• 제목/요약/키워드: Standardized patients

검색결과 838건 처리시간 0.031초

각안정 잠김 압박 금속판을 이용한 전위된 근위 상완골 골절에 대한 수술적 치료 (Operative Treatment of Displaced Proximal Humerus Fractures with the Angular Stable Locking Compression Plate)

  • 김동욱;김종관;정성원;김현수
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.27-34
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    • 2011
  • 목적: 전위된 근위 상완골 골절에 대하여 PHILOS 각안정 잠김 압박 금속판을 이용한 수술적 치료 후 임상적 및 방사선학적 결과와 합병증에 대하여 알아보고자 하였다. 대상 및 방법: 2007년 3월부터 2010년 2월까지 근위 상완골 골절로 PHILOS 금속판 고정술을 시행한 44명의 환자를 대상으로, 평균 12개월의 추시 관찰을 시행하였다. 임상적 평가는 VAS 점수와 Constant 점수를 이용하였으며, 방사선학적 평가는 단순 방사선 검사 상 경간각과 내측지지대의 존재 유무로 평가하였다. 결과: 최종 추시에서 평균 VAS 점수는 2.8점, Constant 점수는 평균 70.5점이었으며, 방사선학적 평가 결과 평균 경간각 122.5도로 양호군은 불량군에 비해 통계적으로 유의한 소견을 보였다. 내측 지지대가 존재하는 경우 36예 또한 존재하지 않는 8예에 비해 통계적으로 유의하였다. 12예에서 금속판의 고정 실패 등의 합병증이 관찰되었다. 결론: PHILOS 금속판을 이용한 전위된 근위 상완골 골절 고정술은 술기가 용이하고 만족할 만한 결과를 얻을 수 있다고 생각된다.

견관절 역행성 인공관절 치환술의 원칙 (Reverse Total Shoulder Arthroplasty: Where we are? "Principles")

  • 노규철;서일우
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.105-110
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    • 2011
  • 목적: 견관절 역행성 인공관절 치환술의 합병증을 이해하고 이에 대한 최신의 예방 및 치료 방법을 고찰하는 것이 본 논문의 목적이다. 대상 및 방법: 기존의 구속형 인공관절 기구 (구-소켓 관절 혹은 역행성 구형 관절 디자인)는 견갑골의 외측에 회전 중심이 유지되어 제한된 관절 운동과 관절와 기구에 발생한 과도한 회전력으로 인해 조기 해리를 유발하여 실패해왔다. Grammont 역행성 인공관절 기구는 삼각근이 작용하는 새로운 생역학적 환경을 도입하여 회전근개 결손을 보상할 수 있도록 해준다. 결과: 임상적 경험이 생역학 개념에 부응하면 역행성 인공관절은 회전근 개 결손 견관절 환자에서 $90^{\circ}$이상의 능동적 거상을 회복하게 한다. 그러나 외회전은 특히 소원근 지방침윤 내지 결손이 있는 환자들에서는 종종 제한이 남는다. 내회전 역시 역행성 인공관절 후에는 거의 회복되지 않는다. 삼각근에 충분한 긴장을 회복하지 못하면 인공관절 불안성이 초래된다. 결론: 인공관절 치환술 후 재수술에서 그 결과는 예측가능성이 떨어지고, 합병증 및 재치환술 비율이 더 높음을 인지해야만 한다. 합병증을 인지하고 예방하기 위해서는 명확한 정의와 평가 지침을 포함한 표준화된 감시 장치가 필요할 것으로 사료된다.

CT상 악성여부가 불명확한 단일 폐결절에서의 양전자방출단층촬영술의 유용성 (Role of PET in Evaluating Indeterminate Solitary Pulmonary Nodule with CT)

