• 제목/요약/키워드: Pre-diagnosis

검색결과 566건 처리시간 0.029초

Tc-99m-MIBI 심근 SPECT 극성지도 분석에 의한 심근 기능의 정량적 평가 (A Quantitative Method for the Assessment of Myocardial Function using the Polar Analysis of Tc-99m-MIBI Myocardial SPECT)

  • 곽철은;이동수;여정석;이경한;정준기;이명철;서정돈;고창순
    • 대한핵의학회지
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    • 제28권2호
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    • pp.172-176
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    • 1994
  • 심근 SPECT에 의한 심근질환의 심도 및 허혈부위를 평가하는 방법으로 정상인의 극성지도와의 비교에 의한 결손지도 평가방법이 상용화되었으나 본 연구에서는 결손부위의 범위만을 산출할 수 있었던 종래의 방법을 개선할 수 있는 관류회복정도 및 심도성적 산출 방법을 시도하여 보았다. 허혈 및 심도성적의 산출에서 부하 및 휴식기 극성지도의 차이를 3등급으로 분할하여 각 등급에 해당되는 화소의 수를 가중하므로서 관류결손부위의 면적이 반영된 허혈 및 심도성적 산출방법을 제안하고자 하였으며, 등급 및 가중치의 할당은 정상인의 잔상동맥영역별 관류분포를 반영하여 고른 등급 할당방법보다 상관도가 개선된 결과를 얻을 수 있었다.

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신혈관성 고혈압의 진단에 있어서 캅토프릴 신스캔의 의의 (Captopril $^{99m}Tc-DTPA$ Renal Scintigraphy in Diagnosis of Renovascular Hypertension)

  • 양형인;이동수;김승철;배상균;최창운;정준기;김성권;이명철;이정상;고창순
    • 대한핵의학회지
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    • 제26권2호
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    • pp.312-317
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    • 1992
  • To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of $^{99m}Tc-DTPA$ renal scan was peformed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyetonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

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척추 경막외 출혈에 대한 수술적 치료성적 분석 (Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas)

  • 조영현;박진훈;김지훈;노성우;김창진;전상룡
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

장애아동 진정치료에 대한 표준진료지침의 개발 (Standard Clinical Procedure(Critical Pathway) on Dental Conscious Sedation for the Disabled Children)

  • 김민수;배영은;김지연;조안나;윤현서;송은주;정태성
    • 대한소아치과학회지
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    • 제42권3호
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    • pp.226-232
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    • 2015
  • 소아 청소년치과에서 장애아동 및 청소년을 안전하고 효율적으로 치료하기 위해서는 여러 사람의 다양한 협조가 필요하다. 이 연구는 장애아동의 치과치료 시 자주 이용되는 의식하진정치료의 진료용 표준지침을 시범적으로 개발, 적용하고, 진료과정에 참여한 사람들의 만족도를 평가하기 위해 시행되었다. 의무기록 분석을 통하여 표준진료지침을 개발하고 치료과정에 적용한 후 환자, 보호자, 의료진 및 스탭의 만족도를 설문을 통하여 평가한 결과, 표준진료지침의 적용은 환자, 보호자 및 의료진과 보조자가 전반적으로 만족한 것으로 나타나 임상적 유용성이 높을 가능성을 암시하였다. 결론적으로 표준진료지침의 개발과 적용은 임상진료과정의 표준화를 통하여 진료에 대한 예측가능성을 높이고, 환자 안전에 대한 불안을 감소시켜 환자와 의료진의 만족도 향상과 진료의 질적 향상을 기대 할 수 있을 것이다.

무절개 수술을 이용한 맞춤형 지르코니아 지대주의 즉시 장착 증례 (Immediate Connection of Customized Zirconia Abutment Using Flapless Guided Surgery: A Clinical Report)

