• Title/Summary/Keyword: 환자관련 요소

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Short-term Mechanical Circulatory Support with Centrifugal Pump in Cardiac Arrest or Cardiogenic Shock - Report of 5 cases- (심정지 혹은 심인성 쇼크에서 원심성 펌프를 이용한 단기목표의 기계적 순환 보조)

  • 양희철;성기익;뱍계현;전태국;박표원;양지혁;이영탁
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1003-1009
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    • 2004
  • Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

The Ornithine Transcarbamylase (OTC) Deficiency Identified by a Novel Mutation (새로운 유전자 돌연변이로 확진된 Ornithine Transcarbamylase (OTC) 결핍증 1례)

  • Song, Ari;Lee, Kiwuk;Yang, Aram;Kim, Jinsup;Park, Hyung-Doo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.3
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    • pp.148-154
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    • 2016
  • A urea cycle disorder is a condition caused by a defect of the enzymes in the urea cycle, and deficiency of ornithine transcarbamylase (OTC), which converts carbamoyl phosphate and ornithine into citrulline, is the most common type of the disorder. OTC deficiency induces the accumulation of precursors of urea, ammonia, and glutamine, leading to neurological symptoms including hypotonia, respiratory failure, seizure, lethargy, and coma and sometimes to death. Because OTC deficiency is inherited in an X-linked manner, typical symptoms such as vomiting, poor feeding, and lethargy appear mainly in male neonates. We recently had a case that presented with neonatal onset lethargy, vomiting, and apnea in a 4-day-old boy. He was diagnosed with OTC deficiency by biochemical phenotype, including hyperammonemia and an increased orotic acid level in the urine. Genetic analysis of the OTC gene showed a novel mutation c.780_781insCAGGCAGTGT (p.Ile261Glnfs*35). He was treated for hyperammonemia using continuous venovenous hemofiltration (CVVH) at 118 hours after birth. After 4 days of CVVH, his consciousness and blood ammonia concentration were normalized, and he was discharged at the age of 53 days. At around 12 months of age, bilateral femur fractures and osteomyelitis occurred in this patient. Two months after the fracture, he died of septic shock, insulin-resistant hyperglycemia, and multi-organ failure.

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Clinical Characteristics of Headache in Orofacial Pain Patients (구강안면통증 환자에서의 두통 양상의 분류)

  • Kang, Jin-Kyu;Ryu, Ji-Won;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.355-364
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    • 2006
  • Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

Integrative literature review of nursing performance in Korea (간호 퍼포먼스에 관한 국내 연구의 통합적 고찰)

  • Cho, Sumi;Lee, Eunjoo
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.2
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    • pp.441-453
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    • 2015
  • This paper review nursing performance in Korea to suggest the direction of future research. A literature review of research nursing performance journal articles was performed. Thirty-three articles were analyzed research design, measurement tools, definition, and variables which with nursing performance. Most of the on nursing performance in Korea descriptive correlation study. There considerable confusion about Korean term and definitions nursing performance. used the instrument developed by Park (1989) to measure nursing performance. The variables with nursing performance leadership and empowerment. No agreement on definitions or concepts of nursing performance evident in Korea. Research on nursing performance that addresses all domains of nursing is needed to analyze the impact of nursing performance on patient and healthcare outcomes.

Correlation Analysis between the Factors Associated with Osteoporosis and the Fat Infiltration Rate of the Multifidus and Erector Spinae Muscles in Osteoporotic Vertebral Compression Fracture Patients (골다공증성 척추 압박 골절 환자에서 다열근과 척추기립근의 지방 침투율과 골다공증 관련 인자의 상관 관계 분석)

  • Jun, Deuk Soo;Baik, Jong-Min;Choi, Ji Uk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.318-323
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    • 2020
  • Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm2, 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.

