• Title/Summary/Keyword: 환자 선별

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Management of Elderly Patients with Spinal Disease: Interventional Nonsurgical Treatment (고령 척추 질환자의 치료: 중재적 비수술 치료)

  • Park, Soo-An
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.9-17
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    • 2019
  • Owing to the upward shift in age structure, there is an increasing number of spinal diseases specific to elderly patients. Elderly spinal patients typically have a poor general condition with several medical comorbidities, low bone mineral density, more extensive and severe degeneration, and less effective treatment outcomes than young patients. This is why spinal physicians need to establish interventional nonsurgical treatment modalities for elderly patients with spinal disease. The objective of this study was to define the spinal disorders problematic to elderly patients and discuss the nonsurgical treatments for each subject.

The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal of Rehabilitation Patient (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myo-Young;Choi, Nam-Gil;Han, Jae-Bok
    • Proceedings of the Korea Contents Association Conference
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    • 2014.11a
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    • pp.189-190
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    • 2014
  • 뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

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Hospital Selection Factors of Patients with Mild Cognitive Impairment (경도 인지장애 환자의 병원선택 요인)

  • Park, Jin-Ju;Oh, Myung-Hwa;Kim, Seung-Il;Kim, Hye-Mi
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.441-448
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    • 2019
  • The purpose of this is to investigate the factors of hospital selection in patients with mild cognitive impairment and to provide information to clinicians and medical institutions in preparation for the ongoing admission of patients with mild cognitive impairment. This study was carried out on 36 participants who agreed to participate in the study from May 1st, 2018 to September 30th, 2018. Data collection was performed using K-MMSE and hospital selection factor tool was modified and supplemented according to the study. The results of this study suggest that the distance from the residence or work place shall be closer to that of the hospital, with the easy of transportation, easy administrative procedure, hospital reputation, new services, service or physical therapy and occupation therapy(p <.05). The conclusion of this study is to inform the clinician about the selection factors of patients with mild cognitive impairment and change the marketing strategy of medical institutions prepare to mild cognitive impairment

A Clinical Analysis of 24 cases of Cardiac Contusion and Cardiac Concussion (둔상에 의한 심타박상과 심좌상의 임상적 고찰)

  • 이계선;정진악;금동윤;안정태;이재원;신제균
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.270-275
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    • 1999
  • Background: In the patients with thoracic injury, we suspect simultaneous cardiac contusion or concussion. We analyzed the patients with possible cardiac injury by electrocardiography, serum creatine kinase (CK), creatine kinase isoenzyme fraction (CK-MB) screening, followed by two dimentional echocardiogram (2-DE) to access the severity of injury. Material and Method: From January 1997 to April 1998, 15-month retrospective study of suspicious myocardial injury was undertaken in including 24 patients admitted for suspected cardiac injury. All patients with history or signs of blunt chest injury were checked serially and the serial CK, CK-MB fraction, electrocardiography (EKG) analysis screening were followed by 2-DE. Result: The age range was between 20-40 years and were predominant male patients in(M:F=3:1). Most common causes of injury were traffic accidents, 15 patients(62.5%). Associated injuries involved multiple rib fractures, sternal fracture and such. EKG findings on the cardiac concussion were within normal limits, EKG findings on the cardiac contusion were nonspecific ST and T wave abnormality. In cardiac contusion patients, CK-MB fraction did not increase significantly on admission but on 2nd, 3rd, 4th hospital days, it increased significantly (p=0.0080, 0.0130, 0.0130). The average admission days were 9.22 in concussion and 26.18 in contusion patients(p=0.0075). Most common complication was the adult respiratory distress syndrome(7 cases), 5 out of the patients with ARDS were mechanically ventilated. There were no deaths. Conclusion: We believe the serial checks of CK-MB, EKG and subsquent two-dementional echocardiographic sector scanning are presently the most sensitive indicators available for structural and functional cardiac injury.

