• 제목/요약/키워드: the expected number of patients

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내과 중환자실 환자의 혈당조절 프로토콜 적용 및 효과 (Application and Effects of a Blood Glucose Control Protocol for Medical Intensive Care Unit Patients)

  • 김은성;최스미;김영삼
    • 중환자간호학회지
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    • 제7권2호
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    • pp.45-57
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    • 2014
  • Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

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Chemotherapy for Malignant Gliomas Based on Histoculture Drug Response Assay : A Pilot Study

  • Gwak, Ho-Shin;Park, Hyeon-Jin;Yoo, Heon;Youn, Sang-Min;Rhee, Chang-Hun;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • 제50권5호
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    • pp.426-433
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    • 2011
  • Objective : The Histoculture Drug Response Assay (HDRA), which measures chemosensitivity using minced tumor tissue on drug-soaked gelfoam, has been expected to overcome the limitations of in vitro chemosensitivity test in part. We analyzed interim results of HDRA in malignant gliomas to see if the test can deserve further clinical trials. Methods : Thirty-three patients with malignant gliomas were operated and their tumor samples were examined for the chemosensitivity to 10 chosen drugs by HDRA. The most sensitive chemotherapy regimen among those pre-established was chosen based on the number of sensitive drugs or total inhibition rate (IR) of the regimen. The response was evaluated by 3 month magnetic resonance image. Results : Among 13 patients who underwent total resection of the tumor, 12 showed no evidence of disease and one patient revealed progression. The response rate in 20 patients with residual tumors was 55% (3 complete and 8 partial responses). HDRA sensitivity at the cut-off value of more than one sensitive drug in the applied regimen showed a sensitivity of 100%, specificity of 60% and predictability of 70%. Another cut-off value of >80% of total IR revealed a sensitivity of 100%, specificity of 69%, and predictability of 80%. For 12 newly diagnosed glioblastoma patients, median progression-free survival of the HDRA sensitive group was 21 months, while that of the non-sensitive group was 6 months ($p$=0.07). Conclusion : HDRA for malignant glioma was inferred as a feasible method to predict the chemotherapy response. We are encouraged to launch phase 2 clinical trial with chemosensitivity on HDRA.

신발디자인 특성에 따른 경증 족부질환 환자의 정형 신발 구매의 의도와 만족도 영향 분석 (An Analysis on the Effect of Intention and Satisfaction on the Purchase of Orthopedic Shoes in Patients with Mild Foot Disease according to the Characteristics of Shoe Design)

  • 박준홍;이준상
    • 한국정보통신학회논문지
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    • 제26권7호
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    • pp.1019-1025
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    • 2022
  • 최근 들어 잘못된 보행 습관과 생활환경으로 인한 족부 질환자들이 늘어나고 있다. 신발디자인 특성에 따른 경증 족부질환 환자가 정형 신발 구매시 만족도와 구매 의도에 어떠한 영향을 미치는지 살펴본다. 신발 디자인 특성은 기능성, 편의성, 심미성으로 구성하였다. 심미성이 정형 신발 구매 시 영향을 미치는 것으로 나타났다. 기능성과 편의성의 요소가 영향이 적더라도 심미성이 높다면 구매의도와 만족도에 영향을 준다. 경증 족부질환별 사회활동 참여 빈도와 착용 목적에 따라 디자인 또한 다양한 요소들이 요구된다. 연구 결과를 통해 알아본 정형 신발디자인 특성 요인을 더욱 보완하여 경증 족부질환 환자들이 일상생활에서 착용할 수 있는 유용한 정형 신발 디자인 개발과 현실적인 활용과 만족으로 이어지길 기대한다.

Genetic testing in clinical pediatric practice

  • Yoo, Han Wook
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.273-285
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    • 2010
  • Completion of the human genome project has allowed a deeper understanding of molecular pathophysiology and has provided invaluable genomic information for the diagnosis of genetic disorders. Advent of new technologies has lead to an explosion in genetic testing. However, this overwhelming stream of genetic information often misleads physicians and patients into a misguided faith in the power of genetic testing. Moreover, genetic testing raises a number of ethical, legal, and social issues. Diagnostic genetic tests can be divided into three primary but overlapping categories: cytogenetic studies (including routine karyotyping, high-resolution karyotyping, and fluorescent in situ hybridization studies), biochemical tests, and DNA-based diagnostic tests. DNA-based testing has grown rapidly over the past decade and includes preandpostnatal testing for the diagnosis of genetic diseases, testing for carriers of genetic diseases, genetic testing for susceptibility to common non-genetic diseases, and screening for common genetic diseases in a particular population. Theoretically, once a gene's structure, function, and association with a disease are well established, the clinical application of genetic testing should be feasible. However, for routine applications in a clinical setting, such tests must satisfy a number of criteria. These criteria include an acceptable degree of clinical and analytical validity, support of a quality assurance program, possibility of modifying the course of the diagnosed disease with treatment, inclusion of pre-and postnatal genetic counseling, and determination of whether the proposed test satisfies cost-benefit criteria and should replace or complement traditional tests. In the near future, the application of genetic testing to common diseases is expected to expand and will likely be extended to include individual pharmacogenetic assessments.