Factors affecting orthodontically induced root resorption of maxillary central incisors in the Korean population (한국인에서의 교정치료로 인한 상악 중절치 치근 흡수에 영향을 미치는 요소)

  • Chung, Dong-Hwa;Park, Young-Guk;Kim, Kwang-Won;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.41 no.3
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    • pp.174-183
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    • 2011
  • Objective: Orthodontically induced root resorption (OIRR) involves partial loss of cementum and dentin of teeth caused by routine orthodontic treatment. It decreases root length and influences the function of affected teeth. In this study, the treatment and patient factors causing apical root resorption in Koreans were determined. The observed factors were extraction, gender, age, displacement of root apex, total treatment period, total teeth length, and shape of the root. Methods: The records of 137 patients treated with full, fixed edgewise appliances were obtained from the Department of Orthodontics, Dankook University Dental Hospital, from November 2007 to December 2008. Periapical radiographs of the maxillary central incisors and cephalometric radiographs of each patient were used to assess apical root resorption and type of tooth movement. Results: The mean amount of resorption was $1.62{\pm}1.58mm$. The amount of resorption in the extraction and non-extraction groups was $2.10{\pm}1.64mm$ and $1.18{\pm}1.39mm$, respectively. The amount of root resorption increased with the total tooth length. Severe root resorption (> 4 mm) was related to abnormal root shape (blunt, pointed, or eroded). Conclusions: The variables significantly related to OIRR were extraction, initial tooth length, and root shape.

Early Surgical Revascularization for Acute Myocardial Infarction (급성 심근 경색후 관상 동맥 우회술의 조기 적용)

  • 지현근;이원용
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1077-1082
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    • 1997
  • To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

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Methodological Issues in Socio-Economic Assessment of the Hydrogen Economy Development (수소경제로 이행을 위한 사회경제적 영향평가 방법론)

  • Kim, Ho-Seok
    • 한국신재생에너지학회:학술대회논문집
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    • 2005.06a
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    • pp.586-591
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    • 2005
  • 우리나라는 에너지의 안정적 공급과 에너지이용 과정에서 발생하는 환경적, 안보적 외부성을 최소화하는 에너지수급 구조를 마련하기 위해 2003년 12월 '제2차 신재생에너지 기술개발 및 이용보급 기본계획(2003-2012)'을 발표하였다. 이 계획에서는 2011년까지 전체 TPES의 $5\%$를 신재생에너지로 공급하는 것을 정책목표로 수립하고 수소, 태양광 그리고 풍력기술을 중점적으로 추진하기로 하였다. 특히 수소부문에서는 주택 및 건물용, 발전용, 수송용 연료전지의 개발을 중심으로 개발하여 세계 기술시장의 $20\%$를 확보한다는 계획을 발표하였다. 이러한 기술 잠재력을 기반으로 우리 정부도 미국이나 일본과 같이 수소경제로의 전환을 준비하고 있으며 2020년대 이후 우리나라의 에너지부문은 새로운 국면에 접어들 것으로 전망된다. 에너지나 환경기술의 효과적 인 개발을 위해서는 이들 기술의 직접적인 비용측면에 대한 분석 즉 경제성 평가와 새로운 기술변화로 인한 중장기적인 사회경제적 영향평가가 선행되어야 한다. 이러한 평가는 대상 기술의 사회경제적 파급효과가 광범위할수록 더욱 복잡한 분석이 요구된다. 본 연구의 주제인 수소에너지기술은 지금까지 이용되던 것과는 전혀 새로운 에너지캐리어(carrier)를 개발하는 것으로 에너지부문 및 여타 다른 산업부문이 공유하고 있는 에너지 관련 인프라의 전면적인 조정이 요구되며 에너지 이용과 관련된 사회경제적 측면의 급속한 변화를 수반한다. 본 연구는 수소경제로의 이행에 대한 사회경제적 영향평가의 방법론적 요소들과 기법을 제시한다."중등도 독성"으로 나타났다 이상의 결과는 전기도금을 이용하여 교정용 선재의 직경을 증가시키는 방법이 임상에 적용되기 위해서는 세포독성을 줄이기 위한 추가의 연구가 필요함을 시사하였다.의하게 가장 낮은 정지. 운동 마찰력을 보였고 브라켓-호선 각도가 증가함에 따라 유의하게 정지, 운동 마찰력도 증가하였다 (P<0.001)%$ 낮추지만(p value=0.260) 평균 $D_{max}$는 거의동일 하여($0.3\%$ 감소, p value=0.867), 전통적인 방법보다 우수성이 크게는 없는 것으로 평가되었다. 그러나 환자의 체곡선이 보상체와 잘 일치하는 경우에는 DII가 $18\%$까지 감소하였다. 결론 : Multistatic field 방법은 모든 환자에 대하여 선량분포의 균일성을 전반적으로 향상시키는 효과적인 방법으로 평가되는 반면 공용보상체의 사용은 보상체의 크기가 환자의 체 윤곽과 잘 일치하는 경우만 효과적으로, 적용의 범위에는 한계가 있는 방법으로 평가되었다.비교하여 계통에 따르는 차이가 있음을 알 수 있었다. 그러므로 가임기 여성의 방사선 진단 및 치료시 Rugh의 10일 법칙을 적용하여 착상전기 방사선 조사로 인한 부작용들을 적극적으로 예방하는 것이 매우 중요하다고 생각한다.equirements of the prematured infants during the early weeks of life. 모든 치근단 수준에서 비표준화 medium 크기 master cone 사용군이 ISO 표준화 규격의 master cone 사용군에 비해

