• 대한한방내과학회지
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• 제40권2호
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• pp.246-253
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• 2019

Objective: In this care report, we address a case of a Parkinson's disease patient with nausea and vomiting. Methods: A patient was treated with Korean medicine therapies including herbal medication (Hyungbangjihwang-tang, Boikyangwie-tang), acupuncture, and electroacupuncture during 35 days of hospitalization. We evaluated the improvements of symptoms by checking the number of vomiting episodes and the presence of nausea. Results: During 35 days of Korean medicine treatment, there was improvement in patient's symptoms. The frequency of vomiting had decreased, and the nausea had decreased and not appeared for the last 7 days. Conclusions: This study suggested that Korean medicine therapies might be effective in relieving gastrointestinal symptoms of Parkinson's disease.

• 종양간호연구
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• 제4권2호
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• 기본간호학회지
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• 제13권2호
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• pp.190-199
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• 2006

Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.47-55
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• 2000

Purpose: The aim of this research is to examine the abnormal liver function complicated with Kawasaki disease (KD) and to analyze its clinical characteristics and complications. Methods: Ninty eight cases were diagnosed as having KD, among which thirty four cases had abnormal alanine aminotransferase (ALT) (>30 IU/L). These abnormal ALT cases were evaluated in terms of age and sex distribution, major symptoms, complications, laboratory and histopathologic findings. Results: Male to female ratio was 2.4:1 and most patients (91.2%) were under 5 years of age. Cervical lymphadenopathy was observed in 3 cases (8.8%); and recurred cases were two (5.8%). Average fever duration was 8 days; average length of hospitalization was 9 days; and average recovery period was 13 days. Immediately after admission, positive CRP was observed in 31 cases (91.2%), leukocytosis (> $10,000/mm^3$) in 26 cases (76.0%), thrombocytosis (> $450,000/mm^3$) in 7 cases (20.6%), and anemia (<10 gm/dl) in 7 cases (20.6%), respectively. GB hydrops or cholecystitis were noted in 3 cases (8.8%), abnormal ECG finding in 1 case (2.9%), coronary dilatation or aneurysm in 2 cases (5.9%). Liver biopsy was done in four cases and revealed mild infiltration of lymphocytes on the portal area and mild bile duct proliferations. Conclusion: The abnormal liver function was noted in 34.7% of KD patients, and subsided all within one month. But the liver function test should be checked closely in patients of the abnormal liver function test complicated with KD despite of its good prognosis.

• 한국임상약학회지
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• 제28권1호
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• 대한간호학회지
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• 제1권1호
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• 대한정형외과학회지
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• 제54권2호
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• pp.127-132
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• 2019

목적: 항 혈소판 제제(아스피린, 클로피도그렐, 실로스타졸)의 술 전 일시적 중단이 슬관절 전치환술 이후의 초기 실혈량 및 동종수혈의 필요성을 증가시키지 않는 안전한 방법인지 알아보고자 한다. 대상 및 방법: 2013년 1월부터 2016년 12월까지 단일 센터에서 단일 술자에 의해서 연속적으로 시행된 네비게이션을 이용한 일차 슬관절 전치환술을 시행 받은 환자를 대상으로 후향적 방식으로 자료를 분석하였다. 총 369건의 환자가 포함되었으며, 항 혈소판 복용 과거력이 없는 271명과 항 혈소판 제제를 술 전 7일간 일시적으로 복용 중지한 98명을 각각의 군으로 나누었다. 두 군 간의 입원 기간 동안의 동종혈액 수혈 빈도와 함께 초기 실혈량을 비교하기 위하여 술 후 1일과 2일에 혈색소 수치 및 적혈구 용적률의 변화량에 대하여 비교하였다. 결과: 수술 7일 전까지 항 혈소판 제제를 복용한 군과 항 혈소판의 복용 과거력이 없는 군 간의 수술 1일과 2일 후의 적혈구 용적률, 혈색소 수치의 변화량, 동종혈액의 수혈 빈도는 통계적으로 유의한 차이를 보이지 않았다. 369명 중에서 입원기간 동안 총 149명이 수혈을 받았다. 수혈을 받은 환자의 군에서 받지 않은 환자군에 비하여 통계적으로 유의하게 상대적으로 고령의 나이, 작은 키, 작은 몸무게, 술 전의 낮은 혈색소와 적혈구 용적률 수치를 보였다. 수혈을 받은 군과 받지 않은 군 간의 성별과 술 전에 시행한 American Society of Anesthesiologists 등급, 수술 7일 전까지 항 혈소판 제제 복용 과거력 유무에 대해서는 통계적으로 유의한 차이점은 없었다. 결론: 항 혈소판 제제의 술 전 7일간의 일시적 중단은 항 혈소판 제제의 복용 과거력이 없는 환자군에 비하여 슬관절 전치환술 이후의 출혈량 및 동종수혈의 필요성을 증가시키지 않는다.

• Clinical and Experimental Pediatrics
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• 제61권8호
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• pp.258-263
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• 2018

Purpose: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile. Results: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ${\leq}3days$ after admission and hospital stay ${\leq}6days$. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ${\leq}3days$. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. Conclusion: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.

• 대한임상검사과학회지
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• 제52권3호
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• pp.221-228
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• 2020

Ochrobactrum anthropi는 oxidase를 생산하는 비발효산소성 그람음성 막대균으로 외관이 비슷하고 oxidase가 양성인 비발효 세균과 혼합배양 시 구분이 힘들고 생화학적 동정 장비로는 정확한 동정에 한계가 있다. 따라서 본 연구에서는 생화학적 검사 방법으로 동정이 힘든 세균동정의 Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry Platform (MALDI-TOF) 법의 유용성을 제시하고자 하였다. MicroScan을 이용해 검사했던 O. anthropi 5례를 분석한 결과, 최종보고까지 6.2일이 소요되었으며 E. coli의 3.0일에 비해 3.5일이 더 소요되었다. 5번 환자 고름 검체는 Achromobater xylosoxidans와 혼합감염으로 여러 번의 계대 배양과 재검사로 인해 11.3일이 소요되었는데, MALDI-TOF법으로 검사한 경우 한 번에 동정되었다. 4명의 환자는 기저질환이 있는 60세 이상이었고 기회감염과 원내감염의 가능성을 배제할 수 없었으며, 그 중 92일 만에 채취된 검체는 imipenem과 meropenem에 내성이었다. 따라서 O. anthropi처럼 동정이 까다로운 세균은 신속하고 적절한 환자 치료를 위해 MALDI-TOF법을 이용한 검사가 매우 유용할 것으로 사료된다.

• Journal of Acupuncture Research
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• 제39권3호
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• pp.222-228
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• 2022

The effect of combined Korean medicine treatment including facial chuna manual therapy was retrospectively investigated in patients with Bell's palsy. There were 16 patients (14 males) who received 2 months outpatient treatment following > 14 days of hospitalization. The Yanagihara score and House-Brackmann grade were used to measure the severity of symptoms and recovery. The patients (mean age 58.5 ± 24.74 years) were categorized based on their medical history of hypertension (n = 10), diabetes millitus (n = 10), or oral intake of steroids early in the diagnosis of Bell's palsy (n = 10). There was no difference between patients who had or did not have a previous history of diabetes mellitus or oral steroid. Both the Yanagihara-score and House-Brackmann grade improved significantly in the total patient sample after treatment (p < 0.001). Combined Korean medicine including facial chuna manual therapy may have a beneficial effect on patient symptoms and recovery.