  • 이경제;최병호;김희준;정승미
    • 구강회복응용과학지
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    • 제28권2호
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    • pp.201-212
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    • 2012
  • 임플란트 주위조직과 치아 주위조직은 조직학, 형태학적으로 유사한 면이 있다. 특히 functional ankylosis라 불리는 티타늄과 연조직의 직접적인 상피부착은 치아주위 조직의 접합상피처럼 염증세포의 치근단으로의 이행 및 그로 인한 골흡수를 막는 역할을 한다. 그러나 반복적인 지대주의 착탈은 임플란트 주위 연조직의 mucosal barrier를 파괴하여 골흡수를 야기할 수 있다. 만일 지대주의 반복적인 착탈 없이 수술 시에 보철 지대주를 채결한다면 골흡수의 양을 줄일 수 있을 것이다. 이는 기존의 수술방법으로는 한계가 있었으나 Cone Beam Computed Tomography(CBCT)를 이용한 guided surgery를 이용함으로써 임플란트 식립의 3차원적 정확성의 비약적인 향상으로 이런 술식이 가능하게 되었다. 본 증례는 정밀한 CBCT를 통한 분석 후 지르코니아 맞춤 지대주를 미리 제작하고 수술 시에 즉시 지대주와 임시보철물을 연결한 경우로 임상적으로 만족할만한 결과를 얻어 이를 보고하는 바이다.

개에 있어서 전신성 홍반성 낭창 일례 (A Case of Systemic Lupus Erythematosus in a Dog)

  • 김주향;김기홍;고인경;이금종;나기정;양만표
    • 한국임상수의학회지
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    • 제17권2호
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    • pp.443-449
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    • 2000
  • A three-year-old male jindo with generalized skin lesions (including seborrhea, hyperk- eratosis, alopecia, papules, and ecchymoses), pruritus lymph node enlargement, and fever was brought to Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National Uni- versity. There were no laboratory findings for parasites and fungi in the hair and skin But, the com- plete blood counts (CBC) showed leukocytosis and severe cosinophilia, It was suspected to be an inflammatory and allergic dermatitis. Thus, prednisoIone (0.5 mg/kg PO, BID for 1 week) and ampi- cillin (10 mg/kg PO, BID for 1 week given. One week later, pruritus and ecchymoses were reduced. These treatments were repeated for 7 day again. Three months later, the dog was presented again due to the relapse and exacerbation of the clinical signs. The signs were as follows; severe pru- ritus, vesicobullous skin lesions, anorexia, emaciation, lameness, and welling of carpal joints that showed inflammatory skin lesion and draining of synovia-like fluid. The values of WBC counts were returned to normal ranges. In contrast, eosinophilia was still observed. Coombs test for patient RBC and serum were negative. Hypoalbuminemia (2.5g/dl) was shown by serum chemistry. The uri- nalysis revealed and presence of leukocytes. Luxation finding of right radial carpal joint by polyarthritis was shown in radiography of affected joints.Lupus eryhematosus(LE) cells also appeared in peripheral blood and synovial fluid of affected joints. Definitely, antinuclear antibody (ANA) of patient serum using feline peripheral blood mononuclear cells was detected by all immu- nofluorescence. Based on these findings such as sedum ANA-Positive. major signs (skin disease, non- erosive polyarthritis with soft tissue swelling. and proteinuria), minor signs (fever), and LE cell-pos- itive, a diagnosis of systemic lupus crythematosus (SLE) was mad\ulcorner in this dog. The dog with SLE was administered with Pre(2.0 mg/kg PO, BID for first 4 week and then QOD) to inhibit the production of autoantibodies and with ampicillin (10 mg/kg PO, BID for first 4 weeks and then QOD) to prevent the secondary infection. The condition of this dog was monitored every 2 weeks by physical examinations, radiography, CBC, serum chemistry and urinalyais. At 8th week of treat- ment, the state of SLE evaluated by physical examinations and laboratory findings was markedly improved except for proteinura.

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노인요당 양성자의 질병관리에 대한 교육 및 추후 관리 양상에 관한 연구 (A Study on the Effects of Health Education and Self-Care Status on the Aged Diabetics)

