• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.234-241
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• 2019

Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

• Korean Journal of Radiology
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• 제25권6호
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• pp.540-549
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• 2024

Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권5호
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• pp.380-385
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• 2010

Introduction: The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac crest has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two team approach and ability to close the wound primarily. This study evaluated retrospectively the morbidity of bone harvesting from the anterior iliac crest to provide a logical guide for recognizing the complications and morbidities of an iliac crest bone graft. Materials and Methods: Fifty healthy patients (mean age of 35.5 years; range 7 to 59) underwent iliac crest bone harvesting for a maxillofacial reconstruction from January 2007 to September 2009 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory deficit, scar, contour defect were measured in each patients by retrospective research. Results: The mean duration of pain is 6.7 days, and mean duration of gait disturbance is 7.2 days. Most patients were free from gait disturbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturbance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints regarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft did not extend the length of hospitalization. Conclusion: This study suggests that split thickness bone harvesting from the inner table of the anterior iliac crest is a well accepted procedure with relatively low morbidity.

• 간호행정학회지
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• 제8권1호
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• pp.17-29
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• 2002

The purpose of this study was to examine the application of the Activity-based Costing(ABC) system to analyze the cost of nursing services in the delivery room in a major medical center.The results of this study are as follows;1. In order to calculate the cost of nursing activities, 67 activities of staff nurses on a delivery room were identified and classified as direct nursing activities(45.2%), the indirect activities(32.1%), general management activities(13.9%) and others(8.8%).2. Nursing cost in the delivery room was classified into activity cost(29.9%) and common cost(70.1%). Activity cost involved direct activity cost of staff nurses. The common costs were categorized into indirect activity & general management cost of staff nurses, management cost of the head nurse and activity cost of assistants.3. The final cost objects of nursing services in the delivery room were nursing service for women who had normal vaginal deliveries and nursing service for women who had preterm labor.The total cost of nursing service for a woman who had a normal vaginal delivery was 165,710 won (100.0%). The cost incurred through direct activity cost of staff nurses(58,242 won, 35.1%), indirect activity & general management cost of staff nurses (55,643 won, 33.6%), management cost of head nurse (16,211 won, 9.8%), activity cost of assistants (35,614 won, 21.5%).If the number of days of hospitalization was presumed to be 14 days, the total cost of nursing service for woman who had preterm labor would be 1,845,901 won (100.0%). The cost incurred by direct activity cost of staff nurses in the activity cost (341,349 won, 18.5%), indirect activity & general management cost of staff nurses in the common cost(779,002 won, 42.2%), management cost of head nurse(226,954won, 12.3%), activity cost of assistants in the common cost(498,596 won, 27.0%).In this study, the cost of the nursing services in the delivery room was calculated based on the ABC system. The results of this study showed that resources are assigned to the nursing activities in the delivery room and the mechanisms for assigning the cost of activities for nursing services.

• Journal of Acupuncture Research
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• 제29권5호
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• pp.139-149
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• 2012

Objectives : The aim of this study was to investigate clinical features of the patients admitted to the department of acupuncture and moxibustion in an oriental medicine hospital in order to provide clinical preliminary data for advancement of acupuncture and moxibustion Methods : Total 526 patients were admitted to the department of Acupuncture and Moxibustion in Dunsan Oriental Hospital of Daejeon University from September 1st, 2011 to August 31st, 2012. Of these patients 11 were discharged on the day that they were admitted and the remaining 526 patients who were hospitalized for over 2 days were investigated this study. We analyzed inpatients by discharge progress notes and medical records, using PASW statistics 18.0 for statistical analysis. Results : 1. There were 361 females(62.9%) and 213 males(37.1%). The age distribution was skewed to 40s and 50s and the average age of the patients was 42.91 years. 2. The prevalence of the diseases groups was in the order of musculoskeletal disease, neuromuscular disease, neuro-psychological disease, and EENT disease. The musculoskeletal disease and neuromuscular disease together made up 92% of all diseases. 3. The prevalence of individual diagnosis was in the order of Bell's palsy, cervical sprain, lumbar sprain, herniated lumbar disc, herniated cervical disc, and lumbar spinal stenosis. 4. There were 261 patients with single diagnosis and 193 with two and 120 with three or more diagnoses. The days of hospitalization significantly increased with the number of diseases the patients were diagnosed with. Conclusions : With high concentration of patients seen in certain disease groups, continuous efforts needed to expand the usage of acupuncture and moxibustion treatments to other disease groups and to explore and develop other diverse treatment methods for better outcome of the disease treated.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.127-134
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• 1994

