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Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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Lower respiratory tract infection of positive antigen test for respiratory syncytial virus on children under 2 years of age (2세 이하의 소아에서 respiratory syncytial virus의 항원검사에 양성인 하기도 감염)

  • Jeong, Jea Heon;Moon, Kyoung Hee;Lee, Chang Woo;Choi, Du Young;Oh, Yeun Geun;Yoon, Hyang Suk;Cho, Ji Hyun;Kim, Jong Duck
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.394-400
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    • 2006
  • Purpose : This study was design and performed for evaluations of resent clinical pattern of bronchiolitis caused by RSV infection with children under 2 year of age for 5 years, who were admitted to pediatric ward. Methods : The inclusion criteria of the patients were children under 24 month-of-age, clinical manifestations of lower respiratory tract infection, and RSV antigen that was detected by a direct immunofluorescence test from the nasal secretions. The additional laboratory and simple chest X-ray findings were reviewed from the medical records of children who were admitted Wonkwang university hospital from Jan. 1999 to Dec. 2003. Results : In the 5 year study duration, 127 patients were enrolled and outbreak of RSV bronchiolitis took place in 2001. The 80 cases(63 percent) of RSV infection were concentrated in later autumn and winter. Number of the cases show coughing were 120(94.5 percent), but rale was audible in 78 cases(61.4 percent). Dyspnea, wheezing, and intercostal retraction were noticed in 27(21.3 percent), 21(16.5 percent), and 4(3 percent) cases respectively. The most common chest X-ray finding was hyperinflation of the lung that was noticed in 110 cases(86.6 percent). Care with mechanical ventilator for more than 2 days required in 5 cases. Conclusion : Lower respiratory tract infection by RSV was common in late autumn and winter season but year-round infection was noticed. The severity of RSV respiratory tract infectiontakes in some degree a grave course. So we suggest that population-based surveillance of acute respiratory infection due to RSV is necessary for assessment of prevalence and epidemiology of this disease.

A Study on the Environment for Lowbirth Weight Infants in Neonatal Intensive Care Unit in the United States (신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구)

  • Han Kyung Ja
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.159-176
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    • 1998
  • In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

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An Analysis of Nursing education Research in China : 1990-1998 (중국 간호교육관련 연구실태 분석)

  • Ko Il-Sun;Li Chun-Yu;Kim Jing-Ai
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.177-190
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    • 1999
  • This study has been conducted on the basis of the literature review of Nursing Education Research in China from 1990 through August 1998. Its purpose was to support the basic data of nursing education which is risen as major revolutionary of nursing in China and those for exchange of information between Korea-China nursing education. It is retrospective and descriptive research analyzing one hundred eighty articles published in The Journal of China Nursing. The results of the study were as follows. 1. Only 33.3% of the professors of Technical Nursing School who have played of major role of nursing education in China have carried out the study related to nursing education. Baccalaureate program professors have marked 22.2% of all studies, and diploma program professors have done 12.2% of all. Therefore, the professors of above the diploma program have done total 44.4%. It explains that the professors of baccalaureate and diploma programs have done more studies related to nursing education than those of Technical Nursing School. 2. In terms of the study design, most of the studies(38.8%) were case studies introducing the curriculum contents that were done at education institutions. And then, 28.5% were reviewing the articles, and 15.6% were descriptive studies. 3. In terms of the content of the study, 38.3% were relevant to education of Technical Nursing School, 15.0% were about baccalaureate education, and 10.4% is about diploma. 4. To analyze the specific contents of the studies ; a. In baccalaureate program, human resources (professor or teaching), course extension, lab, classes, teaching method, education philosophy, goal of education, evaluation method, and human resource development were included. b. In diploma program, teaching contents evaluation method, teaching method, and educational system were included c. In the technical school, there were qualification of professors , teaching method, evaluation method, opening the courses, teaching contents, goal of education and so on. d. Beyond these, there were practice guidance and appraisement, teaching method, and opening new courses which were not specially indicated as educational curriculum and score management as continuing education. What is above tell us that the study regarding development of university system has been progressed actively and widely. It has been for the effort of revolution which based on the China government force to reform of nursing education process during last 10 years. On the base of the result, we suggest the following questions and the alternatives. 1) Since most articles are case studies related to teaching methods and the others doesn't propose the research method. the study which is applied more exact research method is needed. 2) No study is regarding social change and health policy. Because University program, founded in 1983 is on the beginning point, the research about curriculum have to be taken as a top priority as well as to reflect social needs which are based on social changes and national health policy 3) Only one review article study tells nursing Human resource. To appear in large numbers in nursing manpower, avoid the present hospital nurses training system. Then, the study for manpower development which is able to accomplish in many fields has to be advanced. 4) Most studies did not have literature review processes, so it was impossible for researcher to know the past study tendency and there is no relation among studies as to same subject, the education about research method is needed.

