of the sternal blood flow inevitably accompanied by internal mammary harvesting. A study using bone scan is designed to determine the effects of internal mammary artery harvesting technique on the sternal blood flow. Material and Method: From April 2002 to March 2003, 27 patients out of 48 patients who underwent the isolated coronary bypass surgery were enrolled into the study. The enrolled patients underwent bone scan in the preoperative period and postoperative period respectively. Bilateral internal mammary artery was used in 8 patients (BIMA group) and single left internal mammary artery in 19 patients (LIMA group). The patients in LIMA group were divided into two groups: LlMA_skel group, in whom left internal mammary artery was harvested in skeletonized fashion (n=12), and LlMA_ped group, in whom left internal mammary artery was harvested in pedicled fashion (n=7). After the bone scan, the region of interest (ROI) was created on the left of the sternum and the mirror image with the same pixel numbers was placed on the right half of the sternum. The mean counts per pixel on the left side of the sternum was compared with those on the right side and expressed as left to right ratio (L/R ratio). Result: In LIMA group, the L/R ratio decreased from 94.6$\pm$4.1% to 87.9$\pm$6.9% (p=0.003) after the operation as compared to BIMA group, in which no change of the L/R ratio was observed. The changed of the L/R ratio in LlMA_skel group and LlMA_ped group were from 95.3$\pm$4.2% to 88.3$\pm$7.7% and from 93.4$\pm$3.9% to 87.4$\pm$5.8% respectively. The % changes in L/R ratio were -7.44 $\pm$7.08 in LIMA_skel group and -6.17$\pm$9.08 in LiMA_ped group, which did not reach the statistical difference. Conclusion: Ipsilateral sternal blood flow is interrupted by internal mammary artery harvesting as evidenced by the decrease in L/R ratio after left internal mammary artery harvesting irrespective of the harvesting techniques. Skeletonized harvesting did not show superiority in respect to sternal blood flow as compared to pedicled harvesting.

A case of idiopathic pulmonary hemosiderosis with seasonal recurrence (계절성으로 재발한 특발성 폐 혈철 침착증 1예)

  • Kwak, Ga Young;Lee, Na Young;Lee, Moon Hee;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.2
    • /
    • pp.256-260
    • /
    • 2009
  • Idiopathic pulmonary hemosiderosis (IPH) is a rare disease affecting mostly children. This disorder is characterized by recurrent episodes of hemoptysis, bilateral diffuse pulmonary infiltrates, and iron-deficiency anemia. An acute fulminant alveolar hemorrhage can be fatal due to respiratory failure, while chronic hemorrhage leads to hemosiderin-laden macrophages and pulmonary fibrosis. Genetic, autoimmune, allergic, environmental, and metabolic mechanisms of pathogenesis have been suggested, but the etiology of IPH remains unknown. We report on a 9-year-old girl with idiopathic pulmonary hemosiderosis who showed seasonal recurrences without cause.

Convergence Effects of Treadmill Training on Plantar Pressure, Lower Limb Muscle Function, and Balance in Chronic Stroke : A Meta-Analysis (만성 뇌졸중 환자의 트레드밀 훈련이 족저압, 하지 근 기능, 균형에 미치는 융복합적 효과 : 메타분석)

  • Choi, Ki-Bok;Cho, Sung-Hyoun
    • Journal of the Korea Convergence Society
    • /
    • v.11 no.5
    • /
    • pp.87-96
    • /
    • 2020
  • The purpose of this study is to evaluate the convergence effectiveness of treadmill training in patients with chronic stroke through a meta-analysis. After searching the literature based on the patients, intervention, comparison, outcome criteria, and study desigan, a total of 22 studies related to "stroke" and "treadmill" were eligible for inclusion. Effect size was calculated using the comprehensive meta-analysis program for the meta-analysis. Based on the forest plot results, the overall effect size of treadmill training was 0.661 (95% confidence interval: 0.456-0.865), which was statistically significant with a medium effect size (p < 0.05). The effects of treadmill training on patients with stroke were separated by dependent variables of interest-plantar pressure (1.147), lower limb muscle function (0.875), and balance (0.664). The effect sizes were evaluated for the subdomains of timed up and go test (0.553), Berg Balance Scale (0.760), and static balance index (0.654) for balance. Therefore, treadmill training can be expected to have a positive impact on improving the quality of life of patients with chronic stroke. This meta-analysis of treadmill training may the lead to an industry paradigm shift toward healthcare convergence of information, communication, and medical technology.

Cognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis (만성 일차성 불면증 환자에게 적용한 인지행동중재의 효과: 메타분석)

  • Kim, Ji-Hyun;Oh, Pok-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.9
    • /
    • pp.407-421
    • /
    • 2016
  • This paper reports a meta-analysis of sixteen studies that evaluated the efficacy of cognitive behavioral therapy (CBT) for persistent primary insomnia. PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched between January 2015 and June 2015. The main search strategy involved the terms that indicate CBT-I (Cognitive Behavioral Therapy-Insomnia) and presence of insomnia. Methodological quality was assessed using Cochrane's Risk of Bias. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Sixteen clinical trials met the inclusion criteria, resulting in a total of 1503 participants. Stimulus control, sleep restriction, sleep hygiene education, and cognitive restructuring were the main treatment components. CBT-I was conducted for a mean of 5.4 weeks, 5.5 sessions, and an average of 90 minutes per session. The effects of CBT-i on total sleep time (d=-0.31), sleep onset latency (d=-0.29), awakening time after sleep onset (d=-0.55), sleep efficiency (d=-0.70), insomnia severity (d=-0.77) and sleep belief (d=-0.64) were significant. Overall, we found a range from small to moderate effect size. CBT-I also was effective for anxiety (d=-0.30) and depression (d=-0.35). The findings demonstrate that CBT-I interventions will lead to the improvement of both sleep quality and quantity in patients with insomnia.

A Study on Wearing Tests of Mastectomy Brassieres with Prostheses (유방절제환자를 위한 보정용 브래지어와 부속물 착장실험연구(III))

  • Hei-Sun Choi;Kyung Mi Lee
    • Journal of the Korean Home Economics Association
    • /
    • v.40 no.8
    • /
    • pp.13-21
    • /
    • 2002
  • 본 연구의 목적은 유방절제수술을 받은 여성들을 위해 개발한 다섯 종류의 브래지어와 두 종류의 보정물 유형에 따른 착용감과 쾌적성을 검토하기 위한 것이다. 피험자로는 유방절제시술기간이 3년 이상이며 브래지어 사이즈 85에 컵사이즈 A컵인 여성 세 명을 선정하였다. 실험방법은 보정물을 삽입한 브래지어를 하루에 최소 15시간 이상 연속착용하도록 하고 실험복을 착용한 상태에서 피험자들의 일상과 그에 소요된 시간을 기록하도록 하였으며 이 때 착용한 브래지어와 보정물에 대한 느낌을 5점 척도로 표시하게 하였다. 실험기간은 다섯 종류의 브래지어를 하루에 한 가지씩 정해진 순서대로, 처음 5일은 옥보정물과 함께 착용하도록 하고 그 후 5일은 스펀지 보정물과 함께 착용하도록 하였으며 이러한 순서를 두 번 반복하게 하여 총 20일이 소요되었다. 각각의 피험자들에 대해서는 실험이 진행되는 동안 반복적인 면접을 통하여 진행상황을 기록하였으며 아울러 실험복에 대한 제언을 수렴하여 보다 나은 제품개발을 위한 기본 자료화하였다. 실험결과는 다음과 같다. 1. 브래지어에 있어서는 세 명의 피험자가 일치된 결과를 나타내어 일반적인 브래지어 형태와 가장 유사하면서 어깨 끈과 하변밴드 폭만 약간 넓혀준 실험복이 착용감에서 가장 높은 점수를 받았다. 착용자의 편의를 고려하여 앞트임으로 제작한 실험복의 경우에는 앞으로 구부렸을 때 밴드부분이 꺾이는 현상이 생겼으며 피험자들이 모두 뒤트임에 익숙하여 앞트임 브래지어 착용에 불편함을 나타내었다. 브래지어 착장평가에 있어서는 피험자들의 일상적인 행동이나 보정물의 종류가 영향을 미치지 않는 것으로 나타났다 2. 보정물 평가에 있어서는 모든 피험자가 옥가루 재질의 보정물만으로는 수술부위를 자극하는 느낌이 든다고 하였으나 3mm 두께의 스펀지와 함께 삽입했을 때는 아무런 문제가 없는 것으로 나타났다. 또한 보정물의 무게 조절이 가능하므로 실리콘재질의 보정물에서 쉽게 찾아볼 수 있는 무게에 대한 문제를 제기한 피험자는 없었다. 그러나 스펀지로 제작된 보정물에 대해서는 무게가 너무 가벼워 모든 피험자들이 양 쪽 가슴의 균형이 잘 맞지 않는다고 답하였으며 특히, 운동을 즐기고 활동이 많은 피험자의 경우 스펀지로 제작된 보정물에 대해 큰불만을 표시하였다.