• Title/Summary/Keyword: 강북삼성병원

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Treatment of Dysphagia in a Cardiac Transplantation Patient: A Case Study (심장 이식 수술 환자의 연하장애 재활치료: 단일 사례 연구)

  • Lee, Su-Jung;Kim, Tu-Kyu;Seo, Sang-Min
    • Therapeutic Science for Rehabilitation
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    • v.13 no.3
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    • pp.85-100
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    • 2024
  • Objective : This case study aimed to explore dysphagia symptoms in post-cardiac transplantation patients and evaluate the effectiveness of dysphagia rehabilitation therapy in an occupational therapy clinic. Methods : A patient with post-cardiac transplant dysphagia underwent videofluoroscopic swallowing studies to assess the Functional Dysphagia Scale (FDS), Penetration-Aspiration Scale (PAS), and Dysphagia Outcome and Severity Scale (DOSS). Assessments were performed three times at two-week intervals. The treatment, administered from July 19 to August 21, 2023, included eight sessions of 30 minutes each. Treatments included corrective techniques (tongue-hold maneuver, chin tuck against resistance, mendelsohn maneuver, effortful swallowing, and respiratory muscle exercise) and compensatory strategies (chin-tuck position, multiple swallowing, modification of volume, and viscosity), alongside caregiver education. Results : The FDS scores decreased from 50 to 30, PAS scores improved from 5 to 3, and DOSS scores improved from Stage 2 to Stage 4. Conclusion : Dysphagia rehabilitation therapy improved swallowing function in a post-cardiac transplantation patient. However, further studies are required to confirm these findings.

Suggested Protocol for Efficient Medical Image Information Exchange in Korea: Breast MRI (효율적 의료영상정보교류를 위한 프로토콜 제안: 유방자기공명영상)

  • Park, Ji Hee;Choi, Seon-Hyeong;Kim, Sungjun;Yong, Hwan Seok;Woo, Hyunsik;Jin, Kwang Nam;Jeong, Woo Kyoung;Shin, Na-Young;Choi, Moon Hyung;Jung, Seung Eun
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.254-258
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    • 2018
  • Purpose: Establishment of an appropriate protocol for breast magnetic resonance imaging (MRI) in the study of image quality standards to enhance the effectiveness of medical image information exchange, which is part of the construction and activation of clinical information exchange for healthcare informatization. Materials and Methods: The recommended protocols of breast and MRI scans were reviewed and the questionnaire was prepared by a responsible researcher. Then, a panel of 9 breast dedicated radiologists was set up in Korea. The expert panel conducted a total of three Delphi agreements to draw up a consensus on the breast MRI protocol. Results: The agreed breast MRI recommendation protocol is a 1.5 Tesla or higher device that acquires images with prone position using a breast dedicated coil and includes T2-weighted and pre-contrast T1-weighted images. Contrast enhancement images are acquired at least two times, and include 60-120 seconds between images and after 4 minutes. The contrast enhancement T1-weighted image should be less than 3 mm in thickness, less than 120 seconds in temporal resolution, and less than $1.5mm^2$ in-plane pixel resolution. Conclusion: The Delphi agreement of the domestic breast imaging specialist group has established the recommendation protocol of the effective breast MRI.

Multicenter Evaluation on the Efficacy of N-Acetyl Cystine in Relieving the Symptoms of Laryngopharyngeal Reflux Disease (인후두 역류질환에서 N-Acetyl Cysteine의 증상 개선 효과에 대한 다기관 평가)

