• Title/Summary/Keyword: 환자 선호도

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Operative Treatment of Symptomatic Os Acromiale (견봉 골의 수술적 치료)

  • Ji, Jong-Hun;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Moon, Chang-Yun
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.123-130
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    • 2008
  • Os acromiale is the rare shoulder disease and its treatment is controversial. Despite conservative treatments for 6 months include medication, exercise, physical therapy and subacromial steroid injections, operative treatment for uncontrolled symptomatic Os acromiale is considered the treatment of choice. Operative treatment includes excision, arthroscopic or open reduction and internal fixation with a bone graft. Open reduction with tension band wiring and a bone graft is now the preferred treatment. We experienced 8 patients with symptomatic Os acromiale from March, 2001 to March, 2006. The average patient's age was 45 years and the man and women ratio were 2: 6. All 8 cases of symptomatic Os acromiale of the mesoacromion were treated with open reduction and internal fixation using tension-band wiring. The preoperative ASES($47.3\pm24.4$) and UCLA ($16.6\pm5.8$)scores were improved to $88.8\pm7.3$ and $31.5\pm1.9$, respectively, at the 2 year follow up. The overall UCLA score showed 1 excellent result and 7 good results. We think that symptomatic Os acromiale is a specific disease entity, and open reduction and internal fixation using tension-band wiring with K-wire is a good treatment modality.

Pattern of Asthma Management by Primary Physicians in Seoul (서울 지역 내과 개원의 천식 진료 양상)

  • Lee, Eui Kyung;Bae, Eun Young;Park, Eun Ja;Lee, Suk Hyang;Oh, Yeon-Mok;In, Kwang Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.165-174
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    • 2003
  • Background : Asthma is one of the most prevalent diseases in Korea. Although the guidelines of asthma management were reported in Korea, the present pattern of asthma management by primary physicians has not been studied. The purpose of this study is to elucidate the pattern of asthma management by primary physicians. Methods : In November 2002, 710 primary physicians specializing in internal medicine in Seoul, Korea were provided with two scenarios of asthmatic patients, one mild and the other severe. By mail or interview, the physicians were asked several questions about their present pattern of asthma management for the patients in each scenario. Results : Among 710 primary physicians, we obtained the answers from 325 physicians (response rate 46%). The most preferred prescription was oral theophylline. 71% and 81% of the physicians answered that they would prescribe oral theophylline for the mild and severe asthmatics, respectively. The next prescription preferred were mucolytics and oral ${\beta}_2$-agonist, in that order. However, 36% and 56% of the physicians answered that they would prescribe inhaled steroids for the mild and severe asthmatics, respectively. Among diagnostic tests, physicians preferred pulmonary function test to the rank next to chest radiography. Conclusion : The primary physicians in Seoul prefer oral bronchodilators to inhaled steroids in asthma management. More efforts should be made to reduce the difference between the present pattern of asthma management by primary physicians and the asthma guidelines.

THE TREATMENT OF CONGENITAL LYMPHANGIOMA WITH OK-432$(Picibanil^{(R)})$ AND SURGICAL EXCISION (OK-432$(Picibanil^{(R)})$와 외과적 절제술을 이용한 선천성 림프관종의 치험례)

  • Kim, Il-Kyu;Lee, Seong-Ho;Oh, Seong-Sub;Choi, Jin-Ho;Oh, Nam-Sik;Kim, Wang-Sik;Rim, Young-Il;Yang, Dong-Whan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.281-288
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    • 2001
  • Lymphangiomas are relatively rare benign tumors of the lymphatic system, characterized by congenital lymphatic malformation such as anastomosis or obstuction of the lymphatic channels. There are most frequently diagnosed in children younger than 3years. In contrast to that of the hemangioma, the sex distribution of the lymphangioma is nearly evenly divided. The head and neck lymphangioma represents about $70{\sim}75%$ of all lymphangiomas, and they are difficult to manage. Spontaneous regression is rare, and rapid intermittent enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequelae such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosants. Problems associated with surgical excision include the risk of cosmetically unacceptable scarring and the risk of damage to surrounding vital stricture and the high risk of incomplete excision. The sclerosants previously used have numerous other local and systemic side effects. This report describes a case that was successfully treated using OK-432 as a new sclerosant drug and secondary surgical excision for congential cavenous lymphangioma extensively enlarged to tongue, mouth floor and submandibular region.

