• 대한디지털의료영상학회논문지
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• 제13권4호
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• pp.177-183
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• 2011

This study intends to investigate patients' exact exposure doses by comparatively measuring ESD (Entrance Surface Dose) with the DAP meter, which excludes scattered rays, and ESD with the Xi multifunction meter, which includes scattered rays, by posture changes for Esophagography test and UGI test. The materialwere examined through Sonialvision-SafireII SPEC overtube system. ESD was measured by using the DAP meter, and as a tool to measure ESD including scattered rays on the plane of incidence of human phantom, the Xi multifunction meter was used. The average fluoroscopic time of Esophagography test was 4.192 minutes and the average number of images was 47.7, while the average fluoroscopic time of UGI test was 6.881 minutes and the average number of images was 37.8. The ratios of the incident dose of DAP meter and the ESD of Xi meter were calculated bydividing the fluoroscopic time and the number of images by each posture change. As for Esophagography test, the dose increased by 21.6~55.5% in the fluoroscopic test and by 4.8~24.7% in the spot test. In the front spot test, however, the does increased by as little as 5.3%. As for UGI test, the dose increased by 21.1~49.5% in the fluoroscopic test and by 10.1~34.9% in the spot test. It is expected that measuring doses in consideration of scattered rays by posture changes will be an important index in evaluating and managing patients' exact exposure doses for each test above. Furthermore, it is judged that this sort of study is inevitable and desirable to reduce patients' exposure doses after all.

• 대한한방부인과학회지
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• 제35권1호
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• pp.75-90
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• 2022

Objectives: The purpose of this study protocol is firstly to investigate the status of Korean medical treatment of dysmenorrhea, and secondly to investigate effectiveness of the Clinical Pathway (CP) of dysmenorrhea and review the applicability. Methods: This is a multi-center observational study. The data will be prospectively collected from 14 Korean medicine clinics. 45 patients for each of the CP-applied and non-applied groups will be recruited to compare the degree of improvement in menstrual pain. All the diagnosis records, treatment methods, treatment results, adverse events, and medical expenses of patients with dysmenorrhea will be collected. We will investigate the proportion of patients who could be applied with CP, and the actual number of CP applications, and CP completion rate to evaluate the applicability. Additionally, the satisfaction survey will be used to collect feedback from medical staff members and patients. Results: The results of this study will be disseminated through peer-reviewed publications and scientific presentations. Conclusions: This study is expected to provide valuable data for application of standard Korean medicine clinical pathway for dysmenorrhea.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1232-1235
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• 2004

The purpose of this study is to design electrical stimulation system for pharyngeal dysfunction(dysphagia) in stroke patients. Pharyngeal muscle group activity is important, because contracting muscles provide the driving force at the initiation of the swallow and generate the pressure gradients necessary for bolus movement into the esophagus. Although we have many treatment methods for dysphagia, electrical stimulation system will be useful for stroke patients having dysphagia. Electrical stimulation can be divided into the body stimulation and electrodes. The body stimulation is divided again into frequency counter, time control and current measurement part. These parts are to control the current intensity, frequency and stimulating time. And they can be variable according to the patient's clinical assessment. The electrode plays a role to deliver the current from the system to the muscle. Also the position of the electrode can be variable according to the treatment method. We performed the clinical experiment with the stroke patient who has swallowing disorder. The videofluoroscopy was used for the observation. From the result of clinical experiment based on electrical stimulation, we expected that the dysfunction(in pharynx) level of the patient can be improved. However we could not have enough effectiveness of the treatment because of the number of patients, patient's adaptation and treatment period. We will design the optimized electrical stimulation system based on enough clinical experiment in the future.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• 한국임상약학회지
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• 제28권3호
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• pp.181-187
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• 2018

Background: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML. Methods: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days. Results: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was $26.8{\pm}16days$. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49). Conclusion: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.

