• 한국임상약학회지
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• 제9권2호
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• pp.97-102
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• 1999

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

• 임상간호연구
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• 제16권2호
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• pp.5-16
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• 2010

Purpose: The purpose of this study was to develop a motivational enhancement therapy (MET) for coronary artery disease (CAD) patients in early stages of health behavior change and evaluate its effects on health motivation, the stages of change, health behaviors, and cardiovascular risk factors. Methods: Using a non-equivalent control pre-post design, the study was conducted on 42 CAD patients who underwent medical treatment or percutaneous coronary interventions in a hospital. The intervention group (n=21) received the MET (MET 1 during admission, MET 2 after discharge via telephone). The control group (n=21) received a standard care. Data were analyzed using descriptive statistics, ${\chi}^2-test$ and t-test with the SPSS 12.0 program. Results: Participants in the intervention group reported significantly increased scores of health motivation (t=-2.093, p=.043), the stages of change (t=-5.682, p<.001), and health behaviors (t=-3.069, p=.004) and significantly decreased scores of cardiovascular risk factors (t=2.131, p=.039) compared to those of the control group. Conclusion: The findings indicate that the MET is an effective intervention in improving health behaviors and decreasing cardiovascular risk factors for CAD patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.45-51
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• 2015

Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention and treatment. Materials and Methods: Patients with different stages of esophageal/gastric cardia lesions completed two QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1, 6 and 12 months after treatment. Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer, and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancer reported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores before treatment and at 1 month after treatment were $71{\pm}9$ versus $69{\pm}9$ (p>0.01), $71{\pm}8$ versus $61{\pm}11$ (p<0.01), $67{\pm}11$ versus $62{\pm}9$ (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recovered gradually in precursor lesion and early cancer patients, while some continuously deteriorated in advanced cancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions (p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior to corresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patients with early stage cancer, those with advanced cancer showed worse QoL with all function and most symptom measures (p<0.01). Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancer show better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatment may improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling should be given by health care providers during treatment and follow-up to facilitate QoL improvement.

• Journal of Chest Surgery
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• 제46권6호
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• pp.433-438
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• 2013

Background: Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD. Methods: From May 1991 to July 2012, 34 patients (mean age, $67.1{\pm}7.9$ years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed. Results: VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were $54.4%{\pm}8.8%$ and $44.3%{\pm}8.9%$, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality. Conclusion: The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.

• Journal of Chest Surgery
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• 제39권12호
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• pp.939-942
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• 2006

심장 수술 후 발생한 급성 창자간막 허혈은 사망률이 높은 심각한 합병증이다. 주로 위창자간막 동맥의 폐쇄로 발생하며, 보통 진단이 늦어져 불량한 예후를 가진다. 따라서, 빠른 진단과 적절한 수술적 치료만이 성공적인 결과를 가져올 수 있다. 저자들은 대동맥 판막 치환술 후 급성 창자간막 허혈이 발생한 환자 1예를 성공적으로 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

• 지역사회간호학회지
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• 제13권2호
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• pp.363-375
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• 2002

Objectives: The aim of this study was to analyze the trend of research on cancer prevention and early detection in Korea, in order to suggest a future direction of research on cancer prevention and early detection for Koreans. Methods: A total of 97 studies published from 1980 to 2001 were analyzed according to the year of publication, research design, journal type, cancer type, major study concepts, and findings. Results: 1) The number of studies related to cancer prevention and early detection had increased rapidly since the year 1995. 2) The most frequently used research design in the studies was the descriptive study design (55.7%). 3) There were 10 master's theses on cancer prevention and early detection, and 10 studies published in the Korean Epidemiology Journal. 4) When classified by the published field, 47 studies (48.5%) were published in nursing journals, 46 studies (47.4%) were published in medical journals, and 4 studies (4.1%) were published in public health journals. 5) The major topics of the studies were cancer prevention (51.5%), early detection (44.4%), and cancer prevention and early detection (4.1%). 6) Breast cancer was the most largely addressed issue in the studies (N=25; 25.7%), followed by lung cancer (N=23; 23.7%), hepatoma (N=17; 17.5%), gastric cancer (N=16; 16.5%), other general type of cancer (N=6; 6.2%), colorectal cancer (N=5; 5.2%) and cervical cancer (N=5; 5.2%). Conclusion: It is suggested that there should be more studies on cancer prevention and early detection in the future, and, particularly, experimental studies to exam the effects of intervention on cancer prevention and early detection are considered necessary.