1991년 5월 1일부터 1993년 7월 31일까지 영남대학교 의과대학 부속병원 산부인과에서 시행한 136례의 골반경수술에서 다음과 같은 결론을 얻었다. 환자의 나이 분포는 19세에서 55세였고 평균 나이는 31.2세였다. 평균 분만력은 0.96이었으며 거의 대부분의 환자는 2회 이하의 분만력을 보였다. 골반경수술의 가장 많은 적응증은 난관 임신이었고 그 다음으로는 난소낭종이었다. 시술 방법은 주로 난관절제술(58.8%)과 난소난관절제술(16.3%)이었고 입원기간은 평균 2.1일이었고 모든 경우에는 특별한 합병증이 없었다. 이러한 연구결과로 보아 골반경수술은 경제적으로나 사회적으로 또 미용학적으로도 좋은 결과를 보였으며 앞으로 다른 많은 부인과 환자에게 안전하게 적용할 수 있으리라 사료된다.

• 대한중풍순환신경학회지
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• 제23권1호
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• pp.73-84
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• 2022

■Objective The purpose of this case report is to report the effect of Korean medicine treatment on a patient with pontine infarction complaining of discomfort due to aggravated voiding dysfunction after the onset of the stroke. ■Methods The patient was hospitalized for 44 days and treated with herbal medicine, acupuncture, electroacupuncture, moxibustion, and interferential current therapy(ICT). We checked the amount of self-voided volume and postvoid residual urine volume(PVR), and asked the patient to subjectively evaluate the degree of discomfort due to voiding dysfunction. ■Results After 44 days of hospitalization, the patient responded that the subjective discomfort due to residual urine remained 30% and delayed urine remained 50% compared to the day of admission. The maximum amount of PVR was 234 ml on the 3^rd day, and the minimum amount of PVR was checked on 25^th and 35^th day as 0 ml. ■Conclusions This study suggests that Korean medicine treatment may be effective in the treatment of voiding dysfunction after stroke.

• 대한한방부인과학회지
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• 제33권2호
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• pp.77-89
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• 2020

Objectives: The purpose of this study is to analyse current status and treatment of the Korean medicine hospital after chemotherapy in patients with breast cancer. Methods: We investigated the medical records of 21 patients who admitted to Korean medicine hospital after chemotherapy in patients with breast cacner from March 1, 2017 to December 31, 2019. We searched medical records retrospectively and analyzed current status and treatment of Korean medicine hospital. Results: The average age of 21 participants was 52.81±8.38 years and 40s and 50s accounted for 85.6% of the total. After receiving chemotherapy, the average time to hospitalization was 1.87±3.13days and average hospital stay was 9.78±4.14 days. The subjects were classified as 28.6% of stage I, 52.4% of stage II, 9.5% of stage III, and 9.5% of stage IV. The analysis according to the presence of metastasis was 57.1% without metastasis, 33.3% with axillary lymph node metastasis, and 9.5% with distant metastasis. The main symptoms complained when hospitalized by 21 subjects were nausea (54.2%), fatigue (54.2%), and anorexia (50.8%) in over 50%, pantalgia (47.5%), and insomnia (47.5%), dizziness (44.1%), cold sweating (42.4%), lower extremity pain (40.7%), 37.5~37.9℃ fever (39.0%), headache (37.3%), hot flush (37.3%), pruritus (30.5%) are 30% or more. Korean medicine treatment was performed in 87.4% of all hospitalizations and Gwakhyangjunggi-san-gami was the most administered prescription. Extracts of Korean medicine was performed in 100.0% of all patients and Eunkyo-san was most administered extracts medicine. Acupuncture, moxibustion, and cupping treatments were performed in all 21 study subjects. Other treatments was performed at a frequency of hyperthermia (90.5%), lymph massage (23.8%), air compression therapy (23.8%), and Interference current therapy (19.0%) Conclusion: Korean traditional medicine can be used as a countermeasure for side effects after chemotherapy in breast cancer patients.

• 대한한의학회지
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• 제18권2호
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• pp.223-244
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• 1997

Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• 대한간호학회지
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• 제2권1호
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• pp.97-113
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• 1971

The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.