• Pediatric Infection and Vaccine
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• 제11권2호
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• pp.212-215
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• 2004

보체계는 우리 몸에서 감염에 대한 초기 방어를 담당하는데 그중 후기 보체 성분의 결핍시 수막구균의 감염에 쉽게 노출된다. 특히 재발 감염된 수막구균 혈증 환자에서 보체계의 검사가 반드시 필요할 것으로 생각되는 바이다. 저자들은 재발성 수막구균 혈증으로 치료받은 환자에서 C7 결핍증을 경험하였기에 이를 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.970-975
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• 2001

Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

• 해양환경안전학회지
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• 제26권4호
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• pp.346-352
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• 2020

국내 여성 해기사 양성을 위하여 목포해양대학교와 한국해양대학교의 해사대학에 여학생이 입학한지 약 30년이 되었다. 해사대학 여학생은 승선근무예비역제도와 관련없이 해사대학을 선택하고 있으므로, 여학생의 입학 동기, 승선 선호도, 희망 진로 등에 대한 연구가 지속적으로 수행되어야 다른 대학과 해사대학의 차별화 및 비전을 도출할 수 있을 것으로 사료된다. 이에 따라 본 연구에서는 목포해양대학교 해사대학에 재학 중인 여학생 93명을 대상으로 해사대학 입학 동기 및 만족도, 전반적인 승선 인식과 선호도 및 그 이유, 여성의 승선에 대한 주위 인식과 영향, 졸업 후 희망 진로와 학부 교육과정 만족도 등에 대해 설문조사를 실시하였다. 해사대학 입학 이유로는 응답자의 35.5 %가 해양 관련 공무원 및 전문직에 종사하기 위해, 30.1 %는 해기사가 되기 위하여 입학하였다고 응답하여 현재의 해기사 양성을 위한 교육과 더불어 해양 전문가 양성을 위한 추가적인 교과목 편성이 요구된다. 여학생의 승선에 대한 인식으로는 응답자의 88.2 %가 여성의 승선이 보통 이상으로 힘들다고 생각하는 것으로 조사되어, 학교 및 선사에서 직무 외 여성 해기사의 승선 생활을 위한 체계적인 교육 프로그램이 필요할 것으로 사료된다. 여학생의 승선 선호도는 응답자의 69.6 %가 졸업 후에 해기사로 승선을 보통 이상 희망하는 것으로 분석되었다. 여학생의 졸업 후 희망 진로는 응답자의 32.3 %가 항해사 또는 기관사를 선호하는 것으로 조사되었으며, 해양 관련 공무원·공기업 전문직 24.7 %, 해양경찰 18.3 % 등으로 83.9 %가 해양 관련 분야의 진로를 희망하는 것으로 조사되었다. 이에 따라 해기 과목 이외의 여학생의 입학 동기 및 선호 직업군에 따른 교과목 편성 및 심화 교육이 필요한 것으로 분석되었다.

• 간호행정학회지
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• 제6권3호
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• pp.375-388
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• 2000

This study was attempted to help in explore new direction about Clinical Classification System of the pediatric patients visiting emergency center. Data were collected from 276 patients who visited emergency center of E University Hospital during 3 months period form March 1, to May 31, 1999. The results were as follows: 1. Distribution of pediatric patients according to Clinical Classification System, class I(59.9%) topped followed by class II(23.9%), class III(14.1%), class IV(2.0%). Average score of pediatric patients according to Clinical Classification System showed class I.00, class II .02, class III .05, class IV .07. and total mean score of items lowed averaged .01. 2. With the resepect to the Clinical Classification System according to the pediatric patients visiting emergency center, there were stastically significant difference in visiting time($x^2=27.839$, P=.023), experience of admission($x^2=11.365$, p=.010), disease classification($x^2=89.998$, p=.000), state of airway patency($x^2=18.781$, p=.000), consciousness level($x^2=59.774$, p=.000), period of symptom manifestation($x^2=34.112$, p=.000), pediatric patients protector's thinking about pediatric patients state($x^2=49.998$, p=.000), treatment outcome($x^2=72.278$, p=.000), duration of stay at emergency center($x^2=103.062$, p=.000). 3. There were significant correlation between the state of pediatric patients and Clinical Classification System(r=.530, p=.000).

