• 제목/요약/키워드: Onset time difference

검색결과 209건 처리시간 0.039초

급성기 뇌경색환자의 치료시기에 따른 단기 예후 평가 : NIHSS를 이용한 후향적 연구 (Short-term Prognosis according to Time of Treatment of Patients with Acute Cerebral Infarction : Measurement by NIHSS)

  • 박승찬;조승모;김도경;임지연;이재욱;홍진우;이인;이인선;김영균;권정남
    • 동의생리병리학회지
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    • 제26권6호
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    • pp.929-933
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    • 2012
  • This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

한방재활치료를 받은 뇌졸중 환자가 지각한 가족지지와 기능회복에 관한 연구 (Study on the Relationship between Family Support and Functional Recovery in Cerebrovascular Accident Patients with Rehabilitation Treatment of Oriental Medicine)

  • 김광주;이향련
    • 동서간호학연구지
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    • 제2권1호
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    • pp.22-36
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    • 1997
  • Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.

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시보건소 결핵등록관리환자들의 치료충실도에 미치는 요인에 관한 조사 -서울특별시 일개 구보건소 등록환자 중심- (A Study on the Factors which Influenced the Faithfulness to Treatment Among the Pulmonary Tuberculosis Patients Registered in a City Health Center)

  • 이영우
    • Journal of Preventive Medicine and Public Health
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    • 제17권1호
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    • pp.127-135
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    • 1984
  • Personal and social characteristics, disease status, reason of delay of receiving drug from City Health Center and knowledge and attitude on the pulmonary tuberculosis were compared between the faithful group in treatment and the unfaithful group among the patients for pulmonary tuberculosis registered in a City Health Center in order to analyze the factors which influenced the faithfulness to treatment. Record as well as interview survey was done toward all patients of 247 who were registered and being cared during over 6 months in a City Health Center from April 1, 1982 to March 31, 1983, and results were as follows; 1. There was no statistically significant difference in sex and age distribution between the faithful group in treatment and the unfaithful group. 2. There was no statistically significant difference in marital status distribution between the faithful group and unfaithful group in treatment. 3. The lower education group comprised higher proportion than the higher education group among the faithful group in treatment. 4. The proportion of the emlployed was higher than unemlpoyed among the unfaithful group in treatment. 5. The proportion of mild case was higher than severe case among the unfaithful group in treatment. 6. As for the onset of delay of receiving drug, 'less than 3 month after starting treatment' was 59.5% among the unfaithful group in treatment. 7. The reasons of delay of receiving drug were 'no time' (42.2%). 'being away from home' (25.0%), 'being sick' (13.8%), and 'forgot the appointed date' (12.0%). 8. There was no statistically significant difference in the knowledge on the communicability of the tuberculosis between the faithful groups in treatment and the unfaithful group. 9. There was no statistically significant difference in the knowlege on B.C.G. as vaccination drug of tuberculosis between the faithful group and the unfaithful group in treatment. 10. There was no statistically significant difference in the satisfaction on the treatment of health center between the group of faithful and unfaithful in treatment. 11. There was no statistically significant difference in the belief on the complete recovery of tuberculosis between the faithful group and the unfaithful group in treatment. 12. The rate of consulting on tuberculosis treatment with life partner was higher among the faithful group in treatment than the unfaithful group.

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뚜렛 및 만성 틱 아동의 출생순위에 따른 특성 비교 (A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS)

  • 김자성;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제4권1호
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    • pp.124-132
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    • 1993
  • 45명의 틱 증상을 보인 아동들의 임상적 양상을 검토하였고 형제순위별로 나눠 비교하였다. 성비는 14:1로 남자가 압도적으로 많았고 형제순위로는 맏이가 46.7%, 막내가 33.3%. 외동아 15.6%, 쌍생아 4.4%로 맏이가 많았다. 기질성 시사소견은 37.8%에서, 초기발달 이상은 71.1%, 가족관계의 이상이 89.9%에서 보였고 동반 증상들로는 주의력결핍 과잉운동장애 46.7%, 강박장애 17.7%, 격려불안은 24.4%, 범불안, 수면불안은 17.8%, 신체화 증상 및 아뇨가 각각 13.3%, 말더듬 8.9% 외에 분뇨, 우울증 등을 보여 총 84.4%에서 최소한 하나 이상의 동반된 문제를 가졌다. 형제별로 나눠 특징을 비교했을 때 발병 시기에서 현저한 차이를 보였는데 막내 유형은 입학과 연관된 시기에 발병율이 의미있게 높았다.(p<0.01) 쌍생아의 경우는 저 출생체중아가 환아였다. 이들 소견을 종합해볼 때 틱 및 뚜렛 장애의 발현에는 선천적 기질적 요인뿐 아니라 상당한 환경적인 요인이 작용한다고 보겠다.