• 재활간호학회지
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• 제19권2호
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• pp.118-127
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• 2016

Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

• 전자통신동향분석
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• 제34권5호
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• pp.48-57
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• 2019

As the super-aged society approaches rapidly, the number of people suffering from post-stroke and other neurological disorders is significantly increasing, where prompt and intensive rehabilitation is essential for such people to resume their physical activities in normal daily lives. To overcome the inherent limitations of manual physical therapy, various types of exoskeleton robots are being employed. However, the need of the hour is softer, thinner, lighter, and even stretchable systems for precisely monitoring the motion of each joint without restricting the patients' movements in rehabilitation tasks. In this paper, we discuss the technological trends and current status of emerging stretchable rehabilitation systems, in which sensors, interconnects, and signal-processing circuits are monolithically integrated within a single stretchable substrate attachable to the skin. Such skin-like stretchable rehabilitation devices are expected to provide much more convenient, user-friendly, and motivating rehabilitation to patients with neurological impairments.

• 보건행정학회지
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• 제21권4호
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• pp.527-540
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• 2011

Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

• Archives of Plastic Surgery
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• 제41권3호
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• pp.271-276
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• 2014

Background As the obese population increases in Korea, the number of patients who are trying to lose weight has been increasing steadily. In these patients, skin laxity and deformation of the body contour occurs, which could possibly be corrected by various body contouring surgeries. Here, we introduce the brachioplasty method and our experience of various body contouring surgeries performed in our center. Methods From November 2009 to August 2011, five cases of brachioplasty were performed. When the patient presented with sagging of the lateral inframammary crease and bat wing deformity in the axilla, extended brachioplasty was performed; in this case, the deformation of the axilla and lateral chest was corrected at the same time. A traditional brachioplasty was performed when contouring was needed only for skin laxity in the upper arm. Results Complications, such as hematomas or nerve injuries, were not evident. Some patients experienced partial wound dehiscence due to tension or hypertrophic scars found during the follow-up. In general, all of the patients were satisfied with the improvement in their upper arm contour. Conclusions Given the demands for body contouring surgery, the number of brachioplasty surgical procedures is expected to increase significantly, with abdominoplasty comprising a large portion of these surgeries. For the brachioplasty procedure, preparation and preoperative consultation regarding design of the surgery by experienced surgeons was important to prevent complications such as nerve damage or hematoma formation.

• 대한간호
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• 제29권3호
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• pp.49-63
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• 1990

This article reviewed & analyzed 33 studies of the Health Belief Model applied to korean chronic ill patients which were published from 1975 to 1990. The findings of analysis are as follows. The subjects of researchs are patients with various chronic illness including Pulmonary Tb., DM., Hemodialysis & Kindney Transplantation, Hypertension, etc. The type of research is retrospective survey in all studies. The measurement of health' belief in all studies & sick role behavior in most studies have relied on self report. The analysis of the relationship between health belief and sick role behavior was done using correlation coefficient in most studies. To analyze empirical support for the relatiohship between health belief and sick role behavior, Significance ratio was computed. This ratio is value wherein the number of statistically significant findings with relationship in the expected direction for an HBM dimension are divided by total number of studies which reported significance levels for that dimension. Examination of this ratio across the 33 studies reveals susceptibility(30.3%), severity(34.4%), benifit(65.6%), barrier(50%). The following suggestions are based on the above findings and literature review. 1. It is necessary to develop the reliable, valid and standadized instrument for measurement of health beliefs. 2. In the further 'measurement of perceived susceptibility of the chronic ill patients, It is considering that the perceived susceptibility and perceived severity are measured together or the measurement of perceived, susceptibility is eliminated. 3. Relationship between perceived severity and sick role behavior is suggested to be analized using ANOV A, $x^2$ square instead of correlation coefficient. 4. Sick role behaviors should be measured by both self report and objective measurement. 5. Prospective, longitudinal survey should be needed. 6. Other factors influencing sick role behaviors of chronic ill patients should be investigated further.