• 한국융합학회논문지
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• 제8권1호
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• pp.77-87
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• 2017

본 연구는 앞십자인대 재건술 환자를 대상으로 융복합기반 러시안전류와 경피신경전기자극을 적용하였을 때 통증, 근력 및 기능에 미치는 영향을 비교하고자 하였다. 본 연구는 앞십자인대 재건술 환자 40명(러시안전류 적용군 20명, 경피신경전기자극 적용군 20명)을 대상으로 실시하였다. 두 군은 1회 20분, 주5회 4주 동안 각각의 전기중재를 실시하였고, 냉치료와 기기를 사용한 연속수동관절가동운동을 무릎관절주변에 각각 20분간 실시하였다. 치료적 중재의 영향을 알아보기 위하여, 본 연구는 중재 전후에 시각적 상사척도, 무릎 굽힘 및 폄 근력, 무릎상해와 관절염 결과지수, 한국판 다리 기능척도를 측정하였다. 두 군 모두 시각적 상사척도, 무릎 굽힘 및 폄 근력, 무릎상해와 관절염 결과지수, 한국판 다리 기능척도 점수에서 치료적 중재 이후에 통계학적으로 유의한 개선을 보여주었다. 또한, 러시안전류 적용군은 경피신경전기자극 적용군보다 무릎 폄 근력과 한국판 다리 기능척도에서 중재 후 유의한 증가를 보였다. 본 연구의 결과를 바탕으로 앞십자인대 재건술 환자에게 있어 두 중재 방법 모두 효과적인 개선을 보였지만, 러시안전류가 경피신경전기자극보다 무릎근력과 다리기능을 개선하는데 더 효과적이라고 보고하며, 향후 임상에서 앞십자인대 재건술 환자의 재활에 러시안전류의 적용에 긍정적인 이점이 있다고 제언하는 바이다.

• Journal of Chest Surgery
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• 제35권12호
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• pp.876-881
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• 2002

대동맥박리증은 사망률이 매우 높은 질환으로 조기 진단 및 치료가 되지 않으면 예후가 매우 불량한 질환이다. 최근 컴퓨터단층화촬영과 심초음파 기술의 발달로 진단률이 높아지고 조기수술이 가능하게 되었으며 술전 응급실에서 적극적인 약물투여로 사망률이 낮아지고 있는 상태이다. 따라서 이 연구는 후향적으로 응급실에서의 처치 및 수술 결과를 분석하였다. 대상 및 방법: 1991~2001년까지 외과적 교정술을 시행받은 급성 대동맥박리증 환자 42명을 대상으로 하였다. 남자가 18례, 여자가 24례였으며 연령은 평균 51.1세였다. 또한 응급실을 경유한 경우가 34례, 외래를 통한 입원이 8례였다. 결과: 수술은 상행대동맥치환술이 26례였으며 이중 대동맥판막 치환술을 병행한 경우가 7례였다. 하행대동맥치환술은 7례였으며 Bentall술식은 9례에서 시행하였다. 응급실 내원시 혈압강하제와 $\beta$-수용체차단제를 20례에서 투여하였으며 이중 6111(30%)에서 사망하였다. 이런 약물을 투여하지 않은 22례환자중 10례(45.5%)에서 사망하였다. 전체 사망은 16례(38%)였다. 결론: 대동맥박리증은 응급실이나 외래에서 조기진단이 필요하며 가능한한 비침습적 검사방법을 택하고 환자상태에 따라 적극적인 술전 약물처치가 이루어져야 할 것으로 생각된다.

• 대한핵의학회지
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• 제16권2호
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• pp.29-36
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• 1982

Quantification of the regurgitation amount is important before and after valvular replacement surgery. Until now cardiac catheterization with cineventriculography, echocardiography have been used to measure the regurgitation amount, but also have many limitations. EKG gated cardiac blood pool scan provides a simple, non-invasive -method for quantify the regurgitation amount. By calculating the ratio of left ventricular to right ventricular stroke counts (stroke volume ratio) in gated bood pool scan, we measured the left ventricular regurgitation amount in 28 cases of valvular regurgitation and 25 cases of normal group. 1. Stroke volume ratio was higher in cases of valvular regurgitation $(2.11{\pm}0.58)$ than in cases of normal control $(1.15{\pm}0.31)$. (p<0.01). 2. Stroke volume ratio was classified by regurgitation grade using X-ray cineventriculography. In grades of mild regurgitation $(Grade\;I{\sim}II)$, stroke volume ratio was $2.02{\pm}0.29$, and in grades of severe regurgitation $(Grade\;III{\sim}IV)$, stroke volume ratio was $2.55{\pm}0.34$, so stroke volume ratio was well correlated with the grade of X-ray cineventriculography. 3. Stroke volume ratio was classfied by functional class made in New York Heart Association. In classes of mild regurgitation $(class\;I{\sim}II)$, stroke volume ratio was $2.08{\pm}0.26$, and in classes of severe regurgitation $(class\;III{\sim}IV)$, stroke volume ratio was $2.55{\pm}0.38$, Stroke volume ratio well represented the functional class. 4. After aortic and mitral valve replacement in 28 patients, the stroke volume ratio, decreased from $2.11{\pm}0.58\;to\;1.06{\pm}0.26$. Gated blood pool scan provides a noninvasive method of qnantifying valvular regurgitation and assessing the result of surgical interventions.