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하지수술을 위한 0.5% 순수 Bupivacaine 척추마취 (Spinal Anesthesia for Lower Extremities : Comparison of Plain 0.5% Bupivacaine and Hyperbaric 0.5% Tetracaine)

  • 송선옥;구본업
    • Journal of Yeungnam Medical Science
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    • 제7권2호
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    • pp.121-130
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    • 1990
  • 영남대학교 마취과학교실에서 하지에 국한된 수술을 받는 환자 40예를 대상으로 각군 20예씩 0.5% 고비중 tetracaine 2ml와 0.5% 순수 bupivacaine 2.5ml을 사용하여 척추마취를 실시한 결과 다음과 같은 성적을 얻었다. 1. 각군의 연령, 성별, 신장 및 체중은 비슷하였다. 2. 양군 모두 감각차단이 $T_{12}$분절에 도달되는 시간은 4분정도였고, 감각차단 최고분절높이도 $T_{6-7}$이었으며 최고높이에 도달되는 시간도 20분 정도였다. 3. 운동차단정도도 양군이 비슷하여 10분에 대부분이, 20분이내에 전예에서 완전차단이 초래되었다. 4. Bupivacaine군은 감각차단이 $T_{12}$분절이상에서 유지된 시간이 3시간, 술후 진통시간이 7시간으로 tetracaine군보다 작용시 간과 진통시간이 의의있게 길었다(P<0.05). 5. 수축기 혈압의 감소는 bupivacaine군이 훨씬 적었으며(P<0.05), 혈압은 마취후 20~30분에 심하게 감소되었다. 6. 마취후 발생된 부작용은 전체 대상환자에서 두통(3예), 다리저림(5예), 배뇨곤란(3예) 및 배부통(4예) 등이었고 양군사이에 발생빈도의 차이는 없었다. 이 상의 결과로 bupivacaine 척추마취의 임상적 특징은 감각차단 및 운동차단이 나타나는 양상과 마취후 부작용은 고비중 tetracaine과 비슷하고, 고비중 tetracaine보다 혈압감소가 적고 작용시간이 걸고 술후 진통효과가 좋은 점등의 장점이 있으므로 0.5% 순수 bupivacaine은 하지수술을 위한 척추마취제로 유용하게 사용될 수 있을 것으로 사료된다.

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Comparison of Posterior Fixation Alone and Supplementation with Posterolateral Fusion in Thoracolumbar Burst Fractures

  • Hwang, Jong-Uk;Hur, Jin-Woo;Lee, Jong-Won;Kwon, Ki-Young;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.346-352
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    • 2012
  • Objective : We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. Methods : From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. Results : The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. Conclusion : We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.

잠재력훈련 집단상담이 성인 간질환자의 치욕감에 미치는 효과 (The Effect of Human Potential Seminars on the Perceived Stigma of Adults with Epilepsy)

  • 김은자
    • 대한간호학회지
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    • 제28권4호
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    • pp.1003-1012
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    • 1998
  • The purpose of this research was to identify the effect of human potential seminars on the perceived stigma of adults with epilepsy. The research employed a quasi experimental design and unequivalent control group pre-post design. The test was conducted on 15 adults with epilepsy attending one psychiartric out-patient clinic in Masan City, Korea. The stigma questionnaire was used as a pre-test to these patients. HPS was done ten times for five weeks from May 6, to July 26, 1996. The stigma questionnaire was again given, but this time as a post test. The control group of 14 adults with epilepsy were receiving medication at the same clinic. The human potential seminars were structured by McHolland(1972) and translated by Lee, Hae Seung(1990). The stigma research tool was modified and revised to be appropriate to Korean culture. It consisted of 15 sentences. The internal consistency was 0.92 with Cronbach's α. Research results are as follows. 1) To determine the homogenity of the experimental and control groups, the pre-stigma results were used and democratic-sociologic characteristics, job characteristics and disease related variables were compared. There was no significant difference between the two groups. 2) To identify the relationship between stigma and patient characteristics a pre-test was done. The study used both Mann-Whitney U-test and ANOVA test for statistical analysis. The variables related to stigma were the reason of unemployment and age at onset of epilepsy. 3) The test results of the effect of the human potential seminars on stigma in the patients with epilepsy, showed that stigma in the experimental group was lower than in the control group. The statistical method used to determine the difference between pre and post stigma results was the Wilcoxon signed rank test. The test results were statistically significant at the one percent level. 4) As a follow-up evaluation ten more patients(66.7% of the total) were additionally tested. In order to investigate if the stigmas were different between the pre, post and follow-up, Repeated measure ANOVA was used. The test results showed that the stigma scores were statistically different between the three groups at the one percent level(F=10.06, d.f.=2, p=0.00).

