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Prognostic Factors of Pyogenic Spinal Infections

  • Jung, Young-Jin;Kim, Sang-Woo;Chang, Chul-Hoon;Kim, Seong-Ho;Kim, Oh-Lyong;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.445-449
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    • 2005
  • Objective : This study is performed to evaluate the clinical manifestations and prognostic factors among patients with pyogenic spinal infections. Methods : The records and radiologic data of 27 patients treated between 2001 and 2003 were retrospectively evaluated. Results : All patients [mean age, 55.2yrs] were treated with i.v. antibiotics and 13[48.1%] required surgical treatment. Mean follow up duration was 38.9 weeks. The sixteen patients[59.2%] had previous surgical procedure on spine and six patients[22.0%] had local injections. The ten patients had predisposing factor [such as, diabetes mellitus, UTI, liver cirrhosis, septic condition]. The most common symptoms are lower back pain and motor weakness. Causative organisms determined only in ten patients[37%] and Staphylococcus aureus[50%] was most common. C-reactive protein[CRP] and white blood cell[WBC] count were more correlated with clinical outcome than erythrocyte sedimentation rate[ESR]. Conclusion : CRP and WBC level can be significant parameters of treatment and prognosis in pyogenic spinal infection.

Identification of Major Nursing Diagnosis, Nursing Outcomes, and Nursing Interventions (NNN) Linkage for Cancer Patients Undergoing Chemotherapy (항암화학요법 환자에게 적용된 주요 간호진단, 간호결과 및 간호중재의 연계성 확인)

  • Song, Su Mi;So, Hyangsook;An, Minjeong
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.413-423
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    • 2014
  • Purpose: This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy. Methods: This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics. Results: Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified. Conclusion: The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.

Analysis of nursing records of cancer patients with standardized nursing language systems (표준화된 간호용어체계를 이용한 암환자 간호기록의 분석)

  • Lee, Mi-Soon;Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.2
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    • pp.243-254
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    • 2004
  • Purpose: The purpose of this study was cross-mapping unique nursing statements which were identified in the nursing records of patients with six most common cancers in Korea with the standardized nursing languages of NANDA, NIC, NOC and ICNP. Method: The subjects were 72 nursing records which covered 1,502 admission days from August 1, 2003 to June 30, 2003. They were the records of the patients of six most common cancers who were treated at the six 3rd level general hospitals in Busan and Daegu. The unique nursing statements were identified by dividing the statements from the nursing records into the single statements according to their meanings. For cross-mapping, identified unique nursing statements were classified as 'Data(D)' for the subjective, objective data of the patients and the other data such as treatment, admission, discharge, and residence of patient, 'Problem(P)' for nursing problem or diagnosis defined by the nurse's decision, 'Intervention(I)' for nursing intervention for problem solving, and 'Outcome(O)' for patient reaction and results of the provided nursing interventions. Unique nursing statements classified to D, P, I, O were cross-napped by using Microsoft Excel 2000. The statements of D were cross-mapped with ICNP Nursing phenomena, P with NANDA nursing diagnosis and ICNP nursing phenomena, I with NIC and ICNP nursing intervention, and O with NOC and ICNP nursing phenomena Result: The results of this study were as follows. 1. Number of unique nursing statements were 506 in the records of lung cancer patients (18.12%), 480 in stomach cancer(17.19%), 458 in liver cancer(16.40%), 456 in colon cancer (16.33), 457 in breast cancer (16.36%) and 436 in cervix cancer (15.60%). 2. The range of percentage of cross-mapped unique nursing statements with the standardized nursing languages were as follows: P with NANDA nursing diagnosis $87.50{\sim}100%$, I with NIC $59.72{\sim}74.43$, O with NOC $61.05{\sim}72.64%$, and D, P, I and O with ICNP $60.92{\sim}69.95%$. 3. Number of the standardized nursing languages identified in this study were 21(12.66%) from 155 NANDA nursing diagnosis, 76(15.64%) from 486 NIC Nursing interventions, 54(17.47%) from 260 NOC nursing outcomes, and 343(13.03%) from ICNP 2,634. Conclusions: By the results of this study, NANDA, NIC, NOC and ICNP were found that they can be used as the language systems for nursing record and nursing information system for cancer patients. But, further study on the unique nursing statements which were not cross-mapped with the standardized nursing language systems will be necessary.

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Effects of Nonsurgical Spinal Decompression Treatment on the Level of Pain and Quality of Life in Patients with Cervical or Lumbar Disc Herniation: A Retrospective Observational Study

  • Kim, Beom Seok;Lee, Ye Ji;Kim, Hyo Bin;Sung, Ki Jung;Jeon, Ju Hyun;Kim, Eun Seok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.259-269
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    • 2020
  • Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results: No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EuroQol- 5 dimension and EuroQol visual analogue scale scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion: This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine.