Treatment of Invasive Candida Osteomyelitis of the Mandible: A Case Report

  • Hae-In, Choi;Ji-Su, Oh;Jae-Seak, You;Seong-Yong, Moon;Ji-Yun, Choi;Hyun-Jeong, Park
    • Journal of Oral Medicine and Pain
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    • 제47권4호
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    • pp.212-216
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    • 2022
  • Osteomyelitis in the oral and maxillofacial area is a relatively uncommon inflammatory disease that occurs due to odontogenic causes such as endodontic infection, facial trauma, insufficient blood supply caused by some medical conditions, and iatrogenic postoperative infections. Among them, the incidence rate of candida osteomyelitis in this area is minimal; therefore, no consensus on the diagnosis, treatment, and prognosis has not been established yet. With the increasing number of immunocompromised elderly patients, candida osteomyelitis of the jaw is expected to become more prevalent. In this case report, we present an 81-year-old male patient with candida osteomyelitis of the jaw, including the maxillary and ethmoid sinuses.

가상현실과 포톤 네트워크를 이용한 고령 환자용 여행체험 콘텐츠의 구현 (Implementation of Traveling Contents for Elderly Patients using Virtual Reality and Photon Network)

  • 임수빈;조면균
    • 융합정보논문지
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    • 제8권6호
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    • pp.123-128
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    • 2018
  • 최근 고령인구 증가와 장기요양 보험의 도입으로 요양기관에 입주하는 고령 환자의 수가 빠른 속도로 증가하고 있다. 이러한 장기요양 환자들은 만성질환과 치매 등의 질환을 앓고 있어 거동이 불편하거나 인지력이 떨어지는 어려움을 겪을 뿐 아니라, 가족과 떨어져서 우울증에 시달리므로 심리 및 정서적인 지원이 절실하다. 그리하여, 본 논문에서는 거동이 불편한 고령 환자를 위하여 VR과 포톤네트워크를 이용하여 물리적으로 떨어져 있는 가족들과 함께 평소에 가보지 못했던 해외여행 체험을 가상으로 제공하고자 한다. 기존 VR을 이용한 여행체험 서비스는 혼자 체험하는 반면, 제안하는 콘텐츠는 포톤 네트워크를 통해 가족 및 친구들이 네트워크로 참여함으로써 여행 체험 시 대화는 물론 지인들의 옆모습을 보며 함께 경치를 즐길 수 있다. 이를 통하여 고령의 장기 요양환자로 하여금 심리적 안정감을 회복하고 치유의 의지를 높여서 투병생활에서 삶의 질을 높이는데 도움을 줄 것이라 기대한다.

Cancer Incidence and Mortality in Osaka, Japan: Future Trends Estimation with an Age-Period-Cohort Model

  • Utada, Mai;Ohno, Yuko;Shimizu, Sachiko;Ito, Yuri;Tsukuma, Hideaki
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3893-3898
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    • 2012
  • In previous studies we predicted future trends in cancer incidence for each prefecture in order to plan cancer control. Those predictions, however, did not take into account the characteristics of each prefecture. We therefore used the results of age-period-cohort analysis of incidence and mortality data of Osaka, and estimated the incidence and mortality of cancers at all sites and selected sites. The results reflect the characteristics of Osaka, which has and is expected to have large number of patients with liver cancer. We believe our results to be useful for planning and evaluating cancer control activities in Osaka. It would be worthwhile to base the estimation of cancer incidence and mortality in each prefecture on each population-based cancer registry.

고혈압 환자를 위한 블루투스 기반의 포터블 헬스케어 게이트웨이 개발 (Bluetooth based Portable Healthcare Gateway Development for Hypertention Patients)

  • 김종탁;소재영;김종훈;강운구
    • 디지털융복합연구
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    • 제11권12호
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    • pp.339-344
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    • 2013
  • 최근 만성질환자의 증가로 생활 속에서 건강관리의 중요성이 증대되고 있다. 일상생활 중에 사용자에 의해서 측정된 생체신호가 특정 건강관리 디바이스에 의해서 자동으로 건강관리센터의 서버에 전송된다면 환자의 건강증대 및 건강관리 서비스의 확산에 기여할 것으로 예상된다. 본 논문에서는 사용자가 휴대 가능한 포터블 헬스케어 게이트웨이(Portable Healthcare Gateway)를 개발한다. 본 게이트웨이는 USB형으로 설계되고 표준화된 데이터 전송이 가능하여 사용자의 위치 및 PHD(Personal Health Device)에 제약을 받지 않고 데이터 전송이 가능하다. 개발된 포터블 헬스케어 게이트웨이는 유비쿼터스 환경에서 고객의 건강을 증진시킬 수 있는 효과적인 서비스를 제공한다.

Outcomes of Triple-Negative Versus Non-Triple-Negative Breast Cancers Managed with Breast-Conserving Therapy

  • Bhatti, Abu Bakar Hafeez;Khan, Amina Iqbal;Siddiqui, Neelam;Muzaffar, Nargis;Syed, Aamir Ali;Shah, Mazhar Ali;Jamshed, Arif
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2577-2581
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    • 2014
  • Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.

Trends in breast reconstruction: Implications for the National Health Insurance Service

  • Hong, Ki Yong;Son, Yoosung;Chang, Hak;Jin, Ung Sik
    • Archives of Plastic Surgery
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    • 제45권3호
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    • pp.239-245
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    • 2018
  • Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05). Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.