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Patient′s Preferances for Nurse′s Nonverbal Expressions of Warmth During Nursing Rounds and Administration of Oral Medication (간호회진과 경구투약시 환자가 선호하는 간호사의 비언어적 온정행위에 관한 연구)

  • 김형선;김문실
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.381-398
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    • 1990
  • Nursing involves deep human interpersonal relationships between nurses and patients. But in modem Korea, the nurse - patient relationship tends to be ritualistic and mechanestic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was expecially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression, hand motion and head nodding. Data analysis included frequencies, percentages and X²-test. The results of this study may be summerized as follows : 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting(50.7%) or standing(49.3%) opposite the patient. Preferred distance between the nurse and the patient was close to the bed(93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part (41.1%). Preferred facial expression was a smile(97.3%). Preferred hand motions were light gestures(41.1%). Patients preferred head nodding which approved their own opinions(69.9%). 2. Patient's preferences for nurse's nonverval expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that the medication had been taken(58.9%). Preferred distance from the patient was at arm's length, 0.5-1m(64.4%). Patients preferred direct eye contact(58.9%) and a smile(94.5%). Patients preferred that the nurse put the medicine directly the patient's hand(64.4%). Whether the nurse nodded her head or not was not considered important. 3. The relation of general characteristics and patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds and administration of oral medication. During nursing rounds, the age of subjects(p=0.010) and the standard of education(p=0.026) related to the distance between the nurse and the patient. The sick hospital ward related to the eye contact(p=0.017) and facial expression(p=0.010). During administration of oral medication, the age of subjects(p=0.044) and days of hospital treatment (p=0.043) and the sick hospital ward(p=0.0004) related to the facial expression. From this study, nurses can learn what kind nonverbal expressions of warmth are preferred by patients during rounds and administration and thus will enhance nurse- patient interpersonal relationships.

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No Association between Val108/158Met Polymorphism on Catechol-O-Methyl Transferase(COMT) Gene and Smooth Pursuit Eye Movement(SPEM) Abnormality in Korean Schizophrenia Patients (한국인 정신분열병 환자의 안구추적운동 이상과 COMT 유전자의 Val108/158Met 다형성의 연합 연구)

  • Jang, Ho Joon;Moon, Hyun-Il;Lee, Yeon Jung;Kim, Im-Yel;Lee, In-Sang;Seo, Han-Gil;Kim, Ki-Hoon;Shin, Tae-Min;Park, Byung-Lae;Shin, Hyung Doo;Han, Sun Ho;Han, Sang-Woo;Woo, Sung-Il
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.288-296
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    • 2008
  • Objectives : We investigated the association of Val108/158Met polymorphism on catechol-O-methyl transferase(COMT) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenia patients. Methods : We measured SPEM in 217 Korean schizophrenia patients(male 116, female 101) and divided them into two groups, one was a good SPEM function group and the other was a poor SPEM function group. Then we analyzed Val108/158Met polymorphism on COMT gene. We compared the differences of genotype and allele distributions of the polymorphism on COMT gene between the two groups. Results : The natural logarithm value of signal/noise ratio(Ln S/N ratio) of the good SPEM function group was $4.39{\pm}0.33$(mean${\pm}$s.d.) and that of poor SPEM function group was $3.17{\pm}0.71$. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the Val108/158Met polymorphism on COMT gene between the two schizophrenic groups. Conclusions : The results suggest that Val108/158Met polymorphism on COMT gene is not related to SPEM function abnormality in schizophrenia.

