• 제목/요약/키워드: selected patients

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급성 뇌경색 환자의 Brain-CT 소견과 Barthel ADL을 이용한 예후에 관한 고찰 (Clinical Observation for Prognosis Utilizing Brain Computerized Tomography Findings and Barthel Index In Acute Cerebral Infarction)

  • 이원철
    • 대한한의학회지
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    • 제18권2호
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    • pp.316-325
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    • 1997
  • In a 36-month period, 23 selected Patients with Acute Cerebral Infarction were studied utilizing Computerized Tomography, Barthel Index in an attempt to correlate Brain Computerized Tomography findings with 1week, 4weeks rehabilitation and evaluate the influences of the size and location of the lesion. The study suggested that the size of the lesion had impact on 4 weeks rehabilitation. There was significant different between the patients with Middle Cerebral Artery Pial Territory Infarction(I.P.B.M.C.A.) lesion and the patients with Lacunar Infarction(L.I.), Striatocapsular Infarction(S.C.I.), Internal Watershed Infarction(I.W.I.) lesion, but there was no significant difference between the patients with L.I. lesion and the patients with S.C.I. lesion and the patients with I.W.I. lesion. The size and location of the lesion should be considered together in predicting the functional outcomes of Acute Cerebral Infarction.

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환자와 병원종사자간의 의료서비스 만족도 차이분석 -종합병원을 중심으로- (Differences of Satisfaction between Patients and Hospital Employees with Medical Care Services in the General Hospital)

  • 김순재
    • 가정과삶의질연구
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    • 제17권1호
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    • pp.73-86
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    • 1999
  • The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.

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Premarin검사를 이용한 무월경환자에서의 시상하부-뇌하수체의 기능평가 (Evaluation of the Hypothalamic-pituitary Function by Premarin Test for the Patients of Amenorrhea)

  • 이진우;나종구
    • Clinical and Experimental Reproductive Medicine
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    • 제11권2호
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    • pp.17-25
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    • 1984
  • Hypothalamic-pituitary function in patients of 6 selected groups of amenorrhea was evaluated by performing premarin test. Selected amenorrheic patients were divided into 6 groups of Turner's syndrome(5), adrenogenital syndrome(3), Sheehan's syndrome(4), moderate hyperprolactinemia(3), severe hyperprolactinemia(9) and functional oligoamenorrhea(9) the diagnoses of which were performed according to modified our own protocol for management of amenorrheic patients. As control 20 normally cycling women in mid follicular phase determined by their symptothermal charts during last 6 months designed by WHO were compared. The premarin test which is one of the tests evaluating the hypothalamic-pituitary function by the principle of negative and positive feed back effect's of estrogen was performed by injecting 20 mg of premarin in volus intravenously. The levels of serum LH before, 24, 48, 72, 96 and 120 hours after injection of premarin were measured by double antibody technique radioimmunoassay the reagents of which were supplied by WHO. The results were as follows: 1. Both negative and positive feed back effects by exogenous estrogen were well preserved even in the patients of gonadal dysgenesis although the baseline levels were much higher than normal. 2. In the patients of Sheehan's syndrome one could observe the minimal response of feed back effect in the case with minimal pituitary function. 3, Androgens in adrenogenital syndrome and prolactin in hyperprolactinemia may suppress mainly the positive feed back effect rather than the negative one. The suppressive effect can be abolished by proper treatments which can eliminate those suppressive hormones. 4. This premarin test may be beneficial for predicting the result of clomiphene in ovulation induction.

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국내 유방암 환자의 삶의 질 측정 도구 개발에 관한 연구 (Development of a Quality of Life Scale for Patients with Breast Cancer in Korea)

  • 채영란;최명애
    • 성인간호학회지
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    • 제13권3호
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    • pp.486-495
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    • 2001
  • The purpose of this study was to develop a Quality of Life(QOL) scale for breast cancer patients in Korea and to test the validity and reliability of the instrument. To achieve the purpose of the study, a questionnaire was developed to interview 10 breast cancer patients and distributed to 155 patients with breast cancer in Korea. For data analysis, SPSS WIN 8.0/PC were used. Item analysis and factor analysis were carried out to test validity of the QOL scale. Cronbach's ${\alpha}$ and Guttman split half coefficient were used to test reliability of the scale. The results were as follows; As a result of the item analysis, 27 items were selected from the total of 34 items. 6 factors were selected by factor analysis. Six factors were labeled as 'response to cancer diagnosis and treatment', 'family well-being', 'physical concerns', 'psychological well-being', 'spiritual well-being', and 'economic concerns'. Six factors were explained by 72.236% out of the total variance. The first factor explained 20.738% and the second factor explained 16.593%, which were major factors for Korean breast cancer patients. Chronbach's ${\alpha}$ coefficient of the tool was .9120, and Guttman split-half coefficient was .8148. The scale was identified to be a tool with a high degree of reliability and validity. Therefore, this scale can be effectively utilized for assessment of Quality of Life of patients with breast cancer in Korea.