  • 윤석부;최준영;김선정;최용;최연성;이경한;김상은;권오정;이경수;김병태
    • 대한핵의학회지
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    • 제31권1호
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    • pp.83-89
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    • 1997
  • CT에서도 악성 여부가 불명확한 단일 폐결절의 감별진단에 있어 PET이 어떠한 도움을 줄 수 있는지 알아보고자 이러한 환자 30명을 대상으로 FDG-PET을 시행하여 각 환자에서 구한 pSUV, aSUV, TAC 양상, 50/10비의 4가지 매개변수를 조직검사결과와 비교하여 다음과 같은 성적을 얻었다. 1) 4가지 매개변수의 악성판정 기준치로 $pSUV{\geq}3.5$, aSUV>2.5, TAC=상향, 50/10비${\geq}1.45$를 적용하였을 때 악성판정에 있어 각각의 예민도는 86.7%, 66.6%, 86.7%, 73.3%였으며, 특이도는 86.7%, 86.7%, 46.7%, 86.7%였다. 2) 4가지 매개변수중 구하기 용이한 점과 정확도를 감안할 때 임상적으로 pSUV가 가장 유용하였다. 3) pSUV를 사용하였을 경우 CT에서 불확실한 단일 폐결절의 87%에서 정확한 진단이 가능하였다. 4) 기관지 폐포암을 제외할 경우 예민도가 100%였다. 이상의 결과에서 FDG-PET에서 구한 pSUV는 여러 가지 매개변수중 가장 용이하게 구할 수 있으며 비 침습적으로 단일 폐결절의 악성여부를 가릴 수 있는 유용한 방법이었다.

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$^{18}F$-FDG PET 검사를 위한 당뇨 환자의 혈당 조절에 관한 연구 (A Study of Diabetic Control for Diabetic Patient in $^{18}F$-FDG PET)

  • 차민경;남기표;이영희;최재민;조시만
    • 핵의학기술
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    • 제12권1호
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    • pp.57-61
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    • 2008
  • Purpose: $^{18}F$-FDG PET is to evaluate the tumor using glucose metabolism. Blood Glucose Level (BGL) is important factor that affects on a result of examination. But it often appears the distort result on diabetic patient due to a failure of BGL control. The aim of this study is to make a effective guideline for diabetic patient prescribed $^{18}F$-FDG PET and improve accuracy and reliability of examination. Materials and methods: A subject of study is 69 diabetic patients and divided them into 3 groups; 1) BGL is less than 120 mg/dl & performed PET, 2) BGL is over than 120 mg/dl & performed PET, 3) BGL is over than 120 mg/dl & not performed PET. And we investigated the type of diabetic medications and the time of dosage, whether they have meal or not. And we analyzed SUV of liver and mediastinum to recognize the effect of BGL on PET images. Results: As a methods to diabetic control, Amalyl showed high percentage of 27.5% in oral medication and Humulin R showed 14.5% in insulin. Their peak time was 2-3 hrs, 2-4 hrs and duration time was 24 hrs, 5-7 hrs. The number of that had a breakfast was 16, 7 mens (43.8%) couldn't perform PET as over 120 mg/dl and 5 mens (31.3%) performed PET as less than 120 mg/dl after they took a medication. When we set the SUV of normal for 1.5-2.0, 1.0-1.5 on liver and mediastinum, the percentage out of the range was 31.8%, 52.9%, 62.5% in 120-139 mg/dl, 140-159 mg/dl, 160-200 mg/dl respectively. Conclusions: We completed standardized guideline for diabetic patients. As a result of this study, improved customer satisfaction and increased economic benefits. It is expect to be a effective model in other PET centers.

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야제 환아의 한의치료에 대한 질적 연구 - 주양육자의 서술을 중심으로 - (A Qualitative Study on Traditional Korean Medicine Treatment for Child Patients with Night Crying - With a Focus on Descriptions by Main Fosterers -)