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말초성안면신경마비(末稍性顔面神經痲痺)에 대한 SSP치료요법과 전침요법의 병행치료 효과 (Effect of Combined Silver Spike Point Therapy and Electroacupuncture on Patients with Peripheral Facial Paralysis)

  • 황지혜;이동건;이현진;조현석;김경호;김갑성
    • Journal of Acupuncture Research
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    • 제24권4호
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    • pp.69-80
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    • 2007
  • Objective : This study was designed to evaluate the effect of combined Silver Spike Point Therapy and Electroacupuncture on symptoms with Peripheral Facial Paralysis. Methods: We investigated 112 cases of patients with Peripheral Facial Paralysis. The patients were divided into two groups. Group A and B were both treated with basic oriental medicine treatment including Electroacupunctre and Group B was treated with Silver Spike Point Therapy additionaly. We evaluated the tratment effect of each group by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System before treatment, after 2weeks and 4weeks treatment and Changing Point -period from onset of Peripheral Facial Paralysis to the day which the change begins to be seen at the face-. Results: 1. In Changing point, two groups showed significant differences. 2. As a results of evaluation by using Gross Grading system of House-Brackmann, Yanagihara's Unweighed Grading System, treatment scores showed significant difference over time in each group. 3. After 4weeks treatment, Group B showed significant difference on Gross Grading system of House-Brackmann, Yanagihara's Unweighed Grading System compared with Group A. 4. After 2weeks and 4weeks treatment, the Improvement Indexes of Group B were higher than those of Group A and statistically significant. And after 2weeks and 4weeks treatment, Ratio of Group B on mean of Improvement Index was 1.47 times and 1.34 times as large as those of Group A. Conclusions : Combined Silver Spike Point Therapy on Peripheral Facial Paralysis was more efficacious than the only use of basic oriental treatment including Electroacupuncture.

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kMIT를 이용한 비유창성 실어증 환자 음성 언어의 치료효과 연구 (Effects of Continuous Speech Therapy in Patients with Non-fluent Aphasia Using kMIT)

  • 이주희;고명환;김현기;홍기환
    • 대한후두음성언어의학회지
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    • 제16권2호
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    • pp.158-164
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    • 2005
  • Melody intonation therepy (MIT) is to improve the linguistic aspects of the verbal utterance for aphasic patients utilizing the intact right brain. It is applied to the aphasic patients with good comprehension, poor fluency, and little available speech are thought to be ideal candidates. The purpose of the study was to investigate the effects of Korean Melody intonation therapy (kMIT) in patients with non-fluent aphasia. Five male non-fluent aphasic patients were participated in this study. Average ages were 49.9 years old. Each therapy took 45-50minutes once a week for six months. Aphasic Screen lest (RISS) was used to assess language parameter such as Auditory comprehension, oral expression, reading, writing and calculation ability before and after kMIT. Mean of Length Utterance, verbal intelligibility and articulation disorder were assessed also. Computerized Speech Lab was used to assess the acoustic characteristics of aphasic patients before and after kMIT. The results are as follows : 1) Auditory comprehension, oral expression, reading, writing and calculation ability of the subjects increased after UH'. However, only oral expression showed significant difference (p<0.05). 2) Mean of Length Utterance of five patients generally increased after Un. 3) After kMIT, verbal intelligibility increased and showed significant difference (p<0.05). 4) Misarticulation rate generally decreased after m. 5) Voice Onset Time of the alveolar lenis /t/ and velar lenis /k/ gradually decreased after kMIT. 6) However, intonation pattern were increased gradually in yes'no question after kMIT.

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뇌졸중 환자의 일상생활 및 인지기능 회복에 대한 의·한의 협진 재활치료의 효과 (Effect of East-West Integrative Rehabilitation on Activities of Daily Living and Cognitive Functional Recovery in Stroke Patients: A Retrospective Study)

  • 문소리;금동호
    • 한방재활의학과학회지
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    • 제30권2호
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    • pp.105-123
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    • 2020
  • Objectives This study was conducted to verify the effectiveness of east-west integrative rehabilitation therapy on activity of daily living and cognitive functional recovery in stroke patients by comparing with integrative rehabilitation therapy group and conventional rehabilitation therapy group in a single institution. Methods The medical records of 106 stroke patients hospitalized in Department of Rehabilitation Medicine, Dongguk University Bundang Oriental Hospital from January 1, 2017 to February 28, 2019 were reviewed. After screening and dividing it into conventional rehabilitation (CR) group and integrative rehabilitation (IR) group, Korean version of Modified Barthel Index (K-MBI), functional independence measure (FIM), clinical dementia rating-sum of boxes (CDR-SB) were statistically analyzed. Results IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.001) and there was a statistically significant difference in K-MBI and CDR-SB score changes than CR group (p<0.05). And chronic patient of IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.01) and there was a statistically significant difference in CDR-SB score changes than CR group (p<0.05). In particular, the earlier the treatment initiation time, the more the improvement in function and when the treatment started within 2 years from the onset and patients took acupuncture and pulsed electromagnetic therapy, all scales significantly improved (p<0.001). Conclusions IR showed more improvement on activities of daily life and cognitive functional recovery than CR in this study.