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COMPARISON OF THE CHRONOLOGY OF ROOT RESORPTION OF DECIDUOUS TEETH BETWEEN EARLY 1990S AND EARLY 2000S (1990년대 초와 2000년대 초의 유치 치근 흡수의 연령 비교)

  • Lee, Keun-Hye;Nam, Dong-Woo;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.362-371
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    • 2004
  • It is essential to have adequate knowledge of the timing of root resorption of deciduous teeth for diagnosis and treatment planning in pediatric and orthodontic dentistry. Dental development is also influenced by hereditary characteristics, environmental factors, race, sex, endocrine reaction, nutrition, socioeconomic condition and secular factor. The aims of the present study were to determine the mean age of root resorption of deciduous teeth in contemporary Korean children and to compare the mean age of root resorption time of deciduous teeth between early 1990s and early 2000s. The study population was made up of Korean children attending the pediatric dentistry ward of Kyungpook National University Hospital. One thousand thirty seven children's panoramic radiograph (girls: 528 persons, boys: 509 persons) in $1990{\sim}1992$ and one thousand sixty five children's panoramic radiograph (girls: 394 persons, boys: 671 persons) in $2001{\sim}2003$ were examined. This study utilized a cross-sectional design. Due to the problems of imaging in the maxillary region and the mandibular incisor region, the mandibular deciduous canine, the mandibular deciduous first molar and the mandibular deciduous second molar were chosen for examination. The results were as follows. 1. There is a tendency for the teeth to resort earlier in the early 2000s group than the in early 1990s group. At the Res c stage, the difference of the mean age was 0.4 years. 2. At the Res c stage, the order of difference of the mean age from smaller to larger for the girls was the mandibular deciduous canine, the mandibular first deciduous molar, and the mandibular second deciduous molar. On the other hand, for the boys, the order was the mandibular second deciduous molar, the mandibular first deciduous molar, and the mandibular deciduous canine. The difference was larger with aging in girls and smaller with aging in boys. 3. There is a tendency for the teeth to resort earlier in girls in both the early 1990s group and the early 2000s group. The difference of the mean age between girls and boys was 0.3 year. 4. The commencement of root resorption of the mandibular deciduous canine was slower than that of the mandibular first deciduous molar. However, the completion of root resorption of the mandibular deciduous canine is faster than that of the mandibular first deciduous molar. The total elapsed time of root resorption from commencement to completion was shortest in the mandibular deciduous canine. 5. For each of the teeth in the early 1990s and the early 2000s groups, the speed of root resorption was in the later stage faster than in the earlier stage. In order to know about the exact timing of root resorption of deciduous teeth, periodic and longitudinal studies preferably covering the entire period of growth, is required.

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The Effects of the Breast Self-Examination Participant Education program on Breast Self-Examination Compliance and Health Promoting Behaviors in Adult Women (유방 자가 검진 참여 교육 프로그램이 유방 자가 검진 이행과 건강 증진 행위에 미치는 영향)

  • Park, Eun-Hwa;Ryu, Eun-Jung;Choi, Kyung-Sook
    • Asian Oncology Nursing
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    • v.3 no.2
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    • pp.133-144
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    • 2003
  • This study is carrying out a before and after experiment design for the non-equal comparative group to identify the effects of the breast self-examination education on breast self-examination participant education compliance and health promotion in women. The subject of this study was 58 women residing in Chungju. Their age ranged from 20 to 40. These women were not pregnant or did not breast feed, as well as they did not have any breast disease, at the time of survey. They were available for the response to the questionnaires, and understood the purpose of this study. They also agreed to participate in the study, and responded to the 3rd time questionnaires to the end. Thus, brochures and lectures were provided side by side to a group of 19 of those women, and only brochures were provided to another group of 39 of those women. With regard to education, a brochure and a program using a breast model were applied. Then, the frequency of the breast self examination compliance, breast self examination capability and the relations between the breast self examination and activities to promote health were measured, before the education, after 4 weeks of education and after 12 weeks of education. Before education and after 4 weeks of education. I collected the questionnaires myself visiting them, and after 12 weeks of education, the questionnaires were collected by mail. In relation to the study tool, the breast self examination activity was measured by two measuring tools: breast self examination activity frequency and breast self examination compliance capability. As for the frequency, the number of self examination for the period of 3 months, before the questionnaire survey, was measured in the form of self report. In relation to the tool to measure the breast self examination capability, the BSEPRI tool, which was developed by Wood in 1994, was used. Here, as the score was higher, the capability was indicated to be higher. The translated and revised version of Health Promoting Lifestyle Profile II (Walker, Sechrist & Pender. 2002) was used as a tool for health promotion. As the measured score was higher, the health promoting activity was indicated to be higher. The results of this study were as follows: 1. As a result of checking the breast self examination compliance frequency between the experiment group that received the breast self examination participant education and the comparative group that did not receive the education, there was a significant difference in interaction between groups by time, as time passed by. 2. As a result of checking the breast self examination compliance capability between the experiment group and the comparative group, there was a significant difference in interaction between groups by time, as time passed by. 3. As a result of carrying out a repetitive measurement analysis, between the experiment group that received the breast self examination education and the comparative group that did not receive the education, which was carried out to validate the hypothesis that the former would have higher health promoting activities than the latter, there was no significant difference after the breast self examination education was conducted.