  • Kim, So Yean;Kwon, Tack Kyun;Kim, Han Su;Son, Young Ik;Woo, Seung Hoon;Woo, Jeong-Soo;Lee, Seung Won;Lim, Jae Yol;Chung, Man Ki;Joo, Young Hoon;Cha, Wonjae;Choi, Seung Ho;Hong, Hyun Jun;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.87-93
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    • 2018
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) is relatively common disease. N-acetyl cysteine (NAC) has both mucolytic and antioxidant effect, also may be beneficial in inflammatory airway diseases. The purpose of this study was to evaluate the efficacy and safety of inhaled NAC therapy in LPRD. Materials and Method : We retrospectively reviewed the medical records of 525 LPRD patients at 12 medical centers. Finally 401 patients subjected to inhaled NAC therapy for 2 months were enrolled in the study. We analyzed the change of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) after use of NAC for 4 weeks and 8 weeks in addition to the patient's compliance of the treatment. Results : The RSI score significantly decreased from $19.87{\pm}6.34$ to $12.78{\pm}6.93$ after 4 weeks and to $10.65{\pm}7.47$ after 8 weeks. The RFS score also significantly decreased from $9.29{\pm}3.4$ to $7.17{\pm}3.41$ after 4 weeks and to $6.1{\pm}3.73$ after 8 weeks (p<0.05). During the treatment periods, 42 patients (10.4%) reported to have 80 episodes of discomfort. Throat discomfort (33%) and nausea (28%) were most common complaints, but the duration of discomfort was usually less than 4 weeks. Conclusion : Inhaled NAC treatment is highly effective for the reduction of both subjective and objective findings in LPRD patients. This study will provide the evidence of new treatment option for patients with LPRD. However, further studies will be needs to assess the real effect of inhaled NAC therapy as a standard treatment regimen of LPRD.

Anatomical Variations Encountered during Adrenal Venous Sampling: A Report of Three Case Series and Review of Literature (부신정맥채혈술 중 발견된 해부학적 변이들: 3건의 증례 보고 및 문헌 고찰)

  • Juyoung Pak;Hyoung Nam Lee;Myung Sub Kim;Hyerim Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.456-462
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    • 2024
  • Primary aldosteronism is a group of disorders in which the autonomous secretion of aldosterone is associated with hypertension and hypokalemia. It is crucial to determine the laterality of aldosterone hypersecretion because treatment options differ accordingly. Adrenal venous sampling (AVS) is considered the most reliable method for assessing the laterality of primary aldosteronism. This procedure is often technically challenging because of the small size and varied locations of the adrenal veins. A better understanding of anatomical variations and careful review of imaging studies would improve sampling success. This report presents three cases of anatomical variations encountered during AVS.

Primary Sternal Tuberculosis with Spontaneous Fracture Treated by Resection and Reconstruction -A Case Report- (원발성 흉골결핵의 외과적 치험 -1례 보고-)

  • 배상일;김미혜;오태윤;장운하
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.190-193
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    • 1998
  • We experienced a case of primary sternal tuberculosis with destroyed midsternum and bony defect. An 22-year-old female was admitted to our hospital two times for severe sternal pain and spontaneous fracture without history of trauma. On hospital admission, chest X-ray and chest CT showed destruction of midsternum and soft tissue swelling. Fine needle aspiration cytology revealed tuberculous osteomyelitis with cold abscess. And the patient was treated with usual anti-tubeculosis medication for preoperative preparation. At operation, we confirmed midsternal destruction with cold abscess and multiple sinus tracts. After removal of diseased sternal segment and cold abscess, we performed sternal reconstruction with autologus iliac bone graft. The pathologic report was compatible with tuberculous osteomyelitis and caseous necrosis The postoperative course was smooth and uneventful, and she remains well without sternal instability two months later.

