• 대한간호학회지
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• 제35권1호
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• 한국임상수의학회지
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• 제37권3호
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• pp.141-144
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• 2020

Modified rush immunotherapy (IT), by combination of rush IT and conventional IT, provides a faster method to reach maintenance dose, leading to higher patient adherence when compared with conventional IT, decreasing systemic adverse reactions when compared with a standard rush IT. Ten atopic dogs of this study include fulfillment of Favrot's criteria. Offending allergens were identified by the use of IDST. During the induction period, the dogs were received a total of 10 injections. Five injections were administrated every 30 minutes in a day with gradually increasing amounts and concentrations of allergens, and the last 5 injections were administered every 3 days. The efficacy of 10-injection induced mRIT was assessed using the canine atopic dermatitis extent and severity index (CADESI). During maintenance period, reduction rate from baseline scores varied between 3.2% and 60.9% and the after 6 months of therapy for CADESI-03 score in 6 of the 10 dogs. Adverse reactions were not observed in these dogs during induction period by mRIT with 10 injections. Based on these results, our modified rush IT protocol is considered to be a useful protocol to treat canine atopic dermatitis.

• 대한두개안면성형외과학회지
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• 제14권2호
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• pp.73-80
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• 2013

It is important to distinguish deformational plagiocephaly from craniosynostosis, the two conditions are different with respect to clinical progression and treatment options. Deformational plagiocephaly is diagnosed based on the patient's medical history and physical examination. Until recently, there has been no standardized method of evaluation. Visual assessment, anthropometric assessment, digital scanning, and radiologic evaluation are mostly commonly used modalities for diagnosis and assessment. Treatment of deformational plagiocephaly requires an understanding of natural progression of the disease. Deformational plagiocephaly should be classified according to its severity before the proper method and time for treatment are determined. Treatment includes repositioning, physiotherapy and remodeling with the use of orthotic devices. In general, repositioning is preferred for patients younger than six months old while treatment with the use of orthotic devices such as helmet is preferred for patients over six months old. Moreover, treatment with the use of orthotic devices is also favored for severe plagiocephaly. There is continuing research on the relation between deformational plagiocephaly and developmental delay.

• 말소리와 음성과학
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• 제3권4호
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• pp.109-115
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• 2011

The purposes of this study were to identify acoustic parameters of connected speech and to contribute to acoustic analysis of dysphonic voice about patient's natural speech voice as well as sustained phonation of vowels. Acoustic parameters of sentences included LTAS (long-term average spectrum) mean and spectral slope over frequence ranges such as 0-4kHz, 0-6kHz, 0-8kHz, 0-12.5kHz as well as HNR. Acoustic parameters of the vowel 'a' included jitter, RAP, shimmer, NHR, and HNR. Based on 'G' of GRBAS for the severity of dysphonia, two experienced raters judged and classified as four groups including controls, mild, moderate and severe dysphonic group. Connected speech was two sentences extracted from 'stroll' passage. Parameters of the vowel and LTAS mean of the sentences were measured by CSL. The spectral slope of the sentences and HNR of the vowel and the sentences were measured by Praat. Data were statistically analyzed by Spearman correlation and Kruskal-Wallis test using SPSS 12.0. The results of this study are as follows: First, jitter, RAP, shimmer and NHR were significantly different between the groups. Second, for several frequencies, LTAS mean and spectral slope of the sentences were significantly different between the groups. Third, the HNR of the sentences were significantly different between the groups. Forth, there was a presence of correlation between HNR and NHR of the vowel and HNR of the sentences. Accordingly, this study concluded that LTAS, spectral slope, and HNR were predictive parameters of connected speech voice for dysphonic voice.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.69-74
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• 1997

과대비성의 수술적 치료에 있어서 인두측벽의 운동성이 수술 후 어느 정도 남아있는가와 측두문의 크기를 어느 정도 유지하는 것이 적당한가를 결정하는 것이 환자의 만족도를 높이고 좋은 결과를 얻는데 중요한 부분을 차지함을 알 수 있었다.