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Effects of Foot Massage and Supportive Communication by Hospice Volunteers on Depression, Anxiety, and Mood of Cancer Patients Who Undergo Intravenous Chemotherapy at Out-patient Department (호스피스 자원봉사자의 발마사지와 지지적 의사소통이 외래 항암화학요법 환자의 우울, 불안 및 기분에 미치는 효과)

  • Hur, Hea-Kung;Song, Hee-Young
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.232-242
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    • 2010
  • Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer (조기유방암환자의 이차원치료계획과 삼차원치료계획의 방사선조사범위의 차이)

  • Jo, Sun-Mi;Chun, Mi-Son;Kim, Mi-Hwa;Oh, Young-Taek;Kang, Seung-Hee;Noh, O-Kyu
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.177-183
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    • 2010
  • Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

Interstitial Vaginal Needle Implantation in Gynecological Tumors : Design and Construction of Applicator (부인과암에서 조직내 삽입 방사선치료 - Applicator의 고안 및 제작-)

  • Kang, Seung-Hee;Chun, Mi-Son;Kang, Hae-Jin;Jung, Chil;Son, Jeong-Hyae
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.167-175
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    • 1998
  • Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

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Analysis of Prognostic Factors in Glioblastoma Multiforme (다형성 교모세포증 환자의 예후인자 분석)

  • Chang Sei Kyung;Suh Chang Ok;Lee Sang Wook;Keum Ki Chang;Kim Gwi Eon;Kim Woo Cheol
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.181-189
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    • 1996
  • Purpose : To find the more effective treatment methods that improving the survival of patients with glioblastoma multiforme(GBM), we analyze the prognostic factors and the outcome of therapy in patients with GBM. Materials and Methods : One hundred twently-one patients with a diagnosis of GBM treated at Severance Hospital between 1973 and 1993 were analyzed for survival with respect to patients characteristics, that is, duration of symptom, age, and Karnofsky performance status, as well as treatment related variables such as extent of surgery and radiotherapy. Results : The median survival time(MST) and 2-year overall survival rate (OSR) of the patients with GBM were 13 months and $20.8\%$, respectively. Duration of symptom, age, Karnofsky performance status(KPS), radiotherapy, and extent of surgical resection were associated with improved survial in a univariate analysis. Patients whose duration of symptom was longer than 3 months, had the 2-year OSR of $47.2\%$(p=0.0082), who were younger than age 50, $32.9\%$(p=0.0003) In patients with a KPS of 80 or higher, the 2-rear OSR was $36.9\%$(p=0.0422). Patients undergoing radiotherapy had the 2-year OSR of $22.9\%$(p=0.0030), and surgical resection of $23.3\%$ (p<0.000). A Cox regression model confirmed a significant correlation of duration of symptom, age, radiotherapy, and extent of surgical resection with survival, excluding KPS(P=0.8823). The 2-year OSR were $22.3\%$ and $19.4\%$, combined with chemotherapy or without, respectively(p=0.6028). The duration of symptom of 3 months or shorter, 50 years of age or older, and undergoing stereotactic biopsy only were considered as risk factors, then patients without any risk factors had the MST of 29 months and 2-year OSR of $53.9\%$ compared to 4 months and $0\%$ for Patients who had all 3 risk factors. Most of all treatment failures occurred in the primary tumor site($80.4\%$). Conclusion : The duration of symptom, age, radiotherapy, and extent of surgical resection were a prognostically significant indeuendent variables. To get a better survival, it seems to be reasonable that the study design which improves the local control rates is warranted.

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