  • 이선자;권연희
    • 한국보건간호학회지
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    • 제2권2호
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    • pp.99-116
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    • 1988
  • This study examined the effect of Health Education on the aged. One of the Study objectives was to improve knowledge. attitude and self-care practice about diabetes of the aged who have responded positive in the urine sugar test. The other study objective was to find out factors influencing knowledge. attitude and self-care practice about diabetes. and the relationship among the three variables. The subjects, consisting of 45 positive responders in the urine sugar test, were selected from the elderly who attend elderly citizen center in southern part of Seoul Then they were divided into an experimental and a control group. The study design was set to compare the pre and post test data between the experimental and the control group with the measures of results from Health Education services including nursing care intervention programs on the aged diabetics. The first data collection was carried out in August. 1986 through questionaires and urine sugar testing. The second data collection was done in September, 1987 through the same methods. The results of the study are summarized as follows; 1. General characteristics of the subjects The experimental group has 9 females and 14 males and the control group has 12 females and 10 males. As for the educational level, more than half of the subjects in both group had completed at least 6 years of education. And there was no significant difference in urine sugar levels between the two groups. 2. The effect of Health Education on the extent of change in knowledge, attitude and self-care practice about diabetes was found to be significant. The first hypothesis that knowledge, attitude and self-care practice about diabetes in the aged will be unchanged by Health Education. was rejected by increased the three variables and decreased urine suger level in the experimental group. The second hypothesis that knowledge, attitude and self-care practice about diabetes wouldn't be concerned with each other, was rejected. That is. the three variables and urine sugar levels showed a significant positive relationship with each other but diabetic knowledge to urine sugar level had an insignificant positive relationship. The third hypothesis that the amount of learning Health Education will have no relationships with knowledge. attitude and self-care practice about diabetes. was rejected. That is, the more number of times an elderly person participated in Health Education. they increased their diabetic knowledge. attitude and self-care practice and decreased their urine sugar level. 3. Except for Health Education, an other factor influencing diabetic knowledge was educational level. And an other factor influencing the diabetic attitude was experience of the diagnosis of diabetes. 4. Except for Health Education. the other factors influencing self-care practice were experience of the diagnasis of diabetes, sex and experience of the hospitalization for diabetes. But factors influencing urine sugar level weren't found. Although the results seem to be plausible, this study is not without its problems. In paticular, the sample used is limited in its scope and size. So, more empirical work needs to be done for other diseases as well as diabetes before any general conclusions are to be made.

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뇌경색 환자에게 실행한 한방음악치료 전후(前後)의 Ink foot print analysis 1례 (The Effectiveness of Ink Foot Print Analysis by Using Pre-post Oriental Medicine Music Therapy on Patient One Case with Cerebral Infarction)

  • 이승현;박경수;신현대
    • 한방재활의학과학회지
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    • 제18권3호
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    • pp.147-156
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    • 2008
  • Objectives : Oriental Medicine Music Therapy is a new way of treating and preventing various diseases and promoting health by means of music specially picked and designed to produce Qi(氣) fitting to an individual person in the areas of the structure of human body, physiological function, pathological change, diagnosis and treatment. Therefore, it can facilitate the efficiency of the treatment much better and faster than only with herb or acupuncture. Equilibrium between body and mind is its originality. Methods : A 38-year old man came to hospital suffering from left side weakness, dysarthria because of cerebral infarction. After one week's medication in the part of neurology, he was sent to the oriental medicine music therapy center, and he took ten times' medical treatments once a day. Before and after the treatments, implementing 'Ink foot print analysis', as for the movement capacity and walking of left side weakness, these results are acquired. Results and Conclusions : 1. Before the oriental medicine music therapy, except the acceleration and deceleration section, within three meters, a right foot's step was measured 30.55 cm and a left foot was measured 15.2 cm, and the step distance was 15.2 cm. After the 10 times treatments, the right foot's step was 112.6 cm, the left foot's step was 113 cm, and the step distance improved to 51.8 cm. 2. The normal person's average step is about 38 cm, and it could be decreased owing to a decreptitude, pain, fatigue, and the weakness of the legs. In spite of all, from the increased 50 cm step measurement with the patient's body condition, it means that his movement capacity is recovered. 3. In the measurement of walking time, before 10 times treatments, it took 46.35 seconds within 6M, but after the treatments, it increased to 7.47 seconds as same as a normal person's walking speed. 4. In insomnia, and the abnormality of a facial muscle, it shows lots of improvement, and even the accuracy of a pronunciation, but despite of the 10 times treatments, the 'ㄹ(r)' sound placed under a vowel is unclear. 5. Before the 10 times' treatments, he can move the left side shoulder with pain and cannot move below the left elbow. After the treatments, the pain was disappeared, and he was able to move over 60 cm without pain. And improving of the movement of fingers, he can beat over 8 times with a drumstick.

