• 대한감각통합치료학회지
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• 제20권3호
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• pp.48-59
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• 2022

목적 : 본 연구는 자폐스펙트럼장애 아동을 대상으로 국내에서 제공되는 감각통합중재 방법을 체계적으로 고찰하여 중재효과를 제시하고자 하였다. 연구방법 : 연구대상은 2011년 1월부터 2020년 12월까지 최근 10년간 국내 학회지에 게재된 연구로 하였다. 검색에 사용된 데이터베이스는 학술연구정보서비스(RISS)와 디비피아(DBpia)이었다. 검색어는 '자폐', '자폐스펙트럼', '감각통합', '중재'이었다. 분석에 사용된 연구는 총 10개로, 연구 근거의 질적수준과 방법론적 질적수준으로 분석하였고, 결과는 대상자, 중재, 대조, 결과의 PICO(Patient, Intervention, Comparison, Outcome)로 제시하였다. 결과 : 연구분석에서 근거의 질적 수준은 수준 IV가 가장 높았고, 다음으로 수준 II 이었다. 근거의 방법론적 질적 수준은 '우수'의 연구가 가장 많았고, 다음으로는 '보통'이었다. 연구대상자는 자폐스펙트럼장애아동과 부모이었고, 실험설계는 단일대상연구 빈도가 가장 높았다. 중재는 적응행동과 감각조절을 확인하는 연구가 가장 많았고, 중재측정을 위해 사용된 평가도구는 감각프로파일(Sensory Profile)과 캐나다작업수행측정(Canadian Occupational Performance Measure; COPM)의 빈도가 가장 높았다. 분석에 사용된 10개의 모든 연구에서 감각통합중재로 인해 다양한 결과 값에 긍정적인 향상 및 통계학적으로 유의한 효과를 보였다. 결론 : 최근의 임상환경에서 자폐스펙트럼장애 아동을 대상으로 감각통합중재는 지속적으로 이루어져왔다. 앞으로의 연구에서는 다양한 감각통합중재방법과 근거의 질적 수준이 높은 연구가 이루어지는 것이 필요하다.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.567-574
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• 2001

Objective : As for growth hormone(GH) secreting pituitary adenoma, it's remission should be declared on the basis of satisfactory controlling of the tumor, normalization of hormonal level, and symptomatic improvement of the patient. Several modalities of treatment have been applied and administered, and yet, this disease still remains as inveterate one to be fully treated. The purpose of this study is to evaluate the outcome of gamma knife radiosurgery(GKRS) for GH secreting pituitary adenoma, and to identify various factors affecting the outcome of the treatment. Method : A group of 24 out of 35 patients, treated by Leksell gamma knife unit during the period of March of 1992 through October of 1997, had been observed for more than two years. The mean target volume of microadenoma was $449.3mm^3(range 216-880mm^3)$, and that of macroadenoma was $3183.1mm^3(range 1456-13125mm^3)$. The tumor margin was covered with 50% isodose profile, and mean marginal dose was 25.2Gy(range 15-32.4Gy). The mean number of isocenter was 4.3(range 1-6). The exposed dose to the optic apparatus was less than 8Gy. The mean follow-up period was 37.8months(range 24-102months). Result : No patients showed any increase in the tumor volume during the follow-up period. And definite shrinkage of tumor volume(tumor volume reduction rate, TVRR : more than 50%) was obtained in 10 patients(41.7%). Twenty one patients(87.5%) had reduced hormonal level compared than pre-treatment level. Among them, normalization of the hormonal level was achieved in 12 patients(50%). Clinicoendocrinological remission was seen in 3 patients (12.5%). According to the results of statistical analysis, tumor volume(p=0.016),duration of symptoms(p=0.046), initial GH level(p=0.017), and the invasion of cavernous sinus(p=0.036) were significantly favorable to post-radiosurgical outcome. The TVRR was significantly related to post-radiosurgical reduction of serum GH level. Permanent complication was not seen. Conclusion : The authors concluded that GKRS is a safe and effective treatment modality for acromegaly. To otain the better outcome of GKRS in GH secreting pituitary adenoma, more careful and sophisticated treatment-planning is recommended.