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Serum Lipid Profiles after Abstinence in Korean Male Patients With Alcohol Dependence (남성 알코올 의존 환자들에서 금주 치료 후의 혈청 지질 농도 변화)

  • Lee, Seoung-Ho;Park, Woong-Sub
    • Korean Journal of Biological Psychiatry
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    • v.15 no.1
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    • pp.23-28
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    • 2008
  • Objectives : The treatment of alcohol dependence requires maintaining abstinence. However, some previous studies have suggested that the abstinence may increase the cardiovascular risk in patients with alcohol dependence. The aim of the present study was to examine the effect of alcohol abstinence on lipid profile in Korean male patients with alcohol dependence. Methods : Twenty-eight male patients with alcohol dependence were recruited from a psychiatric unit located at Gangneung Dongin Hospital. Lipid profiles of the patients were compared before and after a month of alcohol abstinence. Results : After abstinence of 1 month, high-density lipoprotein(HDL) cholesterol and triglyceride(TG) level was significantly decreased(p=0.000; p=0.0086, respectively). Low-density lipoprotein(LDL) cholesterol level showed a tendency to increase(p=0.066). Total cholesterol level also showed a tendency to decrease(p=0.074). Conclusions : These results show that acute abstinence of alcohol might paradoxically aggravate dyslipidemia in patients with alcohol dependence. Thus, this study shows that more concern associated with cardiovascular risk is needed during short-term abstinence period.

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Anaphoric Resolution in Anomia and Wernike Aphasia (실어증에서 나타나는 참조어 정보처리과정의 특성 : 명칭 실어증과 이해성 실어증을 중심으로)