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Clinical and Biochemical Diagnosis in Children with Leigh Syndrome (Leigh 증후군 환자의 임상적 생화학적 진단)

  • Lee, Sun Ho;Jeon, Mina;Lee, Hyun Joo;Park, Dae Young;Kim, Se Hoon;Lee, Young-Mock
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.72-77
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    • 2015
  • Purpose: Deficits of the respiratory chain are reported to be the major cause of Leigh syndrome is said to be the underlying causes. The need for biochemical diagnosis to draw more accurate diagnosis or prognosis to support treatments is rapidly increasing. This study tried to analyze the aspects of clinical characteristics and biochemical diagnosis of mitochondrial respiratory chain complex (MRC) defect in Leigh syndrome, using methods of biochemical enzyme assay. Methods: We included total number of 47 patients who satisfied the clinical criteria of Leigh syndrome and confirmed by biochemical diagnosis. All those patients went through muscle biopsy to perform biochemical enzyme assay to analyze MRC enzyme in order to find the underlying cause of Leigh syndrome. Results: MRC I defect was seen in 23 (48.9%) cases taking the first place and MRC IV defect in 15 (31.9%) following it. There were 9 (19.2%) cases of combined MRC defect. Combined cases of type I and IV were detected in 7 (14.9%) patients while type I and V in 2 (4.3%). The onset age of symptom was less than 1 year old in 28 (59.6%). The most common early symptom, observed in 23 (48.9%), was delayed development, but there were other various neurological symptoms observed as well. In regard with the disease progression, 35 (74.5%) patients showed slowly progressive course, the one that progressed continuously but slowly over 2 years of period. As for Maximum motor development, 22 (46.8%) were bed-ridden state, most of them suffering serious delayed development. Patients showed various symptoms with different organs involved, though neuromuscular involvement was most prominent. Delayed development was seen in all cases. Multifocal lesion in brain MRI study was seen in 36 (76.6 %) cases, taking a greater percentage than 11 (23.4%) cases with single lesion. In MR spectroscopy study, the characteristic lactate peak of mitochondrial disease was identified in 20 (42.6%) patients. Conclusions: Further analysis of clinical and biochemical diagnosis on more extended group of patients with Leigh syndrome will enable us to improve diagnostic precision and to understand the natural course of mitochondrial disease.

Surgical Treatment for Acute Acromioclavicular Joint Dislocation (급성 견봉쇄골관절 탈구의 수술적 치료)

  • Kim Jeong Hwan;Kim Chong Kwan;Lee Saeng Guk;Kim Young O;Park Jae Kyu;Yoon Jong Ho
    • Clinics in Shoulder and Elbow
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    • v.4 no.1
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    • pp.17-23
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    • 2001
  • There has been considerable controversy concerning the methods for treatment of dislocation of the acromioclavicular joint, especially in grade III injury. The authors have treated 24 cases of the complete dislocation of the acromioclavicular joint from January 1990 to July 2000. We performed 14 cases of coracoclavicular wiring operation, 10 cases of modified Phemister operation and compared the results and complication of wiring operation with modified Phemister. The clinical results in modified phemister operation were excellent in 8 cases(80%), good in 1 case(l0%), fair 1 case(10%). In wiring operation, excellent is 11 case(78%), good is 2 case(14%), fair is 1 case(14%). The complications of modified Phemister operation were breakage and migration of K-wire in 2 cases. In wiring operation, breakage of wire was in 2 cases but migration was not showed. We prefered coracoclavicular wiring operation for dislocation of acromioclavicular joint of active young adults because of the following advantages: 1) violation of acromioclavicular joint can be avoided but rotation of the clavicle was not restricted. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy because wire was not migrated when breakage of wire was occured.

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Network-based regularization for analysis of high-dimensional genomic data with group structure (그룹 구조를 갖는 고차원 유전체 자료 분석을 위한 네트워크 기반의 규제화 방법)