• 근관절건강학회지
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• 제8권1호
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• pp.5-26
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• 2001

Many studies have reported that regular aquatic exercise can lead to improvement of health for patients suffering from arthritis. In spite of these benefits, the adherence rate has shown as few as 26% of patients with arthritis who had completed the aquatic exercise education program. Moreover, when patients with arthritis begin an aquatic exercise, 47% withdraw within the first 6 month. No study has been found that constructs model to explain aquatic exercise adherence of patients with arthritis. The purpose of this study were to identify the factors influencing exercise adherence and to construct and test a structural model to explain aquatic exercise adherence of patients with arthritis. Hypothesized model was constructed on the basis of Bandura's social cognitive theory and literature review. Exogenous latent variables included in this model are group cohesion and barrier, endogenous latent variables are self-efficacy, outcome expectancy and self-evaluation. Empirical data used was collected through individual interviews with the structural questionnaire on 249 patients with arthritis who had completed the 6-week aquatic exercise education program of Korean Rheumatology Health Professionals Academy. The interviews were performed from September 6, 1999 through October 8, 1999. A model tested by the covariance structural analysis with LISREL 8.12a program and by descriptive statistics and correlation with SAS 6.12 program. The results are summarized as follows: First, hypothesized model showed a good fit to the empirical data. In the modified model added one new path showed a much better fit. Second, group cohesion had a direct, indirect positive effects, self-efficacy and self evaluation had a direct positive effects on exercise adherence. Barrier had a direct, indirect negative effects on exercise adherence. Outcome expectancy had a direct negative effect, indirect positive effects through self-evaluation on exercise adherence, but total effects was not significant. Total effect size of the variables were group cohesion, self-efficacy, barrier and self evaluation in order. All variables accounted for 54% of the total variance of exercise adherence in the model. In conclusion, this model confirmed to be proper in explaining of aquatic exercise adherence. Group cohesion, self-efficacy, outcome expectancy, self-evaluation, barrier contributed to the aquatic exercise adherence of patients with arthritis. The results of this study suggested that improvement of group cohesion, self-efficacy and self-evaluation, motivation of outcome expectancy through self-evaluation, and reduction of the barrier should be included in the strategy of nursing intervention for the aquatic exercise adherence of patients with arthritis.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

• 대한간호학회지
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• 제15권3호
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• pp.5-20
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• 1985

The purpose of this study was to assess the value-of post-operative treatment in terms of nursing care in the allevation of pain. More specifically, the effects of supportive touch and patient education were examined. On the date before each patient's operation, the Bevels of anxiety, depression and affiliation were examined. The post-operative treatment was adminis. tered after an initial measurement of the patient's fain, according to the experimental category for the three days following the operation. On the final day, the level of anxiety and depression were again measured. The subjects of this study were 138 patient from the general surgical and gynecological wards in H university Hospital in Seoul. The study was conducted over a three-month period from June 24, 1984 to September 18, 1984. All patients had undergone laparatomies. Various standard instruments were used to measure the pain, anxiety, depression and affiliation levels. for pain, 5 grate Simple Descriptive Scale, and the Mclachlan four-range Observational Pain Scale were employed. For anxiety and depression, respectively the Spielberger State Anxiety Inventory and Beck Depression Inventory (B.D.I.) were used. Lastly, the affiliation was determined by the Mehrabian Affiliation Scale. The outcome of the research was as follows: 1. The first hypothesis concerning the existence of lower pain levels of Experimental Group A and Experimental Group B than the pain levels of Control Croup C was not supported. 2. The second hypothesis concerning the existence if lower anxiety levels of Experimental Group A and Experimental Group B than the anxiety levels of Control Group C was supported at the level of F=3.58 (p=.03). 3. The third hypothesis concerning the existence of lower depression levels of Experimental Group A and Experimental Group B than the depression levels of Control Group C was not supported. 4. The fourth hypothesis concerning the existence of different levels of pain in accordance with the levels of affiliation in Experimental Group A was not supported. 5. A positive correlation did exist between pain and anxiety after surgery (r=.34, p=.0001). Thus, the fifth hypothesis was supported. 6. A positive correlation did exist between pain and depression following surgery(r=.36, p=.0001). Thus, the sixth hypothesis was supported. Based on the above results, it was found that supportive touch and patient education either through human sources or via tape recorder do influence the anxiety of a patient after surgery, that a Positive correlation between pain, anxiety and deparession exist, that affiliation does not alter the influence of supportive touch, and that the graph on which pain levels were depicted indicates the possibility of development even if the effects of supportive touch did not reach a meaningful level. Thus it can be concluded that patient education, regardless of its form, is essential for the patient after surgery and that supportive touch, when reasonably modified and supplemented, can be an effective method of alleviating pain.