• 한국병원경영학회지
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• 제17권4호
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• pp.133-166
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• 2012

Hospitals tend to provide uniformed service to patients despite their various demands stemming from the severity of disease stages or the uncertainties in information of treatment stages. To identify service factors and provide effective contextually aware service models that patients demand depending on their evolving circumstances, the study conducted a survey on service quality based on importance and satisfaction of cancer patients. The study surveyed 286 patients and caregivers on importance and satisfaction through a questionnaire comprising of 17 questions at the outpatient clinic of cancer centers of university hospitals in 5 cities. Based on the risks of the disease and uncertainties in information of treatment stages, the cancer patients were grouped into diagnosis stage; low-risk treatment stage; high-risk treatment stage; stabilization stage. Depending on the patient's situation, the importance and satisfaction of service factors were ranked. These factors were categorized into 4 groups from a managerial perspective into 'keep it up area', 'focus here area', 'low priority area', 'overdone area'. This study provides an effective medical service model that can accommodate patients based on management areas of cancer patients.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.37-39
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• 2009

Purpose: Langerhans cell histiocytosis is a heterogenous group of Langerhans cell proliferative disorders and includes eosinophilic granuloma, Letterer-Siwe diseases, and Hand-Schuller Christian disease. We report a case of eosinophilic granuloma on frontal area. Methods: A 17-year-old male presented with swelling and tenderness on Lt. frontal and periorbital area. CT and MRI showed a $33{\times}25mm$ sized mass that involved Lt. frontal calvarium, frontotemporal meninges, and orbital roof. Results: Total excision of the mass and adjacent soft tissue, calvarium, and orbital roof was performed. Orbital roof defect was reconstructed with absorbable plate and calvarial defect was done with outer cortex of temporal bone flap. The histology revealed proliferation of histiocytes and eosinophils. Immunologically, these histiocytic cells expressed S-100 protein and CD1a. The patient is currently taking conservative treatment. Conclusion: The severity of these disease and their prognosis and treatments are various. For unifocal cranial Langerhans cell histiocytosis, complete excision is the treatment of choice. We report this case with review of literature.

• 대한한의학회지
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• 제22권2호
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• pp.10-21
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• 2001

Objectives : Atopic dermatitis(AD) assume an remarkable clinical aspect and it s diagnosis almost depends on clinical symptoms. Therefore, we aimed to study the clinical diagnostic standard of AD for more accurate treatment. We repert as follows; Methods : For 6 months from March to August in 2000 we selected fifty outpatients who were prognosis of AD in the department of dermatology, Oriental medical hospitol, Dong-eui University. Results and Conclusions : 1. We classified of the grade, the condition of AD patient was slight and severe, by the sum of total by the clinical index of AD (diagnostic features). 2. By consulting previous oriental medical theories, we divided symptom-complex of AD into two type ; one was damp-heat type and the other was deficiency of blood- wind-dryness type. 3. Male to female ratio was 17 : 33 and the third stage, more than half of the patients were adolescents. 4. According to the results of symptom-complex of AD patients, on the first examination damp-heat type was more than deficiency of blood-wind-dryness type and in progressing treatment, the condition has been change to deficiency of blood-wind-dryness type. 5. In the lesions of AD, arm and knee were most serious skin lesions and in symptoms of AD, pruritus was most complained, and in progressing treatment, erosion and erythema were greatly improved. 6. When we measured the levels of serum Total IgE, that of thirty eight patientswere higher than that of normal, but elevation of serum IgE levels was not correlated with the severity of AD.

• 대한후두음성언어의학회지
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• 제29권1호
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• pp.5-8
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• 2018

Patients who have the head and neck cancer are usually treated by surgery, radiation therapy, chemotherapy, or combinations of them. These treatments can induce variable degree of aspiration with dysphagia. The type and severity of aspiration depends on the size and location of the original tumor, the structures involved, and the treatment modality used for treatment. The management of aspiration after the head and neck cancer's treatment begins with an accurate evaluation for the cause and mechanism of aspiration through modified barium swallow (MBS) and fiberoptic endoscopic examination of swallowing (FEES). Then, the clinician can use postures, maneuvers, and exercises to treat the swallow disorder and to help the patient achieve optimal function. To achieve optimal swallowing without aspiration, multidimensional rehabilitation by various medical personnel is definitely necessary.

• 성인간호학회지
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• 제21권2호
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• pp.187-198
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• 2009

Purpose: This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit. Methods: Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics. Results: First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3. Conclusion: Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.