• Title/Summary/Keyword: 환자 선별

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Study on Relationship Between Intima Medial Thickness and the Plaque in Stroke Patients on Carotid Artery Sonography (뇌경색 환자에서 초음파로 측정한 경동맥 내막-중막두께와 죽상경화반의 관련성에 대한 연구)

  • Lee, Mi-Hwa;Kwon, Duk-Mun;Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.161-168
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    • 2009
  • The carotid intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and is the only non-invasive test that is currently recommended by the American Heart Association for evaluation of the risk. However, use of this parameter has a limitation because it assumes uniform thickness throughout the blood vessel, whereas atherosclerosis is a focal phenomenon that is confined to intima. In fact, plaque can be found along the atherosclerotic blood vessels even though its value is unknown. The aim of this study is to analyze the carotid plaque and IMT in the stroke patients. We investigated the patients with ischemic stroke, who were admitted to the department of neurology at the Stroke Special Hospital from January to March 2008. After the carotid IMT and plaque were assessed by B-mode ultrasonography, IMT and carotid plaque to risk variables (age, sex) were analyzed. The distribution of CCA IMT was significantly different in terms of age (p = 0.004). Likewise, the distribution of carotid plaque was also significantly different in terms of age (p = 0.006). Carotid plaque was 69 and 92% in normal and abnormal CCA IMTs respectively. The results showed that the CCA IMT was closely associated with carotid plaque.

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Healing Landscape Design for Hospital Outdoor Space - A Case of the Kyeongsang National University Hospital in Changwon - (치유경관의 개념을 적용한 병원 옥외공간 조경설계 - 창원 경상대학교 병원을 사례로 -)

  • Min, Byoung-Wook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.1
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    • pp.82-92
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    • 2013
  • This paper presents a landscape design proposal for the Kyeongsang National University Hospital in Changwon, Kyeongsangnam-do. The site is located at 555 Samjeongja-dong, Seongsan-gu, Changwon, Kyeongsangnam-do, and its area is approximately $79,743.1m^2$. The goal of the design was to create a landscape that helps the patients' recovery and public well-being as well as respects the surrounding environment. In order to achieve this goal, three design subjects were considered: maximizing the healing functions of the landscape, promoting ecologically regenerative landscape, and increasing the aesthetic value of the landscape based on the local context. For the healing aspect, first, therapeutic plants were carefully selected and various healing programs were introduced to the open space area such as the sensory garden, meditative space, the medicinal herb garden, outdoor acupressure treatment facilities, remedial playground etc. In addition, as the importance of patient's privacy is emphasized in research, the space and circulation patterns were divided according to the characteristics of the users. For ecological consideration, the design proposed to preserve and extend the existing ridgeline with pine forest, and recover the natural water system and recycle the water for the landscape management. For the aesthetic experience of the people, in contrast to the surrounding evergreen forest, diverse deciduous and flowering plants were introduced to arouse a sense of the season, and fruit bearing trees for wildlife to create a specific mood of being in nature so that people can listen to the songs of the birds and watch squirrels play etc. In addition, all the spaces and facilities were designed and placed according to universal design principles so that there would be no barrier for the patients to use them. Also, a sustainable management scheme was suggested to maintain the landscape in ecological and economical ways.

Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

Manifestation of Cognitive Function in Geriatric Patient with Subjective Memory Complaint (주관적 기억력 저하를 호소하는 노인 환자의 인지기능 양상)

  • Park, Han-Kyul;Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bai, Dai-Seg
    • Journal of Yeungnam Medical Science
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    • v.27 no.1
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    • pp.27-36
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    • 2010
  • Purpose : The purpose of this study was to find out cognitive function of the patients with subjective memory complaint. Material and Methods : From March 1st 2005 to May 31st 2009, 155 normal individuals without any medical illness who visited Yeungnam University Hospital to undergo medical checkup with neurocognitive test was enrolled, and checked by using Cognitive Assessment & Reference Diagnostic System. Results : 107 of the patients had normal cognitive function, 21 patients (about 15%) were diagnosed with dementia, and 10 patients (about 7%) were diagnosed with considerable psychiatric illness, such as depression, anxiety disorder, adjustment disorder. In amnesia, agnosia, aphasia, attention, calculation, dysexecution, Dementia group and Psychiatric illness group has worse score than Normal individuals group. But, in apraxia, Dementia group has worse score than Psychiatric illness group and Normal individual group. Conclusion : Because the patients with subjective memory complaint can be diagnosed as any psychiatric illness as well as dementia, sensitive screening test and early psychiatric approach is needed.

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Factors affecting Diabetic Eye disease and Kidney disease Screening in Diabetic Patients (당뇨병 환자의 당뇨성 안질환 및 신장질환 합병증 검사 수검 여부에 영향을 주는 요인)

  • Kang, Jeong-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.226-235
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    • 2020
  • This study was undertaken to investigate factors that affect the assessment of complications in diabetic eye and kidney diseases. Data was obtained from the National Community Health Survey, 2017. The subjects included were 25,829 respondents who had been diagnosed with diabetes. Logistic regression analysis was applied to determine the factors affecting associated diabetic eye disease (fundus examination) and kidney disease (microalbuminuria examination) complications. The diabetic eye disease complication rate was 35.6%, and diabetic kidney disease complication rate was 39.8%. Complications arising due to diabetes were determined to be 35.6% for eye diseases and 39.8% for kidney related diseases. Ed. Notes: The original sentence is not very lucid. I have suggested an alternate edit. I leave it to the author's discretion to accept or reject the same. Please delete whichever sentence is not suitable. Walking activity (OR=1.03, OR=1.02), hemoglobin A1c (HbA1c) recognition (OR=2.33, OR=2.33), blood glucose level recognition (OR=1.61, OR=1.71), diabetes drug therapy (OR=2.67, OR=3.05), and diabetic management education (OR=1.45, OR=1.47) were more likely to be evaluated for eye and kidney disease complications. Our results indicate that to increase the rate of screening for diabetic complications, it is necessary to develop a diabetes management system that includes the type and timing of diabetic complications, as well as different promotional methods that recognize HbA1C and blood glucose levels. Ed. Notes: Do you mean 'screening' methods? Please revise appropriately, if required. In addition, it is essential to develop a guideline for the management of diabetes mellitus, and to incorporate a screening test for diabetic complications in the national screening system.