• 디지털융복합연구
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• 제14권11호
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• pp.369-377
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• 2016

본 연구의 목적은 인공관절치환수술을 받은 환자의 섬망의 발생예방과 조기중재를 탐색하기 위함이다. 전자의무기록자료중 60세 이상 환자 821명을 대상으로 연구를 수행하였다. 자료분석 방법은 SPSS 20.0을 이용하여 대상자 서술통계와 섬망발생율의 차이는 $x^2$-test와 t-test를 시행하고, 다중 로지스틱 회귀분석(multiple logstic regression)으로 분석하였다. 연구결과 인공관절치환수술 환자에게 섬망 발생률은 13.5%였고, 섬망 발생의 영향요인에서는 연령, 낙상력, 신체활동, 정서상태, 수술전 체질량지수가 주된 요인으로 나타났다. 이상의 연구결과를 바탕으로 섬망의 예방, 조기발견을 위해 조기중재가 필요한 방안 모색을 제언한다.

• 대한한방내과학회지
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• 제22권4호
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• pp.633-638
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• 2001

Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early thrombolysis is beneficial for patients with acute ischemic stroke. However its therapeutic efficacy is not known in combination with oriental medical therapy. In this study, we investigated the safety and the clinical effect of continous intravenous urokinase therapy and oriental medical therapy. Methods : Twenty eight patients with acute onset of ischemic stroke no later than three days received continous infusion of urokinase and oriental medical therapy. We estimated the subjects's neurological deficit and functional status with National institute of Neurologic Disorders and Stroke Scale(NIHSS) and Europian Stroke Scale (ESS) prior to therapy, on day 3, 7, 14 after the starting urokinase therapy and on day at discharge. Results: After day 7, the scores of NIHSS and ESS were improved significantly. There are no differences in therapeutic effects of the interval between onset of stroke and initiation of therapy. Complication were noted in four(14%) patients, but these are not fatal complication and make no neurological deficiency. Conclusion : The results of these investment suggest that continuous intravenous urokinase with oriental medical therapy could be a safe and effective intervention to prevent from progression in acute ischemic stroke. But this findings should be confirmed in multicenter double blind controlled trial.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.252-258
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• 2017

Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children. Only 3 patients had associated injuries and all were haemodynamically stable. Serum amylase levels were raised in 12 patients at admission which ranged from 400-1,000 IU. Computed tomography scan made a correct diagnosis in 14 patients. Grades of the injury varied from grade I-V (1, 3, 6, 4, 1 patients respectively). Fourteen patients were managed conservatively. One patient underwent laparotomy for suspected superior mesenteric hematoma. The average duration of enteral feeds was 3.7 days and of hospital stay was 9.4 days. Six patients formed pancreatic pseudocysts; two were managed conservatively while the other four underwent cystogastrostomy. The patients were followed up for a period of 1-12 years. All remained asymptomatic and none had exocrine or endocrine deficiencies. Conclusion: Non-operative treatment for isolated blunt trauma of pancreas in children may be safely followed for all the grades of injury; if associated injuries requiring surgical intervention are ruled out with a good quality imaging and the patients are hemodynamically stable. It did not increase the hospital stay and morbidity and avoided operative intervention on acutely injured pancreas.

• 한국융합학회논문지
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• 제12권10호
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• pp.353-363
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• 2021

본 연구는 입원환자 섬망의 아형별 위험요인, 증상 및 중재를 조사하기 위해 시행되었다. 상급종합병원에 입원한 뒤 섬망을 진단받은 환자 108명의 전자의무기록을 SPSS WIN 26.0 프로그램을 이용해 분석하였다. 분석결과, 대상자는 고령, 남성, 정형외과, 골절이나 절단 환자의 비율이 높았다. 섬망의 아형은 과활동형 51.9%, 저활동형 6.5%, 혼재형 41.7%이었다. 위험요인 중 우울과 향정신성 약물 복용은 저활동형 섬망군에게 더 많이 선행되었다. 섬망의 중재 중 행동문제 관리와 공격적 행동 중재는 과활동형, 혼재형 섬망군에게 주로 시행되었고 정서적 지지는 저활동형, 혼재형 섬망군에게 주로 시행되었다. 공격적 행동을 동반할 경우 즉각적으로 중재를 제공받을 가능성이 높았다. 따라서, 추후 입원환자의 섬망을 조기발견하고 중재할 수 있도록 중재전략과 프로토콜을 개발하기 위한 연구가 요구된다.