• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.234-241
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• 2004

연구배경 : MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 못한 실정이다. 본 연구는 MAC 폐질환 환자를 대상으로 clarithromycin이 포함된 내과적 치료의 효과를 알아보고자 하였다. 대상 및 방법 : 2000년 1월부터 2003년 12월까지 삼성서울병원 호흡기내과에서 진단된 MAC 폐질환 환자 56명 중 clarithromycin이 포함된 병합 항생제 치료를 6개월 이상 시행한 환자 15명을 대상으로 하여 후향적 조사를 시행하였다. 결 과 : 남자가 6명(40%) 여자가 9명(60%)이었고, 연령의 중앙값은 67세(범위 53-87세)였다. 원인균은 M. intracellulare가 12명(80%), M. avium이 3명(20%)이었고, 객담 도말 양성환자가 13명(87%)이었다. 5명(27%)의 환자는 upper lobe cavitary form, 그리고 10명(67%)은 nodular bronchiectatic form이었다. 모든 환자에서 clarithromycin, rifampin, ethambutol을 투여하였고, 8명(53%)의 환자는 streptomycin을 함께 사용하였다. 치료기간은 중앙값 17개월(범위 8-22개월)이었다. 6개월 이상 치료한 15명 중 8명(53%)에서 균음전에 성공하였다. 6개월 치료 후 단순흉부방사선 촬영에서 10명(67%)이 호전되었고 5명(33%)은 변화가 없었다. 균음전에 실패한 1명은 폐절제술을 시행하였다. 폐절제술을 시행한 환자를 제외하고 12개월 이상 내과적 치료를 시행한 9명 중 4명(44%)이 균음전에 성공하였다. 12개월 치료 후 단순흉부방사선촬영에서 6명(67%)이 호전을 보였다. 전체적으로 내과적 치료 후 균음전에 성공한 환자는 9명(60%)으로, 이 중 5명의 환자는 치료 시작 1-2개월 후부터 배양 음성이 유지되었다. 1명의 환자에서 위장관 장애와 시신경염으로 치료를 중단하였다. 결 론 : MAC 폐질환에서 clarithromycin을 포함한 내과적 치료 후 균음전에 성공한 환자는 60%에 불과하였다. 보다 효과적인 치료약제의 개발이 필요하며, 내과적 치료에 반응하지 않는 환자에서는 폐절제술을 고려하여야 할 것으로 사료된다.

• Journal of Chest Surgery
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• 제47권3호
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• pp.249-254
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• 2014

Background: Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Methods: One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to $0.8\;{\mu}g/kg/hr$; n=67) or remifentanil (range, 1,000 to $2,500\;{\mu}g/hr$, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care. Results: When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects. Conclusion: This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.

• Journal of Chest Surgery
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• 제45권2호
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• pp.116-119
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• 2012

A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.

• The Journal of Korean Physical Therapy
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• 제26권2호
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• pp.130-135
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• 2014

Purpose: The purpose of this study was to examine the impairments of body structures, activity limitation, and participation restriction. In addition, we wanted to provide basic data on correlation between impairments of body structures, activity, and participation in Disabled Persons Living at Home. Methods: After selection of 128 people with physical disabilities more than the third level and brain damage disabilities living at home, we conducted testing for impairments of body structures, activity, and participation, according to the ICF checklist. Results: Impairments of body structures was highest in the upper and lower extremity. 2) Mobility, domestic life, and self care were more limited. 3) Also, the structure related to movement showed correlation with mobility, domestic life, and self care. Conclusion: We observed differences in participation and activities of persons with disabilities Living at Home depending on the impairments of body structures. After thorough review of the status of Disabled Persons Living at Home, we decided to appropriate support and social services.

• Advances in pediatric surgery
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• 제3권1호
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• pp.32-40
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• 1997

A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

• The Journal of Korean Physical Therapy
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• 제34권6호
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• pp.304-311
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• 2022

Purpose: The purpose of this study was to investigate the knowledge, awareness and performance of COVID-19 infection control among physical therapists and to identify the impact factors on performance Methods: Data were collected from March 16th to March 24th in 2022 from the physical therapist's in Busan. Data analysis was conducted on 170 surveys, after excluding 27 surveys that were found to be unsuitable for data analysis. Results: When correlating the study variables, knowledge and awareness were found to have a positive, meaningful correlation with performance. Performance of COVID-19 personal infection control regression analysis showed that the working department (clinic and long-term care hospital), clinical experience, the more knowledgeable, the awareness (personal), and the more clinical experience had significant positive impacts on the performance of COVID-19 infection control. Performance of COVID-19 treatment room infection control regression analysis showed that the working department (long-term care hospital), educational experience, the awareness (treatment room) had significant positive impacts on the performance of COVID-19 infection control Conclusion: The results of this study may be used as basic data for educating physical therapist's working at the COVID-19 response department. This study suggests that physical therapist's need educational programs to improve their knowledge and awareness and performance of infection control against infectious diseases such as COVID-19. Differentiated physical therapists practice education curricula must be developed and provided after understanding the varying characteristic of physical therapist's with different levels of work experience.

• 한국병원경영학회지
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• 제4권2호
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• Childhood Kidney Diseases
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• 제22권1호
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• pp.7-11
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• 2018

Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.

• 한국보건간호학회지
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• 제21권1호
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• pp.15-24
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• 2007

Purpose: The study aim was to provide basic data needed for formulating systematic visiting nursing strategies by comprehending the characteristics and self-care ability of the object families of public health centers in Korea. Method: The research examined 252 families and 339 family members of the vulnerable class that were registered in a visiting nursing program of an urban public health center. The data of 220 families were analyzed using descriptive analysis, t-test, and ANOVA, after excluding any incomplete data. Result: 1. The most frequent characteristics of families were solitary families (52.8%) and financially vulnerable families (87.3%). The most frequent way of family detection was request of the community office. 2. The most frequent type of family problems were vulnerable families (93.2%), followed by patient families (91.0%). 3. The mean score was 11.67 for family self-care ability. 4. The variables of the number of family members, disease type of the patient family members, and the type of vulnerable family showed a significant difference of family self-care ability. Conclusion: This study suggests that vulnerable families demand specific nursing interventions focused on their own problems and that visiting nurses need to obtain and use supportive resources.

• 가정간호학회지
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• 제23권2호
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• pp.121-128
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• 2016

Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.