• 대한기관식도과학회지
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• 제13권2호
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• pp.34-39
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• 2007

Background: The mediastinum is the anatomic space which is restricted and the clinical aspect varies according to location, size and type of neoplasm. Diagnostic and therapeutic approaches to mediastinal neoplasms have changed over and over. We presented our recent therapeutic experiences with these neoplasms. The object and method: The 36 patients were treated in operation from 2000 until 2006. The male patients were 20 and the female patients were 16. Age of the patients ranged from 5 to 70, and the median age was $46.4{\pm}21.9$. The child patients were two. Result: The most prevalent anatomic distribution of the neoplasm was anterosuperior mediastinum. The most common neoplasm was thymoma, followed by thymic cyst, teratoma, ganglioneuroma. The complete excison of neoplasm was accomplished in 96% of patient group except thymoma patient group. One patient underwent total thymectomy, and the other 12 patients underwent extended thymectomy from 13 thymoma patient group. In the malignant neoplasm, 7 patients were received additional treatment after operation. There was short-term death of 1 person and late death of 1 person. Conclusion: Our results except clinical manifestation are compared favorably with other reports. Surgery is the management of choice for patients with mediastinal neoplasm and early curative resection is considered to optimize clinical outcome for patients.

• 동의생리병리학회지
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• 제29권2호
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• pp.152-159
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• 2015

As for medical education, not only acquirement of knowledge but also practical clinical competence is important because it is needed on primary medicine. Under this trend, Clinical Performance Examination(CPX) is already being practiced in medical college. But in spite of its importance, CPX is not yet practiced in Korean medical college. So, by contemplating necessity and outcome of CPX, We try to offer basic data for future imposition and improvement of CPX in Korean medical education. 49 students of grade 3 in a Daejeon Korean Medical College were targets of investigation. After educated about CPX in advance, They treated simulated patient and answered questionnaire about CPX. Then, their treatment was scored by Professor and simulated patients. Total 49 members responded to the survey and the results of the analysis were as follows. The answer that CPX is useful(Mean=4.12) and essential for acquiring professionalism of treatment(Mean=4.02) was got high scores. But many respondents replied about necessity of better CPX environment and felt difficulty about PPI(45%). Meanwhile, Professor group(Mean=9.24) tended to give more high score than Simulated patient group(Mean=7.94). This study can be very useful for composing basic data of CPX in Korean medical College and improving practical clinical competence of students. But this study has also some limits like area, respondent selection, group module etc. So, more detailed and comprehensive survey is needed. This work was supported by the Daejeon University Research Grant.

• 대한한방내과학회지
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• 제32권4호
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• pp.497-503
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• 2011

Objectives : To assess the effect of Bojungiki-tang for symptomatic management in stable asthmatic patients after initial treatment. Methods : Outcome measures of asthmatic patients were recorded using patient's charts and inquiry. Compared with the patient's state right after they got their treatment, "Excellent" was if it was almost the same state, "Good" was if the patient's state was maintained for almost 70%, "Fair" was for 50%, "Poor" was for under 50% or if the patient required another treatment. Results : Of 25 patients, 21 used Bojungiki-tang for more than one month and 20 maintained a stable state, that is, feeling more than 70% of symptom control compared with previous best status. Conclusions : Bojungiki-tang has a good effect for maintaining asthma after treatment.

• Tuberculosis and Respiratory Diseases
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• 제74권6호
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• pp.264-268
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• 2013

Background: Idiopathic pulmonary fibrosis (IPF) is a lethal pulmonary fibrotic disease. In general, the exaggerated activation of the coagulation cascade has been observed during initiation or maintenance of the fibrotic disease. In our recent study, immunohistochemical expression of protease-activated receptor-2 (PAR-2), which plays a key role in coagulation cascade, was observed in surgical specimen of IPF patients, and associated with poor clinical outcome. The aim of this study was to evaluate the overexpression of PAR-2 in inflammatory cells from peripheral blood and bronchoalveolar lavage fluid in IPF patients. Methods: From May 2011 to March 2012, IPF patients and controls were enrolled in Seoul National University Hospital. Peripheral blood and bronchoalveolar lavage fluid were collected for analysis of PAR-2 expression. Flow cytometry and reverse transcription polymerase chain reaction were used for PAR-2 receptor and mRNA assessment. Results: Twelve IPF patients and 14 controls were included in this study. Among them, flow cytometry analysis was conducted from 26 peripheral blood (patient group, 11; control group, 13) and 7 bronchoalveolar lavage fluid (patient group, 5; control group, 2). The expression of PAR-2 receptor was not different between patient and control groups (p=0.074). Among all 24 population, PAR-2 mRNA assessment was performed in 19 persons (patient group, 10; control group, 9). The mRNA expression of PAR-2 was not significant different (p=0.633). Conclusion: In IPF patients, PAR-2 receptor and mRNA expression were not different from control group.

• 대한간호학회지
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• 제50권3호
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.