  • Kim, Kipoong;Choi, Jiyun;Sun, Hokeun
    • The Korean Journal of Applied Statistics
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    • v.29 no.6
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    • pp.1117-1128
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    • 2016
  • In genetic association studies with high-dimensional genomic data, regularization procedures based on penalized likelihood are often applied to identify genes or genetic regions associated with diseases or traits. A network-based regularization procedure can utilize biological network information (such as genetic pathways and signaling pathways in genetic association studies) with an outstanding selection performance over other regularization procedures such as lasso and elastic-net. However, network-based regularization has a limitation because cannot be applied to high-dimension genomic data with a group structure. In this article, we propose to combine data dimension reduction techniques such as principal component analysis and a partial least square into network-based regularization for the analysis of high-dimensional genomic data with a group structure. The selection performance of the proposed method was evaluated by extensive simulation studies. The proposed method was also applied to real DNA methylation data generated from Illumina Innium HumanMethylation27K BeadChip, where methylation beta values of around 20,000 CpG sites over 12,770 genes were compared between 123 ovarian cancer patients and 152 healthy controls. This analysis was also able to indicate a few cancer-related genes.

A Study of Depression and Health Related Quality of Life in Patients with End-Stage Renal Disease on Hemodialysis (혈액투석 중인 말기 신장질환 환자의 우울과 삶의 질)

  • Kim, Hyoung-Jun;Lee, Woo-Mi;Ahn, Seon-Ho;Song, Ju-Heung;Kim, Jae-Min;Kim, Sung-Wan;Lee, Sang-Yeol
    • Anxiety and mood
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    • v.2 no.2
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    • pp.128-135
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    • 2006
  • Objective : In this study, we investigated the prevalence of depression and its impact on the healthrelated Quality of life (HRQoL) of the patients with End-Stage Renal Disease (ESRD) on Hemodialysis. Method : The Quality of life (QOL) of patients was evaluated by HRQoL Questionnaire, "Medical Outcome Survey 36-Item Short Form Health Survey Korean Version (SF-36-K)". The patients on Hemodialysis in ESRD, were chosen from the hemodialytic room at Wonkwang University and Jeongeup-Asan Hospital. The number of patients was 95 (64 from Wonkwang University Hospital and 31 from Jeongeup-Asan Hospital) and all of them were above 19 years old. We performed various investigations to find a statistical correlations between HRQoL and physical & psychosocial factors such as the demographic characteristics, clinical characteristics (hemoglobin level and albumin level etc), and the score of Beck's depressive inventory (BDI). Results : The HRQoL value of patients on hemodialysis in ESRD is far poorer than the HRQoL reference value of Koreans and Americans, who are in normal healthly. The prevalence of depressive symptoms by BDI of the ESRD patients on hemodialysis is 68.6%, and age and depression have negative correlations with HRQoL of the patients. However, education level, serum albumin level, and social support have positive correlations with HRQoL. The patient group with depression has significantly poorer HRQoL than the group without depression. Conclusion : The HRQoL of ESRD patients on hemodialysis is not good in both physical and mental aspects. The prevalence of depression is very high and depression has negative impact of HRQoL of patients. Based on our study, it is essential to accompany with therapeutic Strategy to improve the HRQoL of ESRD patients on hemodialysis.

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A Study of Moral Judgment and Ethical Decision Making and Ethical Dilemmas Experienced in Practice by Nursing Students (간호대학생의 도덕판단력과 윤리적 의사결정 및 실습에서 경험한 윤리적 딜레마)

  • Noh, Yoon Goo;Jung, Myun Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2915-2925
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    • 2013
  • This study examined the moral judgments and ethical decision-making and analyzed ethical dilemmas experienced in practice by nursing students. The data were collected using self-reported questionnaires and reports from 189 college students in their 2nd ~ 4th grades. Data collection period was from Nov 6th - 20th in 2012. Each grade's P(%) scores were 47.92, 43.74, and 43.75 respectively.. For stage 4 score, each grade's scores were 22.37, 22.98, and 19.74. This result shows that, compared to juniors, senior student's P(%) scores did not drop and stage 4 scores rather decreased, which is in line with the results of previous studies about the effects of ethics education. This finding could be attributed to the regular and voluntary case presentations and discussions required for the senior participants. Regarding ethical decision-making type, the most favored was type 3(35.45%). Among seven categories of the ethical dilemmas facing the students, the most commonly reported was the patient's rights and dignity, followed by practices based on nursing standards, arranging for dying patients. This study raises the need that the curriculum is revised to encourage student's participation in the analysis of ethical issues they confront in the field.