Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.
Roh, Young Sook;Kim, Sunghee;Yang, Sun Hee;Kang, Yoon Sook
Journal of the Korea Academia-Industrial cooperation Society
/
v.14
no.7
/
pp.3349-3357
/
2013
The purpose of this study was to verify the effectiveness of an integrated nursing curriculum based on simulation with problem-based learning (PBL) by comparing the clinical competence and the self-confidence of newly graduated nurses. A non-equivalent control group post-test design was employed to compare the clinical competence and the self-confidence in the clinical performance examination using standardized patients between 39 newly graduated nurses with the traditional nursing curriculum and 35 with the integrated nursing curriculum. Data analysis involved Fisher's exact test, t-test, Pearson's correlation coefficient, and ANCOVA with the SPSS 19.0 program. The total clinical competence mean score graded by the standardized patients was not different between the two groups. However, the total clinical competence mean score graded by faculty was significantly higher in the integrated curriculum group than the traditional curriculum group. The mean self-confidence score was significantly higher in the integrated curriculum group than the traditional curriculum group. Active teaching-learning strategies including simulation or PBL in the nursing curriculum could benefit for nursing students by inducing favorable clinical competence and self-confidence. Longitudinal follow-up studies based on observation are needed to explore the patient outcomes in addition to the learner outcomes in clinical settings.
Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.
Kim, Jung-Hee;Lee, Kyung-Ha;Lee, Se-Joon;Yu, Mi-Kyung;Lee, Kwang-Won
Restorative Dentistry and Endodontics
/
v.30
no.2
/
pp.95-101
/
2005
The aim of this study was to evaluate the microleakage of teeth according to root canal preparation with & without apical enlargement in various size of apical foramen. 60 extracted one canal roots were cross-cutted at 5 mm from root apex and divided into two groups according to their apical foramen size of large (L) and small (S). Each group was subdivided into two groups accordance with their cross-sectional configuration at 5 mm from apex, round (R) and ovoid (O); SR Group, SO Group LR Group, LO Group. Each group was shaped in .02 taper by Quantec series Nickel-Titanium (NiTi) rotary file, obturated by lateral condensation method. Leakage was measured using a fluid transport model under 40 $cmH_2O$ pressure. After the leakage test, blocks which had showed the leakage retreated with .04 taper and ,06 taper and evaluated the degree of fluid filtration in each group. The data was analysed statistically using chi-square test and fisher's exact test. The results obtained were as follows : 1. Significant difference in leakage was found in groups which had different apical foramen size in .02 taper instrumentation (p < 0.05), but not in .04 taper instrumentation (p > 0.05) 2. The difference in microleakage according to the shape of canal was not evident at 5 mm from apex (p > 0.05). 3. There was correlation between .02 taper instrumentation and .04 taper instrumentation in LR group, LO group (p < 0.05).
Purpose: The purpose of this study was to investigate factors associated with suspicious developmental delay in infants and early childhood. Methods: Participants were 133 infants, aged from birth to 6 years old and their mothers, who were being seen at 16 Public health centers in B city. Korean Denver II was used to test infant development. ${\chi}^2$-test, Fisher's exact test and multiple logistic regression were used with SPSS 19.0 to analyze data. Results: Of participant infants, 7.5% were below the 3rd percentile for the weight percentile, 8.4% is a weight curve that crosses more than 2 percentile lines on the growth charts after previous achievement, and 9.8% had suspicious developmental delay according to Korean Denver II. Further the predictive factors related to suspicious development delay in the children were decrease of weight percentile (Odds Ratio [OR]=6.69, Confidence Interval [CI])=1.22-36.45), low economic state (OR=6.26, CI=1.50-26.00), and development delay perceived by their mothers (OR=4.99, CI=1.24-20.06). Conclusion: It is necessary to build a government level system to follow management of development of infants and children from the time of birth. Especially, it is necessary to develop a program for children in low income families.
This paper aims to compare the effectiveness of the chest compression when a person pushes on the infant's chest by using two fingers with the support during infant cardiopulmonary resuscitation, with the effectiveness of it without the support, and to find which one is better. For the study, 50 college woman students were tested during the simulation and the result of the test has been analyzed by chi-square test, Fisher's exact test. In case of the chest compression by using the support, the depth of the chest compression comes to $3.73{\pm}0.33cm$. On the other hand, in case of the chest compression without the support, $2.50{\pm}0.59cm$. It is founded that the method of pushing on the chest by using the support is more effective than that without the support (p < 0.001). It is concluded that the way that a person pushes on the infant's chest by using two fingers with the support during infant cardiopulmonary resuscitation has turned out to be more effective and useful. It is thought that in the future, the further study for it should be conducted.
This study was conducted to examine effects of the spiritual care education program on self esteem, communication, existential well-being and spiritual care competence in nurses. A non-equivalent control group, non-synchronized with pre-posttest design was used. The participants were 63 nurses(30 in an experimental group and 33 in a control group)attending a bachelor program of C Colledge in G metropolitan city. The experimental group attended 7 sessions of a SCE(Spiritual Care Education) program. Sessions were 90 minutes each, held once per week for 7 weeks. The scores for self-esteem, communication, existential well-being and spiritual care competence were measured before and after the treatment. Data were collected between October 10 and December 5, 2017 in an experimental group, April 24 and June 5, 2018 in a control group. Data were analyzed using Chi-square, Fisher's exact test, independent t-test using SPSS/WIN 21.0. The existential well-being(p<.025) and spiritual care competence(p<.001) were significantly increase in the experimental group compared to the control group after the intervention. Results suggest that this SCE program could be effective in increasing the existential well-being and spiritual care competence of nurses.
This study was conducted to develop and evaluate the effectiveness of Multifactorial Fall Prevention Program (MFPP) for local low-income elderly people on physical·psychological, and home environmental hazards, and falling frequency. The selected elderly people was provided the MFPP during an eight-week period of time, once a week, 70 to 90 minutes per each section. The design of this study was non-equivalent control-group with repeated measuring by quasi-experimental study. Data were collected before treatment, 8 week after treatment and 4 week after retention from July to October, 2010. Data were analyzed with numbers, percentage, Fisher's exact test, x2-test, repeated measures ANOVA, ANCOVA and Logistic regression. There were significant differences in fall frequency, balance, fear of falling, fall efficacy, home environmental hazards between the experimental group (EG) and control group (CG). This study showed that the multifactorial fall prevention program(MFPP) was useful nursing intervention for strengthening physical·psychological and environmental functions of the low-income elderly people, as well as preventing fall.
Purpose: The purpose of this study was to identify the effects of an exercise program on frontal lobe cognitive function in seniors. Methods: The participants were 42 seniors using a health center in Seoul (experimental group) and 28 seniors using a facility for elders in Seoul (control group). The exercise program was carried out for 16 weeks from April to August 2007. The frontal lobe cognitive function, which includes short term memory, attention, immediate memory, delayed memory, verbal fluency and motor function, was measured by the Digit Span Forward test, Trail Making test, Immediate recall words test, Delayed recall words, Controlled oral word association test and Finger tapping test. The collected data were analyzed by Fisher's exact test, Chi-square, t-test, and ANCOVA using the SAS program. Results: The major findings of this study were as follows: Attention (p=.009), immediate memory (p=.005), delayed memory (p=.009), and verbal fluency (p=.004) improved after the exercise program. Conclusion: In this study, the exercise program was effective in improving frontal lobe cognitive function in elders. So it provides basic information for further nursing education on exercise programs which will be effective for prevention of early cognitive function decline in normally aging elders.
Purpose: This study was done to develop and test a palliative care program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. Results: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. Conclusion: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.
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