• Title/Summary/Keyword: 서울대학교병원

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Real-World Efficacy and Safety of Everolimus with Low Dose Tacrolimus in Liver Transplantation Recipients (실제 임상현장에서의 간이식 환자 대상 Everolimus와 저용량 Tacrolimus 병용요법의 유효성 및 안전성 평가)

  • Jang, Seoyoun;Kim, Boram;Jeon, Sujeong;Choi, Kyung Suk;Lee, Eunsook;Lee, Ju-Yeun;Lee, Euni;Han, Ho-Seong;Cho, Jai Young
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.44-52
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    • 2021
  • Background: Post-transplant immunosuppression with calcineurin inhibitors (CNIs) is associated with kidney function impairment while mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, can be used for its renal-sparing effects. In this study, we compared the efficacy and safety of everolimus with low dose tacrolimus (EVR+Low TAC) and conventional dose tacrolimus (TAC) in liver transplantation recipients. Methods: Medical records of recipients who received liver transplantation at Seoul National University Bundang Hospital from January 1st 2009 to December 31st 2018 were retrospectively reviewed. Cohort entry date was defined as the day everolimus was initiated and tacrolimus dosage was reduced. All patients were followed up for 1 year. Indicator of efficacy was the incidence of rejection and safety was evaluated by incidence of drug adverse events including renal function. Results: Among 118 patients, there were 40 patients (33.9%) in EVR+Low TAC group. Incidence of rejection, including both biopsy proven acute rejection and clinical rejection, was similar in two groups [7.5% (n=3) vs. 6.4% (n=5), p=1.000]. Renal dysfunction was less frequent in EVR+Low TAC [17.5% (n=7) vs. 35.9% (n=28), p=0.038]. However, incidence rates of dyslipidemia, oral ulcer were more frequent in EVR+Low TAC [45.0% (n=18) vs. 21.8% (n=17), p=0.009; 15.0% (n=6) vs. 1.3% (n=1), p=0.006]. Conclusions: In terms of prevention of rejection, EVR+Low TAC was as effective as TAC and had renal-sparing effect but was associated with increased risk of dyslipidemia and oral ulcer. This study demonstrates that EVR+Low TAC could be an alternative to liver transplant recipients with nephrotoxicity after administration of conventional dose tacrolimus.

Biomechanics of Hip and Hip Replacement Arthroplasty (고관절 및 인공 고관절의 생역학)

  • Lee, Young-Kyun;Choi, Ji Hye;Won, Heejae;Koo, Kyung-Hoi
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.377-383
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    • 2019
  • The biomechanics study of the hip is aims to understand and explore the dynamic principles of weight transfer through the hip joint. This basic science knowledge can be applied in a variety of areas, including degenerative joint diseases and hip replacement arthroplasty. In particular, understanding of the biomechanics of the hip has led to the development of materials, design and fixation of implants, and it can be applied in various areas, such as the selection of surgical methods and the location of the implant. Moreover, it is essential to have good knowledge of the biomechanics of the hip to achieve better clinical results for patients. Therefore, this paper introduces the basic knowledge and biomechanical characteristics of a normal hip and hip replacement arthroplasty, which are needed to approach the biomechanics of the hip.

Oncology Nurses' Professional Quality of Life in a Tertiary Hospital (일개 종합병원 종양간호사의 전문직 삶의 질)

  • Kim, Shin;Kim, Jeong Hye;Park, Jeong Yun;Suh, Eun Young E;Yang, Hwa Jeong;Lee, Su Yeon;Lee, Young Shin;Jeon, Mi Jin;Lee, Soon Haeng;Kim, Kyoung Ok
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.145-155
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    • 2010
  • Purpose: The purpose of this study was to investigate oncology nurses' professional quality of life and its correlations with job satisfaction and job stress in a tertiary hospital in Seoul, South Korea. Methods: A cross-sectional survey design was utilized to investigate 210 oncology nurses from various oncology and hemato-oncology units. Professional quality of life (ProQOL), which is conceptualized with three sub-dimensions (compassion satisfaction, burnout, and secondary traumatic stress), job satisfaction, job stress, demographic and work-related variables were measured. Results: The participants were all women, with the mean age of 28.4. The participants with high ProQOL was only 14.8%, and 75.3% and 77.6% of the participants reported a moderate to high level of burnout and secondary traumatic stress respectively. Job satisfaction, age, and the total years of nursing practice have positive correlations with compassion satisfaction. Also, compassion satisfaction was significantly different according to age group, work units, the level of education, nursing positions, and the years of practice. Conclusion: Since the level of professional quality of life among oncology nurses was relatively low, the program for oncology nurses to improve compassion satisfaction and to decrease compassion fatigue needs to be developed.

The effects of music therapy on labor pain, childbirth experience, and self-esteem during epidural labor analgesia in primiparas: a non-randomized experimental study (음악요법이 초산부의 경막하 무통 분만 중 분만통증, 분만경험, 자아존중감에 미치는 효과: 유사실험 연구)

  • Seong Yeon An;Eun Ji Park;Yu Ri Moon;Bo Young Lee;Eunbyul Lee;Dong Yeon Kim;Seong Hee Jeong;Jin Kyung Kim
    • Women's Health Nursing
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    • v.29 no.2
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    • pp.137-145
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    • 2023
  • Purpose: This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods: In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach's α coefficients. Results: The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group's score was slightly higher, but without a statistically significant difference from the control group. Conclusion: Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.

