• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.297-308
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• 2021

Objective : Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. Methods : This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient's age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. Results : This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40-0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24;95% CI, 0.14-0.40; p=0.60; I2=0%) than in general patient population. Conclusion : The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

• 가정∙방문간호학회지
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• 제12권2호
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• pp.16-32
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• 2005

Purpose: The purpose of this study was to: (1) describe the self-efficacy, perceived barriers and health promoting behaviors and (2) determine the relationship of these variables in stroke survivors. Methods: A convenience sample of 93 stroke survivors who were enrolled in a neurosurgical outpatient clinic in Seoul participated in the study. Results: Among health promoting behaviors, non-smoking was the subdomain with the highest mean score and exercise subdomain had the lowest mean score. Significant factors correlated with health promoting behaviors were age, self-efficacy and perceived barriers. Conclusion: Findings from this study suggest that health promotion programs aimed at enhancing self-efficacy and decreasing perceived barriers would be beneficial for the stroke survivors.

• 대한영상의학회지
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• 제84권4호
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• pp.934-940
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• 2023

뇌실-복강 단락술은 가장 널리 사용되고 있는 수두증의 수술적 치료 방법이다. 단락술과 관련된 합병증은 비교적 흔하게 발생하며, 높은 단락장치 교정술 시행률과 관련이 있다. 그러나 원위도관이 다른 장기 내로 전위되는 경우, 특히 심장 및 혈관 내 전위는 드물게 보고되었다. 드물지만 잠재적으로 위험한 합병증에 대해 알고 있는 것은 신속한 처치를 통해 위중한 상황을 예방할 수 있기 때문에 중요하다. 저자들은 뇌실-복강 단락술 시행 2개월 후 원위도관이 좌측 내경정맥을 통해 심장 및 양측 폐동맥 내로 전위되었던 23세 남자 환자의 증례를 보고하고, 발생 가능한 기전과 치료에 관해 논의해 보고자 한다.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.185-190
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• 2000

본 연구는 1999년 10월 1일부터 2000년 3월 30일까지 대구시 세종 신경외과의원에서 요통을 진단 받고 물리치료실에 내실한 환자 40명과 대조군 40명을 합한 총 80명을 대상으로 하였다. 대상자에게 요추 1번과 5번의 상연을 연결하는 요추 전만각도 측정에서 요통환자의 $29.88^{\circ}$는 대조군의 $35.31^{\circ}$보다 통계적으로 유의하게 감소했다(p<0.01). 성별 전만도 차이는 여성 환자의 $32.32^{\circ}$가 남성 환자의 $27.32^{\circ}$보다 유의하게 증가했고(p<0.05), 대조군에서도 여성이 $36.63^{\circ}$로 남성의 $34.12^{\circ}$보다 증가했으나 통계적 차이는 없었다. 연령별 전만도 차이는 40세 이하의 환자가 $27.95^{\circ}$로 이상의 $32.32^{\circ}$보다 감소하였으나, 대조군은 각각 $35.82^{\circ}$와 $34.27^{\circ}$ 40세 이하가 조금 증가했으나 통계적 유의성은 없었다. 작업자세와 요추 전만도 차이에서 앉아서 작업하는 환자$(31.35^{\circ})$는 서서 작업하는 환자$(28.93^{\circ})$ 보다 증가했으나, 대조군은 양자가 비슷하였다. 따라서 본 연구결과 환자의 요추 전만도가 대조군 보다 유의하게 감소했고, 여성 환자가 남성 환자 보다 증가했다.

• 대한핵의학회지
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• 제34권5호
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• pp.426-432
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• 2000

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.

• 성인간호학회지
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• 제20권2호
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• pp.296-310
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• 2008

Purpose: The purpose of this study was to compare the importance and performance of nursing interventions linked to five nursing diagnoses in CVA patients. Methods: First, total 37 nursing diagnoses were identified from the analysis of 78 nursing records of CVA patients, and then top 5 diagnoses were mapped with nursing interventions. Second, each intervention was compared in terms of importance and performance by 80 nurses working at neurosurgical units from 5 general hospitals. Data were analyzed using mean, SD, and t-test using the SPSS program. Results: Selected the top five nursing diagnoses were Acute Pain, Risk for Disuse Syndrome, Decreased Intracranial Adaptive Capacity, Ineffective Cerebral Tissue Perfusion and Acute Confusion. In general, most of the interventions were scored higher in importance than performance and most of independent interventions were not performed as frequently as it perceived in importance. The interventions which scored high in performance were the interventions ordered by physician or interventions related to medication behavior. Conclusion: We identified which nursing interventions should be performed more frequently and more critically important to nursing diagnoses. We recommend further research that enhances the performance of nursing interventions to provide better quality of nursing services to the patients in practice.

• 대한임상검사과학회지
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• 제45권2호
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• pp.77-85
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• 2013

Intraoperative Neurophysiological Monitoring (INM) is very useful in monitoring the motorsensory pathway and vascular circulation system during intraspinal, or intracranial neurosurgery. Brainstem Auditory Evoked Potentials (BAEPs) are for detecting the problems along the auditory pathways including, the eighth cranial nerve and brainstem. Motor Evoked Potentials (MEPs) is a useful adjunct to conventional monitoring of Somato-sensory Evoked Potentials (SEPs) during surgery. Visual Evoked Potentials (VEPs) has been regarded as having limited significance for the preservation of visual function during neurosurgical procedures. In this paper, we propose that the most appropriate averaging of the number of inspections in the inspection of each used in the operative field, is good and efficient, functionally.

• 대한간호학회지
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• 제35권1호
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• The Journal of Korean Physical Therapy
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• 제9권1호
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• pp.167-175
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• 1997

The purpose of this study was to determine the efforts of cold applied for reducing spasticity in patients with traumatic brain injury and cerebrovascular accident who did not take neurosurgical treatment and medication except patients with spinal cord injury. The participants consisted of 17 men and 28 female was ramdomly assigned to three groups with each 15. The results were as followings after making on observation about the change of skin temperature and spasticity throughout cryotherapy which was performed with cooling air in Group I (1 min), Group II (5 min) and Group III (10 min). 1. It was found that the Group III, Group II, Group I, in the order named, had the statistically significant reduction of skin temperature, the reduction of spasticity showed statistically significance in Group III, Group II, in order named, but did net show it even though there was a little increase in Group I. 2. The reduction of skin temperature and spasticity did not continue over 24 hours at the same time every day for 5 days. 3. The longer cryotherapy was applied the more skin temperature and spasticity reduced, the more skin temperature was reduced the more spasticity reduced.

• 중환자간호학회지
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• 제3권2호
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• pp.13-22
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• 2010

Purpose: This study was intended to examine the effects of educating the Ventilator-Associated Pneumonia (VAP) control for the nurses working in the intensive care unit (ICU). Methods: The study was conducted using one group pre-post test research design. The education on infection control was provided to 31 nurses working at the medical and surgical ICUs. A comparison was then made in terms of the degree of performing infection control a month before, two weeks after, and three months after the education respectively. The incidences of VAP at the medical and surgical ICUs were compared for 3 months before and after the education. Results: The average performance scores between before and after the education showed statistically significant differences. Compared to three months before, the incidence of VAP after the education was decreased slightly from 5.48 to 1.88 per 1,000 ventilator days. Conclusion: It is necessary to continue the VAP education, specifically on infection prevention and control methods and the consistent evaluation of its effects as well as the development of standardized educational program should be approached extensively in further studies.