Knowledge and Education Needs Related to Multidrug Resistant Organisms Infection Control among Small and Medium Size Hospital (중소병원 간호사의 다제내성균 감염관리 지식 및 교육요구도)

  • Lee, Mi Hyang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.463-470
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    • 2020
  • This study was conducted to aid in the development of an infection control educational program for nurses, by assessing the knowledge and educational demand of nurses for MDRO infection control. Totally, 115 nurses participated in the study. Data were collected from November 15-30, 2019, using structured questionnaires. Descriptive statistics, t-test, and ANOVA were applied for analyzing the data. Experience of caring for MDRO patients was reported by 86.1% nurses, whereas 67.8% nurses had received training on MDROs. The average score for knowledge on MDROs was 25.51 out of 27 points, with minimal correct answers given for the query on level of disinfection for medical equipment used by patients, criteria for the preemptive precaution, patient management in the cohort, and timing for removing personal protective equipment. The educational demand was highest for assignment to the precaution, criteria for screening examination, and management of outbreak. Also, educational needs differed with respect to the general educational characteristics and position of the individual. We propose the need to differentiate the educational status according to the career when developing the MDROs program, and the necessity to execute education of MDROs for new nurses and career nurses.

Characteristics of Pain Threshold and Pain Experience in Elderly Patients with Dementia (노인 치매 환자의 통증 역치 및 통증 경험의 특성)

  • Bang, Hyeon-Cheol;Park, Ki-Chang;Kim, Min-Hyuk;Lee, Yeong-Bok;Roh, Hyun-Jean
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.140-146
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    • 2013
  • Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

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Changes of Microembolic Signals after Heart Valve Surgery (심장 판막 수술 후 미세색전의 변화)

  • 조수진;이은일;백만종;오삼세;나찬영
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.316-320
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    • 2003
  • Background: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). Material and Method: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were peformed from middle cerebral artery for 1-hour, before and after HVS. Result: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). Conclusion: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk or embolism after Hvs.

Effect of tDCS Stimulation for Improving Working Memory on Stroke Patients' EEG Variation (작업기억의 향상을 위한 tDCS 자극이 뇌졸중 환자의 뇌파변화에 미치는 영향)

  • Bae, Si-Jeol;Jeong, Woo-Sik;Lee, Hong-Gyun;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.261-272
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    • 2012
  • This study was conducted so as to examine which change tDCS (Transcranial Direct Current Stimulation) for improving working memory can make on the EEC of stroke patients. Among the patients who suffered for more than 6 months by hemiparalysis caused by stroke, 20 patients selected by MMSE and DST were randomly divided into I group (10 patients) fulfilled by only CCT and II group (10 patients) fulfilled by both tDCS and CCT for total 4 weeks, 30 minutes per a day, three times per a week. For examining EEC variation, the absolute spectrum power was calculated by three bands (${\theta}$; 4~8 Hz, lower ${\alpha}$; 8~10.5 Hz, upper ${\alpha}$;10.5~13 Hz) during the task of words, photos and mental calculation with EEC test, before the arbitration, after 2 weeks and after 4 weeks, so the rate of increase and decrease (%) for the reference EEC was obtained. As the results, the first, particular aspects different one another in three bands were detected according to the measuring period and task. The second, in the forth week, there was only a significant difference in lower ${\alpha}$-power of all tasks. Therefore, through the procedure measuring EEC of this study, the degree of working memory's damage can be expressed by numerical value and tDCS should be additionally helpful for brain damaged patients' perception rehabilitation.

The Effects of Orofacial Training Video Program using Smart Device on Oral Cavity Structure and Function, Diadochokinetic Rate in Acute Stroke Patients with Dysarthria (스마트 기기를 활용한 구강안면 훈련 영상 프로그램이 마비말장애가 있는 급성 뇌졸중 환자의 구강 구조 및 기능과 조음교대운동속도에 미치는 효과)

  • Moon, Jong-Hoon;Won, Young-Sik
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.2
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    • pp.391-400
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    • 2017
  • The purpose of this study was investigated the effect of orofacial training video program using smart device on oral cavity structure and function, diadochokinetic rate in acute stroke patients with dysarthria. Present study participated in fourteen acute stroke patients with dysarthria. All subjects assigned that randomized each seven patients in experimental and control group. Subjects of two groups received conventional rehabilitation therapy for 4 weeks. Experimental group performed additionally that orofacial training video program using smart device, supervised under caregivers, during 30 min/day. The outcome measures were the oral cavity structure and function of subscale for KOMSE(: Korean Oro-motor Mechanism Screening Examination), AMR(: Alternating Motion Rate), SMR(: Sequential Motion Rate). In results, Both group showed significant improvements after intervention in all assessments(p<.05). In comparison of change between two groups, experimental group showed significant improvements than control group in oral cavity function, /p ə/ and /tə/ of AMR(p<.05). We suggested that orofacial training video program using smart device expected to positive effects the improvements of oral cavity and articulator function in acute stroke patients with dysarthria.