Various MRI Findings of Toxocara canis Myelitis (개회충 척수염의 다양한 자기공명영상 소견)

  • Sun Young Park;Kyung Seok Park;Eugene Lee;Joon Woo Lee;Yun Jung Bae;Yusuhn Kang;Joong Mo Ahn;Heung Sik Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.135-146
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    • 2020
  • Purpose To describe magnetic resonance imaging (MRI) findings in 10 cases of Toxocara canis myelitis and to analyze these findings to aid in the diagnosis of this condition. Materials and Methods From June 2015 to March 2018, we retrospectively analyzed the electronic medical records and MR images of patients who were diagnosed with Toxocara canis myelitis. The analysis of the MR images was based on a discussion between an experienced spinal radiologist and a radiology resident. Results This study classified MRI findings into the following two types. Type 1 was defined as central and diffuse T2 high signal intensity on the axial plane, which was observed in 50% of all cases. All lesions showed avid enhancement, mostly in the posterolateral or posterior region (4 cases, 80%). Type 2 was defined as wedge-shaped or focal T2 high signal intensity in the posterolateral or posterior region and corresponded to the remaining 50% of the cases. In this case, the extent of the lesion was relatively small and contrast enhancement was observed in only one case. Conclusion This study revealed that various imaging findings could be observed in cases of Toxocara canis myelitis, and the findings were classified into two types.

Analysis of Nursing Interventions Frequently Used with Cancer Patients (암환자에게 제공된 다빈도 간호중재 분석 - 5개 종합병원을 중심으로 -)

  • Moon, Kyung Hee;Ahn, Mee Jung;Kim, Phill Ja;Park, Jung Yeon;Kim, Myung Ae;Park, Ihn Sook;Bae, Su Hyun;Lee, So Jung;Kwon, In Gak;Kim, So-Sun
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.107-122
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    • 2009
  • Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

Effects of Transcranial Direct-Current Stimulation Therapy on Primary Chronic Insomnia: A Proof-of Concept Clinical Trial (일차성 만성불면증 환자에서 경두개 직류전기자극법 치료 효과: 개념 증명 연구)

  • Jun, Jin-Sun;Kim, Tae-Joon;Koo, Sun A;Park, Ji-Sook;Kim, Keun Tae;Yang, Tae-Won;Lim, Jung-Ah;Byun, Jung-Ick;Sunwoo, Jun-Sang;Jung, Ki-Young
    • Journal of Sleep Medicine
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    • v.15 no.2
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    • pp.37-42
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    • 2018
  • Objectives: To assess the effect and safety of transcranial direct-current stimulation (tDCS) in primary chronic insomnia. Methods: A one-month, double-blind, randomized, sham-controlled trial was performed. A total of 7 patients with primary chronic insomnia received tDCS using anodal (n=3), cathodal (n=2), or sham stimulation (n=2). They were followed up at 1 week and 1 month after treatment. The primary outcome measures included improvement in total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) at 1 month follow-up. Results: TST and SE were improved with tDCS at 1 month follow-up in all patients (100%) of the anodal group, one (50%) of the cathodal group, and one (50%) of the sham group. tDCS improved SL at 1 month follow-up in two patients (67%) of the anodal group, one (50%) of the cathodal group, and none (0%) of the sham group. With respect to adverse events, transient itching sensation occurred in one patient of the anodal group. None of the other groups reported adverse events. Conclusions: Our results suggest that tDCS may be effective and safe for treatment of primary chronic insomnia. A larger controlled study needs to be further investigated.

An Integrative Review on the Contents and Effectiveness of Depression and Anxiety Interventions applied to Unmarried Mothers Living in Residential Facilities (시설에 거주하는 미혼모에게 적용된 우울 및 불안 감소를 위한 중재의 통합적 문헌고찰)

  • Gwon, Taekyun;Lee, Gumhee;Kang, Eunbyeol;Moon, Jungyi;Jeong, Juae
    • Perspectives in Nursing Science
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    • v.16 no.1
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    • pp.45-54
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    • 2019
  • Purpose: The purposes of this study was to review the literature on intervention for treating anxiety and depression among unmarried mothers living in facilities, and to understand core that could promote the development of more effective interventions. Methods: Key words in English and Korean were used to search through eight electronic databases-PubMed, Cochrane Library, EMBASE, CINAHL, RISS, DBpia, NDSL, and the National Assembly Library. Results: Ten studies were ultimately selected for the integrative review and were evaluated in terms of contextual and methodological quality. The studies consisted of seven quasi-experimental studies and three case report studies. The selected studies utilized music, art, forest therapy, dancing, education, and play programs to change mothers' perceptions, emotions, and behavior and to improve their relationships with their babies or others. Conclusion: It is important to consider mothers' self-awareness and emotional expression, and to improve their relationships with their babies or others as core elements when developing intervention programs for anxiety and/or depression among unmarried mothers living in residential facilities.

The Development of Outcome Indicators for Advanced Practice Nurses (전문간호사의 성과지표 개발)

  • Sung, Young Hee;Yi, Young Hee;Lim, Kyung Choon;Jeong, Jae Sim;Cho, Myung Sook;Kim, Kyoung Ok;Kim, Myung Ae;Park, Kwang Ok;Kim, Eul Soon;Hwang, Moon Sook
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.157-174
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    • 2010
  • Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

Jaundice in Young Children (소아 황달의 영상 평가)

  • Young Hun Choi;Seul Bi Lee;Yeon Jin Cho;Seung Hyun Lee;Su-Mi Shin;Jung-Eun Cheon
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.966-978
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    • 2022
  • Jaundice in children have various etiologies. Among them, physiological jaundice is a very common disease observed in more than half of full-term neonates. When jaundice persists or develops after 2 weeks of age, the total/direct bilirubin is measured in consideration of the possibility of cholestasis. In case of cholestasis, imaging studies differentiate biliary atresia and other disorders of the extrahepatic bile ducts. In this review, we briefly presented the major differential diseases of cholestasis in children and introduced diagnostic imaging techniques, including normal findings.