• 재활복지
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• 제22권4호
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• pp.83-102
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• 2018

본 연구는 척수손상이 고령이 됨에 따라 만성질환과 2차 합병증에 미치는 요인을 알아봄으로써 효율적으로 관리와 예방에 관한 기초적인 자료를 제공하고자 한다. 대상자는 2013년 4월부터 2018년 4월까지 S병원에 입원한 척수손상 200명 대상으로 하였다. 의무기록 조사를 통해 만성질환인 고혈압, 당뇨, 간염, 결핵과 2차 합병증으로 폐렴, 기립성저혈압, 욕창, 부종, 자율신경반사항진, 심부정맥 혈전증, 이소성골화증, 중추성통증, 경직(상지/하지), 근 골격계 통증, 변비, 구축, 우울증, 골절, 고칼슘혈증, 불면증, 신장결석, 신경인성 방광 및 장, 비요로감염, 비만, 골다공증, 폐혈증, 수면무호흡, 요로감염의 발생유무를 조사하였다. 연구 결과 50세 미만보다 50세 이상 척수손상이 만성질환 및 2차합병증에 영향을 미치는 요인들로 나타났다. 50세 이상의 만성질환 유병 오즈비는 고혈압 11.8배, 당뇨 6.7배이며, 2차합병증 유병 오즈비는 골다공증 7.5배, 폐렴 5.2배, 신경인성통증 0.4배로 나타났다. 고령척수손상의 만성질환 및 2차합병증의 지속적인 관리와 서비스의 필요성을 시사하고, 향후 대상자의 확대와 다양한 특성을 포함한 연구가 이루어줘야 할 것이다.

• 가정간호학회지
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• 제23권2호
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• pp.139-146
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• 2016

Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

• 한국보건간호학회지
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• 제15권2호
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• pp.334-341
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• 2001

The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.379-385
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• 2015

Chronic subdural hematomas mainly occur amongst elderly people and usually develop after minor head injuries. In younger patients, subdural collections may be related to hypertension, coagulopathies, vascular abnormalities, and substance abuse. Different techniques can be used for the surgical treatment of symptomatic chronic subdural hematomas : single or double burr-hole evacuation, with or without subdural drainage, twist-drill craniostomies and classical craniotomies. Failure of the brain to re-expand, pneumocephalus, incomplete evacuation, and recurrence of the fluid collection are common complications following these procedures. Acute subdural hematomas may also occur. Rarely reported hemorrhagic complications include subarachnoid, intracerebral, intraventricular, and remote cerebellar hemorrhages. The causes of such uncommon complications are difficult to explain and remain poorly understood. Overdrainage and intracranial hypotension, rapid brain decompression and shift of the intracranial contents, cerebrospinal fluid loss, vascular dysregulation and impairment of venous outflow are the main mechanisms discussed in the literature. In this article we report three cases of different post-operative intracranial bleeding and review the related literature.

• 대한족부족관절학회지
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• 제17권2호
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• pp.84-92
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• 2013

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.

• 대한임상독성학회지
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• 제2권2호
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• pp.116-122
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• 2004

Purpose: Several risk factors related with chronic complications and mortality related with liver injury of mushroom poisoning were reported. But, there were few reports about the long term outcomes. The aim was to evaluate the long term clinical outcomes in mushroom poisoning regarding the risk factors. Methods: Clinical data were reviewed and outcomes were evaluated with medical records and/or telephone interviews. The patients who had one or more risk factors such as markedly elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT), prolonged prothrombin time (PT) were classified into high risk group. Patients had no risk factor classified into low risk group. Results: From June 1989 to December 2003, nineteen mushroom poisoning patients admitted to Asan Medical Center, seven were male, and mean age was $58\pm9$ years old. All the patients accidentally ingested and the interval from ingestion to symptom onset was $9\pm4$ hours. There were four patients in high risk group, and fifteen in low risk group. In high risk group, peak AST was $2,263.3\pm1,303.0IU/L$most prolonged PT was $38.0\pm27.4\%$, and stuporous mental status was shown in one patient. In low risk group, laboratory values returned to the normal values but histological evaluation revealed specific features of toxic hepatitis on sixth hospital day. Chronic complications such as persistent or chronic hepatitis, mortality was not occurred during follow up period (from 10 months to 16 years) in both groups. Conclusion: Although the number of patients were small, there were no chronic complications or mortality related with liver injury after mushroom poisoning regardless risk factors of chronic complications and mortality.

• Journal of Chest Surgery
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• 제21권3호
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• pp.497-509
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• 1988

Current therapy of aortic dissections remains unstandardized because of the relative rarity of these catastrophic events and conflicting reported results of various therapeutic strategies. Hence, we reviewed our current results and planned to purify our method of interpretation of results and so, to standardize therapeutic managements. This study comprised unselected, consecutive 27 patients with aortic dissections who were operated at Seoul National University Hospital from Jan 1983 to March 1988. The results from analysis of their preoperative, operative and postoperative finding were as follows: 1] 7 patients had acute type A, 14 had chronic type A, 4 had acute type B, and 2 had chronic type B. 2] The causes of dissections were unclear, but 8 patients had Marfan`s syndromes, 2 had previous operative histories on cardiovascular systems and 2 had congenital heart diseases. 3] Multiple preoperative variables were found to correlate significantly with operative mortality and complications. The prevalences of such preoperative major complicating factors were significantly more frequent in acute than chronic [P < 0.05] and type A than type B [P < 0.01]. 4] Operations were performed according to the type of the dissections and whether it was acute or chronic. Usually dacron tube graft replacements were performed[25/26]. Intraluminal sutureless graft replacement was performed in 11 patients. Of the 14 patients with combined aortic regurgitation, concomitant aortic valve resuspension in 4, seperative aortic valve replacement in 1, and aortic valve replacement with coronary reimplantation were performed in 9 patients. 2 patients had concomitant arch vessel managements. 5] Over-all operative mortality rate was 33% and 54% for acute type A, 25% for acute type B, 29% for chronic type A, 0% for chronic type B respectively. The main causes of operative mortality were cardiovascular complications [mainly CPB-weaning failure] in acute cases and hemorrhagic complications in chronic cases.

• Journal of Chest Surgery
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• 제11권2호
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• pp.227-231
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• 1978

Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.

• The Korean Journal of Pain
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• 제27권3호
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• pp.297-300
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• 2014

This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.267-268
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• 2007

Complications after surgery for chronic subdural hematoma [SDH] include recurrence of the hematoma, tension pneumoencephalus and intracerebral hematoma. We report an unusual case of development bilateral of acute subdural hematoma after drainage of chronic subdural hematoma in a 48-year-old woman. Pathophysiological mechanisms of this uncommon entity are discussed and relevant literature is reviewed.