  • 김혜진;전채헌;김은지;김현호;임정태;유수향
    • 대한한방소아과학회지
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    • 제32권1호
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    • pp.44-53
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    • 2018
  • Objectives This study sets out to examine treatment experiences of child patients with night crying based on the traditional Korean medicine. Also, the study traces the process in which clients chose traditional Korean medicine treatment, and proposes a possible future direction of Korean medicine treatment. Methods The investigator conducted a semi-standardized open-ended question interview with two main fosterers of a child who received traditional Korean medicine treatment for night crying, and examined two fosterers' experiences of a child with the traditional Korean medicine treatment. Their interviews were recorded with their facial expressions and acts for analysis. Collected data was analyzed based on the Grounded theory. Results The participants felt a sense of responsibility, worry, and fear for their children with night crying. They had easy access to traditional Korean medicine doctors who were in the community and had positive experiences with traditional Korean medicine treatment. They reported that some people had been forced to use traditional Korean medicine, had misunderstandings about traditional Korean medicine, and had prejudice that night crying is not a disease. They felt there was a room for improvement in terms of the high medical expenses and the absence of a cooperative system between Oriental and Western medicine. Conclusions As the first qualitative study on night crying based on the traditional Korean medicine treatment, this study proposed a future direction for traditional Korean medicine treatment for night crying in the shoes of fosterers. The findings showed that the fosterers chose traditional Korean medicine treatment for night crying child based on their feelings, accessibility and experiences with traditional Korean medicine. Fosterers felt a need for improvement of the general public's perceptions about Korean medicine treatment on night crying, and a cooperative system between Oriental and Western medicine.

퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구 (Study on the Applicability of Thermography as Severity Measurement in the Patients with Osteoarthritis of the Knee)

  • 서병관;류성룡;강중원;안경애;이재동;최도영;김건식;이두익;이윤호;이상훈
    • Journal of Acupuncture Research
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    • 제22권4호
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    • pp.35-45
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    • 2005
  • Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index. Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, VAS were not correlated with the thermal differences of each region. Conclusion : Futher study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

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동종 조혈모세포 이식환자의 이식 전 처치 형태에 따른 영양상태 (Nutritional Status of Recipients of Allogeneic Hemopoietic Stem Cell Transplantation by Types of Conditioning Regimen)

  • 김남초;김희승;최소은;박현정
    • 한국보건간호학회지
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    • 제14권2호
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    • pp.191-202
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    • 2000
  • This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.

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원발성(原發性) 월경통(月經痛) 정도에 따른 하복부(下腹部) 온도차이(溫度差異) 연구(硏究) (The study on the abdominal temperature difference according to primary dysmenorrhea severity)

  • 윤영진;최윤희;조정훈;장준복;이경섭
    • 대한한방체열의학회지
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    • 제3권1호
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    • pp.6-14
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    • 2004
  • Purpose: We intended to research the relations between abdominal temperature and primary dysmenorrhea severity. Methods: We selected the 95 primary dysmenorrhea patients by means of screening test (first screening test-inquiry, second screening test-clinical test, additionally Waist-to-Hip ratio (WHR) by Inbody 2.0). We measured 4 points abdominal temperature (Chon-jung(CV17), Chung-wan(CV12), Kwan-won(CV4), Chung-guk(CV3)) by DITI (DOREX Inc., USA). And then we checked the difference of temperature $({\Delta}T)$ between CV17 and CV4 / CV17 and CV3 / CV12 and CV4 / CV12 and CV3. After that, we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by multidimensional scales (verbal rating scale modified from the one devised by Bibe roglu & Berhrman(VRS; B&B), multidimensional verbal rating scale by Andersch & Milsom(MVRS)). In dysmenorrhea severity, we standardized scale score and 3-group-severity by score (mild, moderate, severe). For statistics, we used Pearson correlations and Spearman's rho correlations, SPSS 11.0 for windows. Results: In case of MVRS, MVRS score and 3-group-severity were not correlated to ${\Delta}T$. In case of VRS; B&B, VRS; B&B score was correlated to ${\Delta}T$ (CV12 and CV4 / CV12 and CV3) and 3-group-severity was correlated to ${\Delta}T$ (CV12 and CV3). Statistically they showed significant result (p<0.05). So we can consider that ${\Delta}T$ (CV12 and CV3) and the primary dysmenorrhea severity by VRS; B&B are most correlated. Conclusion: The primary dysmenorrhea patients showed that severity by VRS; B&B was connected with ${\Delta}T$ (CV12 and CV3). So we can consider DITI as primary dysmenorrhea evaluation instrument and must further research measurement points for the exact primary dysmenorrhea evaluation by DITI.

