• Pediatric Infection and Vaccine
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• 제19권3호
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• pp.111-120
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• 2012

목 적 : 단일 병원 신생아입원실에 입원한 신생아를 대상으로 환자의 임상적 특징에 따른 MRSA 보균율을 알아보고, 그 기원을 추정해 보며, MRSA 보균에 영향을 미치는 요소들을 살펴보고자 하였다. 방 법 : 2008년 1월부터 2011년 12월까지 을지대학교 서울 을지병원 신생아 입원실에 입원하여 MRSA 감시배양검사를 시행받은 1,733명의 신생아를 대상으로 의무기록을 후향적으로 조사하였다. MRSA 감시배양검사는 비강, 서혜부, 직장에서 시행하였고, 퇴원 시까지 매주 반복 시행 하였다. MRSA 감시배양결과에 따라서 보균자와 비보균자로 나누었다. 결 과 : 대상환자 1,733명 중에 415명(23.9%)이 MRSA 보균자였다. 제태기간, 출생체중, 분만 방식, 분만전 산모에게 항생제 투여 여부, 출생장소, 입원전 체류 장소에 따라서 MRSA 보균율에 차이를 보였다(P<0.001). 다변량 검사에서 분만전 산모에게 예방적 항생제를 투여하지 않은 경우가 투여한 경우에 비해서 신생아가 MRSA 보균자가 될 위험도가 2.8배(OR=2.77; 95% CI, 1.88-4.07), 출생장소가 외부인 경우가 본원인 경우에 비해서 2.3배(OR=2.28; 95% CI, 1.17-4.42) 높음을 확인하였다. 결 론 : 신생아 입원환자를 대상으로 한 MRSA 보균율은 23.9%로 상대적으로 높은 보균율을 확인하였다. 환자특성을 고려하여 추정한 HA-MRSA 보균율은 51/511명(10%), CA-MRSA 보균율은 309/858명(36%) 이었다. 본병원 신생아에서 MRSA 보균과 연관된 요인은 산모의 예방적 항생제 사용여부와 출생장소임을 확인하였다.

• 한방안이비인후피부과학회지
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• 제22권2호
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• pp.128-138
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• 2009

Objectives : The purpose of this study is to make a survey on the oriental medical care and to enlarge the domain of oriental medical treatment concerning facial paralysis. Methods : From May 2008 to April 2009, a clinical study was done on 100 inpatients who were diagnosed and treated as facial nerve paralysis at Mok-dong Oriental Medicine Hospital, Dong-shin University Results : The result were as the following 1. The distribution of sex: male 35%, female 65%. The distribution of age was disclosed that fifty was the most in 22 cases(22%). 2. The distribution of the region of facial palsy: Lt 58%(male 23%, female 35%) Rt 41%(male 11%, female 30%) 3. In distribution of contributing frequence in month, June was the most in number(12%) and in season, spring, summer, winter were the same percentage(26%). 4. In distribution of cause, stress(34%), excessive labor(25%), unknown(22%) were investigated higher than other conditions. 5. The distribution of past history: hypertension 14%, diabetes mellitus 4%, both(hypertension, diabetes mellitus) 6% 6. The distribution of period before admission: within a week 80%, 1$\sim$2 week 8%, 3$\sim$4 week 6% in order. 7. The distribution of attended symptoms: mastoid pain 43 cases, dryness of eye 26 cases, tearing 22 cases, headache 12 cases, dizziness 9 cases in order. 8. Other offices patients visited before coming to this clinic: oriental clinic or hospital 35%, local clinic or hospital 29%, none 26%, both(oriental clinic & local clinic) 10%. 9. The distribution of House-Brackmann grade on admission: Gr III 38%, Gr IV 26%, Gr II 22%, Gr V 14% in order. 10. The distribution of House-Brackmann grade on discharge: Gr II 34%, Gr I 32%, Gr III 22%, Gr V 7%, Gr IV 5% in order.

• 한방안이비인후피부과학회지
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• 제31권4호
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• pp.13-21
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• 2018

Objectives : This study was aimed to find significant prognostic factor of inpatients with severe atopic dermatitis (AD) who treated in a Traditional Korean Medicine (TKM) hospital. Methods : A retrospective review of medical records of 39 patients with severe AD who hospitalized for more than 7days was performed. All patients were treated with acupuncture, herbal decoction and herbal wet wrap dressing. Therapeutic effect was assessed by difference of objective SCORing of Atopic Dermatitis index (${\Delta}OSI$) at admission and at discharge. Patients were divided into two groups: improvement group (${\Delta}OSI{\leq}5$) and no-improvement group (${\Delta}OSI>5$), and clinical characteristics, severity, infectious complication, serum total IgE, eosinophil counts, adherence and concomitant treatment were investigated. Results : There were 7 cases in no-improvement group. There was no significant difference in OSI or infectious complication between the two groups. Also, there was no significant difference in total serum IgE and eosinophil counts, which are known to be related to severity of AD. However, the proportion of adherence group was significantly lower in no-improvement group than improvement group. Conclusions : This study suggest that treatment adherence is a significant prognostic factor for treatment outcome in inpatients with severe atopic dermatitis. If the adherence to treatment is improved, the therapeutic effect of hospitalization would increase in spite of severe AD or infectious complication.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.210-214
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• 2009

Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

• 경영과정보연구
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• 제32권1호
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• pp.153-171
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• 2013

본 연구는 부산지역 소재한 병원급 이상 의료기관에 근무 중인 663명의 의료 기관 종사자를 대상으로 하였으며, 전체 연구대상자에서는 상사의 리더십 행태가 서번트 리더십과 변혁적 리더십인 경우에 의료기관 종사자들의 직장몰입에 유의한 긍정적인 영향을 미치는 것으로 나타났다. 의료기관 종사자들이 인식하는 상사의 리더십을 리더십 행태별로 살펴본 결과, 상사에 대한 리더십 행태의 인식은 변혁적 리더십 거래적 리더십 서번트 리더십 순으로 나타났다. 상사의 리더십 행태가 의료기관 종사자들의 직장몰입에 미치는 영향을 직종별로 살펴본 결과, 상사의 리더십 행태가 간호사 직종은 변혁적 리더십인 경우에, 의료기사 직종은 서번트 리더십과 변혁적 리더십인 경우에, 사무행정 직종은 서번트 리더십인 경우에 연구대상자의 개인적 특성변수 통제유무와 관계없이 직장몰입에 유의한 긍정적인 영향을 미치는 것으로 확인되었다.