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양측성 하악지 시상분할술을 이용한 악교정 수술시술 후 교합력과 근전도 변화 (THE OCCLUSAL FORCE AND EMG CHANGE AFTER BSSRO)

  • 이성규;최용관;황대용;김경욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권5호
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    • pp.537-542
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    • 2008
  • BSSRO is most frequently operated among orthognathic surgery techniques for repairment of maxillofacial deformities. In case of patients with maxillofacial asymmetry accompanying mandibular protrusion who are operated by BSSRO, this study considers the recovering time for masticatory force of each tooth and Masseteric EMG and the adequate time enabling normal occlusion. The patients who are operated with BSSRO under general anesthesia in Dankook Dental Hospital, Department of OMS are selected for this study. The control group is devided into 2. 26 patients with facial asymmetry accompanying mandibular protrusion are selected for group 1 and their maximum voluntary bite force and masseteric EMG are measured. Group 2 is formed by volunteers with healthy dentition who are measured maximum bite force and masseteric EMG on both sides of the mouth. At the week of 3rd, 5th, 7th, 9th and 11th, Mann-Whitney U test is carried on for statistical analysis and the result is as follows. 1. Patients with mandibular protrusion showed apparently low maximum bite force and masseteric EMG than patients with normal occlusion. 2. In comparison with control group 1, Occlusal force is regained in incisors and canines at the 9th week and in premolars and molars, 11th week and masseteric EMG is regained at 11th week. 3. Comparing to normal occlusal patients, no recovery could be found in experimental group in every parts of the mouth.

Selective Musculocutaneous Neurotomy for Spastic Elbow

  • Shin, Dong-Keun;Jung, Young-Jin;Hong, Joo-Chul;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제48권3호
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    • pp.236-239
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    • 2010
  • Objective : The purpose of this study was to investigate the effectiveness and outcome of selective musculocutaneous neurotomy (SMcN) for spastic elbow. Methods : We retrospectively reviewed the medical records of 14 patients with spasticity of their elbows. The patients were selected using clinical and analytical scales, as well as nerve block tests, for assessment. Their mean age was 37.29 years (range, 19-63 years). SMcN was performed for these patients, and the mean follow-up period was 30.71 months (range, 19-54 months). Results : The modified Ashworth scale (MAS) scores recorded before and after the SMcN showed that the patients' mean preoperative MAS score of $3.28{\pm}0.12$ was improved to $1.71{\pm}0.12$, $1.78{\pm}0.18$, $1.92{\pm}0.16$ and $1.78{\pm}0.18$ at postoperative 3, 6, 12 months and last follow-up, respectively. On the basis of a visual analogue score ranging from 0-100, the patients' mean degree of satisfaction score was $65.00{\pm}16.52$ (range, 30-90). Conclusion : We believe that SMcN can be a good and effective treatment modality with low morbidity in appropriately selected patients who have localized spastic elbow with good antagonist muscles and without joint contracture.

환자표본자료를 이용한 간경변증 환자의 의료이용 특성 및 의료비용 분석 (Analysis of Medical Use and Costs Related to the Management of Liver Cirrhosis Using National Patients Sample Data)

  • 김혜린;박재아;신지영;박승후;이의경
    • 한국임상약학회지
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    • 제26권4호
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    • pp.341-347
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    • 2016
  • Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

Detection of Traumatic Cerebral Microbleeds by Susceptibility-Weighted Image of MRI

  • Park, Jong-Hwa;Park, Seung-Won;Kang, Suk-Hyung;Nam, Taek-Kyun;Min, Byung-Kook;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.365-369
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    • 2009
  • Objective : Susceptibility-weighted image (SWI) is a sensitive magnetic resonance image (MRI) technique to detect cerebral microbleeds (MBLs). which would not be detected by conventional MRI. We performed SWI to detect MBLs and investigated its usefulness in the evaluation of mild traumatic brain injury (MTBI) patients. Methods : From December 2006 to June 2007, twenty-one MTBI patients without any parenchymal hemorrhage on conventional MRI were selected. Forty-two patients without trauma were selected for control group. According to the presence of MBLs, we divided the MTBI group into MBLs positive [SWI (+)] and negative [SWI (-)] group. Regional distribution of MBLs and clinical factors were compared between groups. Results : Fifty-one MBLs appeared in 16 patients of SWI (+) group and 16 MBLs in 10 patients of control group [control (+)], respectively. In SWI (+) group, MBLs were located more frequently in white matters than in deep nucleus different from the control (+) group (p<0.05). Nine patients (56.3%) of SW (+) group had various neurological deficits (disorientation in 4, visual field defect in 2, hearing difficulty in 2 and Parkinson syndrome in 1). Initial Glasgow Coma Scale (GCS)/mean Glasgow Outcome Scale (GOS) were $13.9{\pm}1.5/4.7{\pm}0.8$ and $15.0{\pm}0.0/5.0{\pm}0.0$ in SWI (+) and SWI (-) groups, respectively (p<0.05). Conclusion : Traumatic cerebral MBLs showed characteristic regional distribution, and seemed to have an importance on the initial neurological status and the prognosis. SWI is useful for detection of traumatic cerebral MBLs, and can provide etiologic evidences for some post-traumatic neurologic deficits which were unexplainable with conventional MRI.