  • Kim, Ga-Young;Hwang, Yu-Mi;Moon, Young-Sun;Park, Yoon;Nam, Ki-Chun
    • Annual Conference on Human and Language Technology
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    • 1999.10e
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    • pp.455-461
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    • 1999
  • 본 연구의 목적은 실어증 화자가 참조어(대명사)를 이해하고 표현하는데 있어서의 오류 반응을 살펴봄으로써 참조어에 관한 처리기제를 알아보는 것이다. 본 연구에서는 명칭성 실어증 환자와 이해성 실어증 환자를 대상으로 하였으며, 각각의 환자에게 두 가지 실험을 진행하였다. 실험 1은 정오판정 과제로 문장, 혹은 문단을 제시하고 사용된 참조어가 옳은지 그른지를 판정하도록 하는 것이다. 실험 2는 채워넣기 과제로 문장, 문단을 제시하고 괄호 안에 들어갈 참조어를 보기에서 고르도록 하는 것이다. 사용된 참조어는 인칭 대명사와 지시 대명사, 그리고 지시 관형사였다. 인칭 대명사의 경우는 인칭과 수로 나누어 각각 1인칭, 2인칭의 단수 복수로 구분하여 제시되었으며, 문장 내에서 각각 주격조사 '가', 보조사 '는', 소유격조사 '의'와 결합되어 제시되었다. (나는, 너는, 우리는, 너희는/ 내가, 너가, 우리가, 너희가/ 나의, 너의, 우리의, 너희의) 지시 대명사의 경우는 사물을 나타내는 것과 장소를 나타내는 것으로 구분되어 제시되었다. (이것, 그것, 저것/ 이곳, 그곳, 저곳) 지시 관형사의 경우는 '이', '그', '저'가 각각 명사와 결합되어 제시되었는데 지시대명사로 분류하였다. 실험결과는 실험과제간(정오판정, 채워넣기), 실험재료간(인칭 대명사, 지시 대명사)의 차이로 분석될 수 있다. 또한 인칭 대명사와 지시 대명사 내에서도 각각의 재료들 간에 오류반응의 특징이 있는 것으로 나타났다 이로 미루어 볼 때 참조어 범주간 별개의 처리과정이 작용하는 것이라고 생각할 수 있다. 물론 인칭대명사와 지시대명사가 사용되는 문맥적 상황, 대명사의 개념적 거리, 빈도, 사용된 문장의 길이 등 여타의 요소들도 고려되어야 할 것이다. 보조용언으로 쓰일 때 어휘적 의미가 전혀 활성화되지 않아 정상인과는 다른 언어처리를 하고 있음이 밝혀졌다.류의 의미가 모두 활성화되는 것을 보여 주었다. 즉, "먹은"과 간은 어절 이해는 구성 형태소로의 분석과 구성 형태소 어휘 접근을 통해 어절 이해가 이루어진다는 가설을 지지하고 있다. 실험 2에서는 실험 1과 다르게 한 뜻으로만 안일 수밖에 없는 "쥐어"와 같은 어절을 사용하여 이런 경우에도(즉, 어절의 문맥이 특정 뜻으로 한정하는 경우) 구성 형태소로의 분석 과정이 일어나는지를 조사하였다. 실험 2의 결과는 실험 1의 결과와는 다르게 어간의 한가지 의미와 관련된 조건만 촉진적 점화 효과가 나타나는 것을 보여주었다. 특히, 실험 2에서 SOA가 1000msec일 경우, 두 의미의 활성화가 나타나는 것을 보여주었는데, 이 같은 결과는 어절 문맥이 특정한 의미로 한정시킬 경우는 심성어휘집에 활용형태로 들어있다는 것이다. 또한 명칭성 실어증 환자의 경우에는 즉시적 점화과제에서는 일반인과 같은 형태소 처리과정을 보였으나, 그이후의 처리과정이 일반인과 다른 형태를 보였다. 실험 1과 실험 2의 결과는 한국어 어절 분석이 구문분석 또는 활용형태를 통해 어휘 접근되는 가설을 지지하고 있다. 또 명칭성 실어증 환자의 경우에는 지연된 점화과제에서 형태소 처리가 일반인과 다르다는 것이 밝혀졌다. 이 결과가 옳다면 한국의 심성 어휘집은 어절 문맥에 따라서 어간이나 어근 또는 활용형 그 자체로 이루어져 있을 것이다.으며, 레드 클로버 + 혼파 초지가 건물수량과 사료가치를 높이는데 효과적이었다.\ell}$ 이었으며 , yeast extract 첨가(添加)하여 배양시(培養時)는 yeast extract 농도(濃度)가 증가(增加)함에

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