• 대한간호학회지
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• 제23권4호
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• pp.664-677
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• 1993

The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1％ of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

• Pediatric Infection and Vaccine
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• 제11권1호
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• pp.126-130
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• 2004

본 저자들은 A군 연쇄구균 감염 후 급성 사구체신염과 동반된 수막구균감염증(수막구균 뇌수막염, 수막구균혈증)에 걸린 7세 남아를 경험하였는데 A군 연쇄구균 감염 후 급성 사구체 신염으로 인해서 C3가 감소하여 수막구균감염증에 감염이 되었는지, 역으로 가능성은 떨어지지만 수막구균감염증의 결과로 C3가 감소하였고 사구체신염이 생긴 것인지 전후 관계가 확실하지 않은 증례를 문헌고찰과 함께 보고하는 바이다.

• 대한임상독성학회지
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• 제14권2호
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• pp.122-128
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• 2016

Purpose: This study was conducted to describe the characteristics of patients with carbon monoxide (CO) poisoning. Methods: We retrospectively surveyed data from the Emergency Department based Injury In-depth Surveillance of 20 hospitals (2011-2014). We included patients whose mechanism of injury was acute CO poisoning caused by inhalation of gases from charcoal or briquettes. We surveyed the annual frequency, gender, age, result of emergency treatment, rate of intensive care unit (ICU) admission, result of admission, association with alcohol, and place of accident. We also surveyed the cause and experience of past suicide attempts by intentional poisoning. Results: A total of 3,405 patients were included (2,015 (59.2%) and 1,390 (40.8%) males and females, respectively) with a mean age of $39.83{\pm}18.51$ year old. The results revealed that the annual frequency of CO poisoning had increased and the frequency of unintentional CO poisoning was higher than that of intentional CO poisoning in January, February and December. The mean age of intentional CO poisoning was younger than that of unintentional CO poisoning ($38.41{\pm}13.03$ vs $40.95{\pm}21.83$) (p<0.001). The rates of discharge against medical advice (DAMA), ICU care and alcohol association for intentional CO poisoning were higher than for unintentional CO poisoning (36.4% vs 14.0%, 17.8% vs 4.7%, 45.2% vs 5.6%) (p<0.001). The most common place of CO poisoning was in one's residence. Conclusion: The annual frequency of total CO poisoning has increased, and unintentional CO poisoning showed seasonal variation. DAMA, ICU care, and alcohol association of intentional CO poisoning were higher than those of unintentional CO poisoning.

• 간호행정학회지
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• 제10권2호
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• pp.243-254
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• 2004

Purpose: The purpose of this study was cross-mapping unique nursing statements which were identified in the nursing records of patients with six most common cancers in Korea with the standardized nursing languages of NANDA, NIC, NOC and ICNP. Method: The subjects were 72 nursing records which covered 1,502 admission days from August 1, 2003 to June 30, 2003. They were the records of the patients of six most common cancers who were treated at the six 3rd level general hospitals in Busan and Daegu. The unique nursing statements were identified by dividing the statements from the nursing records into the single statements according to their meanings. For cross-mapping, identified unique nursing statements were classified as 'Data(D)' for the subjective, objective data of the patients and the other data such as treatment, admission, discharge, and residence of patient, 'Problem(P)' for nursing problem or diagnosis defined by the nurse's decision, 'Intervention(I)' for nursing intervention for problem solving, and 'Outcome(O)' for patient reaction and results of the provided nursing interventions. Unique nursing statements classified to D, P, I, O were cross-napped by using Microsoft Excel 2000. The statements of D were cross-mapped with ICNP Nursing phenomena, P with NANDA nursing diagnosis and ICNP nursing phenomena, I with NIC and ICNP nursing intervention, and O with NOC and ICNP nursing phenomena Result: The results of this study were as follows. 1. Number of unique nursing statements were 506 in the records of lung cancer patients (18.12%), 480 in stomach cancer(17.19%), 458 in liver cancer(16.40%), 456 in colon cancer (16.33), 457 in breast cancer (16.36%) and 436 in cervix cancer (15.60%). 2. The range of percentage of cross-mapped unique nursing statements with the standardized nursing languages were as follows: P with NANDA nursing diagnosis $87.50{\sim}100%$, I with NIC $59.72{\sim}74.43$, O with NOC $61.05{\sim}72.64%$, and D, P, I and O with ICNP $60.92{\sim}69.95%$. 3. Number of the standardized nursing languages identified in this study were 21(12.66%) from 155 NANDA nursing diagnosis, 76(15.64%) from 486 NIC Nursing interventions, 54(17.47%) from 260 NOC nursing outcomes, and 343(13.03%) from ICNP 2,634. Conclusions: By the results of this study, NANDA, NIC, NOC and ICNP were found that they can be used as the language systems for nursing record and nursing information system for cancer patients. But, further study on the unique nursing statements which were not cross-mapped with the standardized nursing language systems will be necessary.

• 대한한방내과학회지
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• 제28권4호
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• pp.863-871
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• 2007

Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.