Identification of immunological parameters associated with the alveolar bone level in periodontal patients

  • Park, Chang-Seo;Lee, Ju-Yeon;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • 제40권2호
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    • pp.61-68
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    • 2010
  • Purpose: The present study was performed to clarify the relationship between periodontal disease severity and selected immunological parameters consisting of serum IgG titer against periodontopathogenic bacteria, the expression of the helper T-cell cytokine by gingival mononuclear cells, and patients' immunoreactivity to cross-reactive heat shock protein (HSP) epitope peptide from P. gingivalis HSP60. Methods: Twenty-five patients with moderate periodontitis had their gingival connective tissue harvested of gingival mononuclear cells during an open flap debridement procedure and peripheral blood was drawn by venipuncture to collect serum. The mean level of interproximal alveolar bone was calculated to be used as an index for periodontal disease severity for a given patient. Each of selected immunologic parameters was subject to statistical management to seek their correlations with the severity of periodontal disease. Results: A significant correlation could not be identified between serum IgG titers against specific bacteria (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Streptococcus mutans) and the severity of periodontal disease. Expression of interleukin (IL)-10 by gingival mononuclear cells was statistically significant in the group of patients who had higher levels of alveolar bone height. However, a similar correlation could not be demonstrated in cases for IL-4 or interferon-$\gamma$. Patients' serum reactivity to cross-reactive epitope peptide showed a significant correlation with the amount of alveolar bone. Conclusions: It was concluded that expression of IL-10 by gingival mononuclear cells and patients' sero-reactivity to the cross-reactive HSP peptide of P. gingivalis HSP60 were significantly correlated with alveolar bone height.

소아의 수술전 환자교육이 신체 및 정서에 미치는 영향 (The Effects of Preoperative Nursing Instruction on tile Physical and Emotional Recovery of Pediatric Surgical Patients - An Experimental Study-)

  • 심치정
    • 대한간호학회지
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    • 제4권2호
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    • pp.44-56
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    • 1974
  • Very few studies regarding the effects of preoperative nursing intervention on children's welfare after surgery have been conducted. The purpose of this study was 1) to evaluate the effects of preoperative nursing instructions on children's physical recovery and emotional state after surgery and 2) to analyse the relationship between the effects of preoperative nursing instructions and the age and general anxiety of child. The study was conducted flow: August 15th to October 30th at Severance Hospital, Seoul, Korea. A total of 41 Pediatric surgical Patients, between the age of 4 to 14, participated in the study. Twenty patients, randomly selected, were visited by the experimenter in the evening before, surgery and received specific preoperative nursing instructions. These instructions were designed to alleviate emotional stress and were adopted to the age of child. The postoperative recovery of these patients were then compared with a randomly selected control group of 21 patients who received only the routine preoperative care by the staff in the hospital Dependent variable were vomiting, pain medication, ability to void, elevation of temperature, infection, the between surgery and hospital discharge and postoperative emotional stress which was measured by the vital signs. Because of the limitation of the sample size it was difficult to obtain valid statistical results. However, the analysis of the raw data indicates that: 1) the preoperative nursing instructions appears to promote physical recovery and it seems especially effective in preventing elevation of temperature and shortening the length of the hospital stay, 2) the preoperative nursing instruction also seems to be effective in relieving the child's emotional stress(situational anxiety) after surgery, 3) the patient's general anxiety level preparatively seems to be a predictor of postoperative problems, 4) the preoperative nursing instructions were an effective means of promoting physical recovery in every age group as long as the child understood the instructions. The above data would seem to indicate that all preoperative pediatric patients four years of age or older, if they can understand, should have preoperative nursing instruction in order to alleviate postoperative stress and enhance physical recovery. The level of general anxiety preparatively deserves special attention since the amount of nursing instruction needed seems to vary with tile level of anxiety.

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