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안면비대칭자의 하악골 악교정수술 후 정면 연조직 변화 예측을 위한 연구 (Prediction of frontal soft tissue changes after mandibular surgery in facial asymmetry individuals)

  • 황현식;;황정현;최학희;임회정
    • 대한치과교정학회지
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    • 제38권4호
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    • pp.252-264
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    • 2008
  • 본 연구는 안면비대칭 환자의 악교정수술 시 경조직 이동에 따른 연조직 변화를 정면에서 평가함으로써 정면 얼굴 이미지 시뮬레이션 프로그램 개발에 도움이 되고자 시행되었다. 안면비대칭이 동반된 하악골 수술 예정 환자 45명을 대상으로 정모 두부방사선규격사진과 얼굴사진(photo)을 술전 및 술후에 각각 같은 각도로 촬영한 후, 술전 및 술후의 방사선사진을 이용하여 경조직 계측점의 변화를, 얼굴사진을 이용하여 연조직 계측점의 변화를 수평 및 수직으로 구분하여 각각 측정한 후 경조직 변화에 따른 연조직 변화를 비교 분석하였다. 연조직 변화와 경조직 변화의 상관성을 살펴본 결과 수평 방향, 수직 방향 모두에서 전반적으로 낮은 상관성을 보였으며, 1 : 1 mean ratio 산출을 위하여 서로 상관성이 가장 높은 경조직 계측점을 연조직 계측점별로 선택한 결과 직하방에 있는 경조직보다는 다소 멀리 떨어져 있는 경조직 계측점이 선택되는 경우가 많이 나타났다. 경조직 변화를 이용하여 연조직 변화를 예측할 수 있는 회귀방정식을 연조직 계측점별로 산출한 결과 연조직 수평변화 예측에 경조직 수직변화도 사용되고 연조직 수직변화 예측에 경조직 수평변화도 사용되었으며, 수평과 수직변화 모두에서 가장 설명력이 높은 방정식은 연조직 menton에서 나타났다. 이상의 연구결과 하부 경조직 계측점과 상부 연조직 계측점의 비율을 이용하는 1 : 1 mean ratio 방법은 불가능한 것으로 나타난 반면 회귀분석을 이용한 연조직 변화 예측은 임상에 도움이 될 수 있는 것으로 나타나 정면 이미지의 경우 컴퓨터를 이용한 시뮬레이션 프로그램이 반드시 필요함을 시사하였다.

알츠하이머병 및 경도인지장애 환자에서 인지기능 및 행동심리증상과 백질고강도신호와의 연관성 (Association between Cognitive Function, Behavioral and Psychological Symptoms of Dementia and White Matter Hyperintensities in Patients with Alzheimer's Disease and Mild Cognitive Impairment)

  • 권지웅;김현;이강준
    • 정신신체의학
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    • 제26권2호
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    • pp.119-126
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    • 2018
  • 연구목적 본 연구의 목적은 알츠하이머병 및 경도인지장애 환자에서 백질고강도신호 차이에 따른 신경인지 기능 및 행동심리증상(BPSD)을 비교하는 것이다. 방 법 본 연구는 후향적 연구로서, 알츠하이머병 및 경도인지장애로 진단받은 115명을 대상으로 하였다. 뇌 자기공명영상의 백질 고강도 신호(white matter hyperintensity, WMH)는 표준화된 시각 기반 척도(Fazekas scales)에 의해 평가되었으며, 참가자들은 Fazekas 척도에 따라 두 그룹으로 분류되었다. 신경인지기능은 임상치매평가척도(CERAD-K)에 의해, BPSD는 한국형 신경정신행동검사(K-NPI)로 평가되었다. WMH의 심각도에 따른 신경인지기능 및 BPSD의 차이를 분석하기 위해 독립표본 t-test를 시행하였다. 결 과 WMH의 중증도가 높은 군은 유의하게 낮은 언어 유창성을 나타내었다(p<0.05). 또한 WMH의 중증도가 높은 군은 유의하게 높은 K-NPI 점수를 보였다(p<0.01). 결 론 WMH와 실행기능과 관련된 신경인지검사 간에는 유의한 연관이 있었다. 또한 WMH는 BPSD의 중증도에 영향을 미치는 것으로 보인다. 임상실제에서 WMH를 알츠하이머 병(Alzheimer's disease, AD)및 경도인지장애(Mild cognitive impairment, MCI)환자를 치료하는데 유용한 정보를 제공할 것이다.