The Clinical Efficacy of Decompressive Craniectomy in Patients with an Internal Carotid Artery Territory Infarction

  • Yoo, Seung Ho;Kim, Tae Hong;Shin, Jun Jae;Shin, Hyung Shik;Hwang, Yong Soon;Park, Sang Keun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.293-299
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    • 2012
  • Objective : To evaluate the surgical efficacy of and factors associated with decompressive craniectomy in patients with an internal carotid artery (ICA) territory infarction. Methods : Seventeen patients (8 men and 9 women, average age 61.53 years, range 53-77 years) were treated by decompressive craniectomy for an ICA territory infarction at our institute. We retrospectively reviewed medical records, radiological findings, and National Institutes of Health Stroke Scale (NIHSS) at presentation and before surgery. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS). Results : Of the 17 patients, 15 (88.24%) achieved a poor outcome (Group A, GOS 1-3) and 2 (11.76%) a good outcome (Group B, GOS 4-5). The mortality rate at one month after surgery was 52.9%. Average preoperative NIHSS was $27.6{\pm}10.88%$ in group A and $10{\pm}4.24%$ in group B. Mean cerebral infarction fraction at the septum pellucidum level before surgery in group A and B were 33.67% and 23.72%, respectively. Mean preoperative NIHSS (p=0.019) and cerebral infarction fraction at the septum pellucidum level (p=0.017) were found to be significantly associated with a better outcome. However, no preexisting prognostic factor was found to be of statistical significance. Conclusion : The rate of mortality after ICA territory infarction treatment is relatively high, despite positive evidence for surgical decompression, and most survivors experience severe disabilities. Our findings caution that careful consideration of prognostic factors is required when considering surgical treatment.

Factors Influencing Functional Status in Patients with Heart Failure (심부전 환자의 기능상태에 영향을 미치는 요인)

  • Song Eun-Kyeung;Kim Cho-Ja;Yoo Il-Young;Kim Gi-Yon;Kim Ju-Hyeung;Ha Jong-Won
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.853-862
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    • 2006
  • Purpose: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. Method: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. Result: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. Conclusion: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

Clinical Features of Vocal Cord Paralysis after Anterior Cervical Spine Surgery (전방 접근법을 통한 경추 수술 후 성대 마비의 임상양상)

  • Kim, Il-Woo;Kim, Beom-Gyu;Kim, Young-Bok;Rho, Young-Soo;Ahn, Hwoe-Young;Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.111-114
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    • 2006
  • Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

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Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses

  • Ko, Seok-Jin;Park, Kyung-Jae;Park, Dong-Hyuk;Kang, Shin-Hyuk;Park, Jung-Yul;Chung, Yong-Gu
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.34-41
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    • 2014
  • Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

A Study on Validity of a Semi-Quantitative Food Frequency Questionnaire for Korean Adults (성인의 식이섭취 조사를 위한 반정량 식품섭취빈도조사지의 타당도 연구 -건강증진센터 내원 성인을 대상으로 -)

  • Shim, Jee-Seon;Oh, Kyung-Won;Suh, Il;Kim, Mi-Yang;Sohn, Chun-Young;Lee, Eun-Joo;Nam, Chung-Mo
    • Korean Journal of Community Nutrition
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    • v.7 no.4
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    • pp.484-494
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    • 2002
  • This study was conducted to validate the semi-quantitative food frequency questionnaire that was developed to assess the intakes of fatty acids, as well as energy, carbohydrates, fat, protein, minerals and vitamins in Korean adults. The validity of the semi-quantitative food frequency questionnaire was tested on 78 subjects (31 men,47 women) aged 34 to 66 years. The semi-quantitative food frequency questionnaire included 93 food items and was validated on two 3-day dietary records. The mean intakes and the Spearman Correlation Coefficients between the semi-quantitative food frequency questionnaire and the two 3-day dietary records were analyzed for each nutrient and food group level. The mean nutrient intakes obtained from the semi-quantitative food frequency questionnaire were estimated to be greater than those of the two 3-day dietary records. The Spearman Correlation Coefficients between the energy-adjusted nutrient intakes from the semi-quantitative food frequency questionnaire and the two 3-day dietary records ranged from 0.24 for polyunsaturated fatty acids to 0.55 for fat in men and from 0.29 for polyunsaturated fatty acids to 0.55 for saturated fatty acids in women, respectively. The Spearman Correlation Coefficients for food intake ranged from 0.11 for teas and beverages to 0.58 for grains and their products in men,-0.04 for potatoes and starches to 0.73 for milk and dairy products in women. Foods consumed regularly had lower intra-person variation and tended to have higher observed correlation coefficients. These results indicate that the semi-quantitative food frequency questionnaire is a useful tool for estimating nutrient intakes, particularly of total fat and saturated fatty acid intakes.