• Journal of Hospice and Palliative Care
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• 제8권2호
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• pp.200-208
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• 2005

목적: 악성 위장관 폐색 환자에서 완화적 시술이나 수술은 폐색의 다양한 증상을 조절할 뿐만 아니라 삶의 질을 향상시킨다. 본 연구는 완화적인 시술을 받았던 악성 위장관 폐색 말기암 환자의 임상적 특징과 예후인자를 알아보고자 하였다. 방법: 2002년 5월부터 2005년 5월까지 본원에서 악성 위장관 폐색으로 진단받아 완화적인 시술을 받았던 48명의 말기암 환자를 대상으로 후향적으로 조사하였다. 완화적인 암절제 환자는 제외하였다. 임상적 특성과 시술내용을 조사하였고 예후인자는 log-rank test를 이용한 단변량 분석을 하고 통계적으로 의미 있는 인자는 Cox's proportional hazard model을 사용하여 다변량 분석을 하였다. 결과: 연령의 중앙값은 65세이고 남자가 25명(52%), 여자가 23명(48%)이었다. 가장 많은 암은 대장직장암으로 26명(55%)이고 다음으로 10명(21%)의 위암이었다. 치료를 전혀 받지 않았던 환자는 25명(58%)이었고 20명(42%)은 치료를 받았으며 이 중 18명은 항암 치료를 받은 과거력이 있었다. 가장 흔한 증상은 통증으로 15명(31%)이었다. 활동도 1점 혹은 2점이 23명(48%), 3점 혹은 4점이 25명(52%)이었다. 가장 많은 완화적인 시술은 대장루술로 19명이 받았다. 완화적 시술로 인한 사망은 없었다. 단변량과 다변량 분석에 의해서 전체 생존기간과 무증상 생존기간에 대하여 활동도 만이 의미있는 독립 예후인자였다. 전체 중간 생존기간은 150일이었으며 무증상 중간 생존기간은 90일이었다. 결론: 완화적 시술을 받은 악성 위장관 폐색 환자의 전체 중간 생존기간과 무증상 중간 생존기간에 대하여 활동도만이 유일한 독립 예후인자였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6033-6038
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• 2015

Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5923-5931
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• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• 대한기계학회논문집B
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• 제37권9호
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• pp.807-814
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• 2013

소화기 내시경에 장착된 808 nm 파장의 고출력 근적외선 레이저를 장벽에 조사하여 병변을 제거할 수 있는 치료용 의료기기의 개발을 목적으로 레이저-조직 상호작용에 관한 기초 실험을 진행했다. 레이저 출력 3~12 W, 조사 시간 5~20 s 범위에서 각 변수의 증가에 따라 천공 깊이가 1~4 mm 범위에서 선형적으로 증가했다. 돼지에서 적출한 각 장기에 대한 레이저 조사 시 천공 깊이가 조직 특성에 따라 달라짐을 확인했다. 온도 측정 결과로부터 열에너지가 레이저 조사 지점에 집중되고 심부로 전달되어 주변 조직의 열손상은 방지됨을 알 수 있었다. 본 연구 결과는 위, 대장 등의 소화기 조직에서 일정한 절개 깊이를 얻기 위해 필요한 근적외선 레이저의 구동 조건을 결정하는데 활용될 수 있다.

• 성인간호학회지
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• 제13권2호
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• pp.209-222
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• 2001

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.552-558
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• 2015

Background The Klippel-Trenaunay syndrome (KTS) is characterized by three clinical features, namely cutaneous capillary malformations, venous malformations, and soft tissue and/or bony hypertrophy of the extremities. The varied manifestations are attributed to the unpredictable clinical nature and prognosis of the syndrome. To elucidate the clinical characteristics of this disease, we reviewed a relatively large number of KTS patients who presented to our vascular anomalies center. Methods We conducted a retrospective study with 19 patients who were diagnosed with KTS and treated in our vascular anomalies clinic between 2003 and 2014, and examined their demographic characteristics, their clinical features, and the treatments administered. Results The sex distribution was balanced, with 9 (47%) males and 10 (53%) females. The mean follow-up period was 4.1 years (range, 7 months-9 years). Most of the patients received conservative treatments such as medication or physiotherapy. Compression therapies such as wearing of elastic garments/bandages were also administered, and surgical interventions were considered only when the patients became excessively symptomatic. Other treatments included laser therapy and sclerotherapy, and all the treatments were adjusted according to each case, tailored to the conditions of the individual patients. Conclusions KTS is an extremely rare, multifactorial disorder that induces widely varied symptoms. Because of this unique feature, plastic surgeons, when not careful, tend to attach a one-sided importance to typical symptoms such as limb hypertrophy or capillary malformation and thus overlook other symptoms and clinical features. KTS can be suspected in all infants who show capillary malformations or limb hypertrophy and require a multi-disciplinary approach for comprehensive management.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.5-11
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• 2009

Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.