• 한국임상약학회지
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• 제28권3호
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• pp.181-187
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• 2018

Background: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML. Methods: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days. Results: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was $26.8{\pm}16days$. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49). Conclusion: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.

• 대한의용생체공학회:의공학회지
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• 제11권2호
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• pp.305-314
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• 1990

In this paper we have implemented and tested TPN which is system to supply sufficent nutrition to nutritionally deficient patient by means of ES (expert system) a kind of A.1 (artificial intelligence) . This system affords to evaluation of nutritional state of patient which is essential to physi- cian. who performs TPN, decision of performing TPN and management of patient-data & calculation of information needing to making TPN fluid. The features were as follolv 1. we input data, take ideal weight of patient and 24hr's creatlnln In urine according to chart in system compare TSF (triceps skin fold), MAC (mid-arm circumference), AMC (arm muscle circumference) to 5th, 15th, 50th percentile and evaluate the nutritional state of patient. 2. Calculation of protein & nonprotein calorie needing to treament of patient can be made exactly by stress factor, activity factor and body temperature. 3. patient's personal recording needing to management of patient date name of chief doc- tor, name of department of admission, chart number, history can by taken very easily. 4. The way of system operating is pull-down Menu one, It can be processing very efficiently. 5. Date processing in system, we can manage memory volume of computer verlr efficiently using of dynamic allocation variables. 6. We can make it very easy to edit & revise the input data, processed data is saved to diskette in 2 files (TDF, THF) , these are semipermanent preservation.

• 한국전자통신학회논문지
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• 제10권12호
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• pp.1403-1410
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• 2015

본 연구에서는 병원정보시스템에서 분야별로 발생하는 의료 빅데이터 자료를 활용하여 가치있는 의료정보를 생성하고 활용할 수 있는 방안을 마련하고자 한다. 본 연구의 결과는 첫 번째, 의료정보시스템의 진료정보와 각종 검사장비 및 의료영상장비와 연동된 PACS의 발생자료를 통합하고 의료 빅데이터를 분석하여 새로운 의료정보를 생성한다. 이렇게 생성된 의료정보는 감염병 및 질병 예방과 질병의 치료를 위한 다양한 건강정보를 생성하게 된다. 두 번째, 환자의 접수내역과 수납내역 그리고 청구내역들을 통합하여 축적해온 의료 빅데이터를 분석하여 다양한 수익통계정보를 생성한다. 이렇게 생성된 수익통계정보는 의료기관의 운영과 수익분석에 활용하기 위한 다양한 경영정보를 생성하게 된다. 이와 같이 병원정보시스템에서 발생하는 의료정보와 공공기관의 의료정보 그리고 개인건강기록의 자료들이 통합이 되면 의료자료를 활용한 가치있는 보건의료정보를 창출하게 된다.

• 대한영상의학회지
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• 제81권4호
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• pp.985-989
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• 2020

클로르페나피르는 널리 사용되는 살충제이며 인간에게는 치명적일 수 있다. 그러나 중추신경계 침범을 동반한 클로르페나피르 중독은 거의 보고되지 않고 있다. 우리는 이전까지 드물게 보고된 클로르페나피르 중독에 의한 백질뇌병증 환자의 자기공명영상 소견을 보고하고자 한다. 약 2주 전에 클로르페나피르를 음독한 71세 남자 환자가 내원 2일 전부터 시작된 양측 하지위약감과 배뇨장애를 주소로 내원하였다. 시행한 뇌 자기공명영상에서는 뇌량, 속섬유막, 뇌줄기를 포함하는 영역에 양측성의 광범위한 뇌백질의 이상을 보였고, 척수 자기공명영상에서는 전반적인 척수에 고신호를 동반한 종창을 보였다.

• 한국임상약학회지
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• 제27권2호
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• Healthcare Informatics Research
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• 제24권4호
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• pp.317-326
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• 2018

Objectives: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. Methods: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. Results: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. Conclusions: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.