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Analysis of Three Years of Airmen Medical Certificate for Preparing Aviation-related Health Promotion Plan (항공종사자 건강증진활동계획에 반영되어야 할 근거자료: 3년간의 항공신체검사 결과 분석)

  • Han, Bok Soon;Kwon, Young Hwan;Shin, Yun Young
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.1
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    • pp.40-49
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    • 2020
  • In accordance with ICAO SARPs, the states should implement appropriate aviation-related health promotion for airmen subject to an aviation medical examination to reduce future medical risks to flight safety. We aimed to analyze the results of the aviation medical examination to use as objective evidence for establishing an aviationrelated health promotion plan. The results of the final issuance of airmen medical certificate from 2015~2017 were collected from the e-sky computer system. The 30 cases (0.3%) in 2015, 22 cases (0.2%) in 2016, 38 cases (0.3%) in 2017 were unfit for flight duty. The 34 unfit out of the total 90 cases were renewal physical examinations. The cardiovascular disease was most commonly in 11 cases, followed by 8 tumors, 4 psychiatric diseases, 3 ophthalmic diseases, 2 respiratory diseases, 2 neurologic diseases, 2 otolaryngological diseases, 1 endocrine disease and 1 digestive disease. The results of this study can be used as objective data in aviation-related health promotion plan. The health promotion activities based on objective data can contribute to improving aviation safety by improving the lifestyles of airmen.

The Effect of Work Interruption on Workload and Perception of Patient Safety Culture in Ward Nurses (병동간호사의 간호업무중단이 업무부담과 환자안전문화인식에 미치는 영향)

  • Doo-Nam Oh;Ye-Won Lee
    • Quality Improvement in Health Care
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    • v.28 no.2
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    • pp.2-13
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    • 2022
  • Purpose:This study aimed to identify the effect of work interruption that influenced workload and perception of patient safety culture on ward nurses. Methods: Participants were 184 ward nurses, with more than 12 months of work experience, from two tertiary hospitals in S city. A descriptive correlational study design was used. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Mann-Whitney U test, Kruskal-Wallis test, Pearson's correlation, and hierarchical multiple regression analysis via SPSS version 27.0. Results: The results showed that general wards nurses had a higher degree of work interruption (t=5.632, p<.001) and workload (t=3.603, p<.001) compared to comprehensive nursing care service wards nurses. More interruption in nursing work caused more burden on work (γ=.440, p<.001) and led to lesser perception of patient safety culture (γ=- .199, p=.007). Finally, the regression analysis showed that work interruption had a statistically significant relevance on nurses' workload (F=20.582, p<.001) and perception of patient safety culture (F=8.792, p<.001). Conclusion: To alleviate ward nurses' work interruption and decrease the negative effect on workload and perception of patient safety culture, it is necessary to mediate nurse staffing level and the number of assistants and utilize the environment.

The Voice Characteristics of Children with Palatine Tonsil and Adenoid Hypertrophy (구개편도와 아데노이드 비대 아동의 음성 특성)

  • Song, Yun-Kyung
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.8
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    • pp.790-795
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    • 2009
  • This study evaluated the voice of 68 normal children and 50 children with palatine tonsil and adenoid hypertrophy with MDVP to examine the hypothesis that their mouth breathing makes the vocal folds dry and this condition contributes to lower the level of voice quality. The results showed that children with palatine tonsil and adenoid hypertrophy had statistically significant elevations in Jitt, RAP, PPQ, Shim and APQ parameters, and had the lower level of voice quality. Therefore, the children with palatine tonsil and adenoid hypertrophy need vocal hygiene education.

Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals (병원간호사의 직장 폭력 경험 실태 및 대응 체계에 대한 인식)

  • Park, Seungmi;Kwak, Eunju;Lee, Ye-Won;Park, Eun-Jun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.3
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    • pp.319-334
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    • 2023
  • Purpose: This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. Methods: One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. Results: A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians' workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital's workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. Conclusion: Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers' competency in managing workplace violence.

Neuroimaging Findings of First-Visit Headache Patients (두통 초진 환자에서 신경영상검사 소견)

  • Kim, Byung-Su;Kim, Soo-Kyoung;Kim, Jae-Moon;Moon, Heui-Soo;Park, Kwang-Yeol;Park, Jeong Wook;Sohn, Jong-Hee;Song, Tae-Jin;Chu, Min Kyung;Cha, Myoung-Jin;Kim, Byung-Kun;Cho, Soo-Jin
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.