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Genetic analysis of Campylobacter jejuni isolates from diarrhea patients in Gyeonggi-do (경기도에서 분리된 Campylobacter jejuni의 유전자 패턴 분석 연구)

  • Kim, Woon-Ho;Choi, Ok-Kyung;Jeong, Jin-A;Park, Sung-Hee;Lee, Yea-Eun;Park, Gwang-Hee;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.54 no.1
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    • pp.31-37
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    • 2018
  • Campylobacter jejuni is an important food-borne pathogen causing gastroenteritis in human. We isolated 208 strains of Campylobacter jejuni from 430 diarrhea patients and food employees with 17 food-poisoning outbreaks between 2014 and 2016 in Gyeonggi area. The strains were tested for genetic relationship and the genotype distribution using PFGE and multiplex-PCR typing. Among the 47 Penner-serotypes known for C. jejuni, it was identified as a genotype consisting of 35 genotypes by multiplex-PCR typing and represented 7 genotypes (HS2, HS4A, HS8, HS15, HS29, HS41, and HS53) in the selected strain. From the PFGE analysis of 11 food-poisoning outbreaks, 5 group of PFGE profile were obtained, and genetic similarity in these clusters ranged from 61.8 to 66.6%. This study examines the genetic diversity of C. jejuni that have been separated in the Gyeonggi area through various genetic analysis methods and identifies the correlation between strains in patients who have been infected with the disease in the future.

Convergence research on cytological diagnosis of gynecological diseases and genital HPV : Based on data from the Obstetrics and Gynecology Department of a general hospital located in Suwon-si (수원시 소재 일개 종합병원 산부인과에서 자궁경부 질환 검사의 실태조사 : HPV와 세포학적 검사의 융합연구)

  • Joung, You Hyun;Lee, Jun Min;Kim, Jong-Wan;Kim, Jae Kyung
    • Journal of the Korea Convergence Society
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    • v.13 no.1
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    • pp.119-129
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    • 2022
  • Cervical cytology has been widely used as a screening tool for cervical cancer. However, Human papillomavirus (HPV) detection and subtype testing are suggested to overcome the high false-negative rate associated with cytology. We aimed to investigate the clinical usefulness and infection rate in the HPV polymerase chain reaction (PCR) test performed in hospitals. HPV PCR data from 217 patients were analyzed. Analysis of variance revealed a significant difference in the infection rate among different age groups (P=0.015). The biopsy results showed that epithelial cell abnormalities and high HPV-positivity rate was observed in 1 (100%) subject aged <29 years, in 4 out of 5 (80%) patients in their 30s, and in 3 out of 4 (75%) patients aged ≥70 years. The prevalence of HPV infection was very high (46.1%). The highest prevalence (87.5%) was observed among patients in their <29, followed by those in their 30s (67.7%) and those in their 40s (31.9%).A high rate of epithelial cell abnormalities (≥ cervical intraepithelial neoplasia type 1, mild dysplasia) was observed in HPV-infected women aged<30 years. Therefore, extensive research and prevention activities are needed in this age group. HPV PCR testing is recommended to complement cervical cytology

The Observation of Clebopride Malate Effect on Funchional Gastrointestinal Disease by Use of Gastric Emptying Time (Gastric Emptying Time을 이용한 기능성 소화기장애환자의 Clebopride Malate에 의한 효능 측정)

  • Chioi, Soo-Bong;Kwon, Kyeong-Soon;Yoon, Seong-Chul;Chung, Moon-Kwan;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.4 no.1
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    • pp.59-63
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    • 1987
  • The measurement of gastric emptying time is useful in differentiation of the hypochondriac neurosis from the functional gastrointestinal disturbance, and also useful in searching the hidden gastrointestinal disease in patients who are believed as the functional gastrointestinal disturbance. We confirmed in this study that the more delayed gastric emptying time was measured in functional gastrointestinal disturbance compared to normal group, and more shortened gastric emptying time was found after treatment with dopamine antagonist (cleboril) in this group.

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Skeletal Factors Related to Open Lock of the Temporomandibular Joint (측두하악관절의 개구성 과두걸림 환자의 골격적 특성에 관한 연구)

  • Nam, Ji-Na;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.267-274
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    • 2013
  • This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

The Effect of Medication in the Patients with Bee-Sting (약물투여가 벌자상환자에게 미치는 효과)

  • Cho, Byung-Jun;Moon, Soo-Jae;Kim, Seon-Rye
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.350-356
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    • 2015
  • The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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