개심술을 받은 심기형 환아모의 교육프로그램 개발을 위한 조사연구 (Descriptive Study on the Development of Educational Program for Mothers with Children who have had Open Heart Surgery in Congenital Heart Disease)

  • 이군자;조현숙
    • 재활간호학회지
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    • 제4권1호
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    • pp.73-83
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    • 2001
  • The aims of this study were to identify the mothers educational needs when they have children who have had open heart surgery in congenital heart disease, to identify the children's characteristics with this problem, and also to provide the basic information on the development of the educational program for the mothers. The subjects of the study were 101 mothers of children and their children hospitalized with congenital heart disease in pediatric wards of G. University Hospital in Inchon and S. Hospital in Puch on from June to November 2000. The study used a Likert-type questionnaire with 39 questions which was based on a previous questionnaire developed by Lee Mi-ryun(1989) for adult open heart surgery patients. The reliability of the questionnaire was Cronbach' ${\alpha}$=.9375. The data were collected directly from mothers of the patients in wards. The t-test, ANOVA was adopted for the data analysis. The key results of the study are as follows : 1) The average age of the children was 32.90 months. The majority of the children are male and weighted 3.0-3.5Kg at birth. Most of the children had VSD(29.7%), and 10.9% of children had a family history of heart disease. 2) An average score of 4.62 out of a maximum of 5.00 was recorded for the educational needs of the children's mother. The highest score of 4.69 was for home care after discharge followed by a score of 4.67 for diagnosis and prognosis on congenital heart disease. And pre-post operation care scored 4.51. The mean scores of single-question items of educational need were, in order, 4.81 for immunization after operation, 4.80 for recovery process, and 4.77 for prognosis of the disease. The score of 4.18 for measurement of intake and output was the lowest. 3) The analysis on the children's mothers educational needs by social-demographic characteristics such as sex, age of patient and mother, economical status, educational status, number of child, hospitalization times, and hospitalization cause showed no significant difference statistically, but there was a significant difference between mothers with jobs and with out jobs.

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가정전문간호사의 대체요법에 대한 인식 (A Study on the Home Care Nurses' Perception of the Complementary & Alternative Therapy)

  • 장경자;김현리
    • 가정∙방문간호학회지
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    • 제13권1호
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    • pp.24-32
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    • 2006
  • The purpose of this study is to predict the degree of taking the complementary & alternative therapy in the home care nursing service and provide basic data for the application of it. To accomplish this, degree of general recognition of the complementary & alternative therapy, experiences, degree of concern, applicability of the therapy, and educational need should be studied. This study is a descriptive research survey on the home care nurses working at 73 medical centers out of 125 nationwide who provide hospital based home nursing care. The data was collected from Sep. 20, to Oct. 20, 2004 by ChoiHeyran's questionaries (2002). The data was analyzed by the frequency and the percentage. The results of this study are as follows ; 1. The degree of pre-cognition on the complementary & alternative therapy is very high. Information about the therapy was mostly obtained through medias. Home care nurses understand that he desirable treatment is to practice medical treatment and complementary & alternative therapy simultaneously. While 50% of them have already practiced complementary & alternative therapy among their patients. The most commonly used therapy is Acupressure. And Home care nurses have open and positive attitudes about the complementary & alternative therapy as to answer they aye ready to recommend it to their patients. 2. Over half of the Home care nurses met patients taking complementary & alternative therapy. 94.5% of them think scientific diagnosis on the effect of the therapy. advice from the doctor. and the special working staff is required to apply it on to the home care nursing. 3. 68.5% of the Home care nurses have taken education on the therapy through general comprehensive instructions and supplementary. Most of them want to have a opportunity education on the therapy because they want to provide comprehensive nursing and diversified nursing service. The preferred educations are Hand acupuncture, Acupressure & Massage and Aromatherapy, in that order. Based on the above results, the followings are recommended. 1. A study that stipulates the types, applications, and efficiency assessment of the complementary & alternative therapy practiced by Home care nurses in the home care nursing care procedure. And systematic and scientific nursing intervention be developed.

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