• Journal of Chest Surgery
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• v.30 no.2
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• pp.137-145
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• 1997

From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were $37.3\pm$ 13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were $51.1\pm33.8$ months ranging from 6 months t 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from $3.02\pm0.73$ to 1 $78\pm0.55,$ and also in cardiothoracic ratio, from 0.61 $\pm0.09$ to $0.58\pm0.08$ at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1 %) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.

• Journal of Sasang Constitutional Medicine
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• v.4 no.1
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• pp.81-106
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• 1992

The purpose of this study was to find out the causal relationship between perceptual level of stress and health state according to Korean constitutions and to analyze that effect on the Korean constitution's health state. Subjects of this study were 87 out patient department of constitution at Kyung-Hee Oriental Medicine Hospital. Data were collected by using interview with Questionaire during 6 months from Feb. 2 to June 31, 1991. The Measurement tools used by this researcher were Go's The Questionaire of Identify about constitution, Lee's stress scale and Go's modified Cornell Medical Index which were approved it's reliability and validity. All of the questionaires of were used after pre- test. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and Pearson correlation. And then this research's issue was tested by SAS program's ANCOVA. The findings of this study was summarized as follow. 1. There was significantly differences in stress perceptual level in Korean constitution. (F=9.68, P=.000). The So Em In (小陰人) were higher than the other constitution on stress perceptional level. 2. In health state, there was significantly difference among Korean constitution. (F=6.654, P=.002). Also the So Em In (小陰人) was lower than the other constitution at health state. Therefore, it was considerate that So Em In (小陰人) was higher perceptual level of stress than the other constitution and the resulting poor health state. 3. Stressful perception was effected on the health state, as a result inverted correlation was constructed between stress perception and health state. (r=-.6034, P=.0001) 4. After exclusion of stress perceptual level, each of the Korean Constitution's health state was not difference (F=1.01, P=.37). It was mean that differences of the Korean Constitution's perceptual level of stress effected on the health state. Bacause So Em In (小陰人) had higher perceptual level of stress than other constitution (F=9.687, P=.000), in proportion to that one's health state was poor. From the results of this study, it could be concluded that the higher stress perceptual level according to Korean constitution, the poorer health state. Further study in this area needs to be consideration that in order to coping with stress, researcher grope for quality nursing intervention with more accurative assessment about Korean constitution.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3349-3357
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• 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.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.55-71
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• 2020

Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

• The Journal of Korean society of community based occupational therapy
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• v.6 no.1
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• pp.49-60
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• 2016

Objective : By organizing systematically the study case that use Robot Therapy as intervention tool according to PICO (Patient, Intervention, Comparison, Outcome), This study aims to investigate the domestic Robot Therapy's present condition. Methods : We searched 710 pieces of domestic scientific journal and master's thesis during the past nine years in 'Research Information Sharing Service' and 'National Digital Science Library' database using the keyword 'Robot therapy'. We finally chose 15 pieces of domestic scientific journal and master's thesis among the domestic studies that based on the full text which is affordable and used robot by therapeutic intervention tool. Chosen studies were layed out by PICO that could organize the resources systematically. Results : The quality of study tool was used to the method of evidence-based study level of 5 step classification. More than three stages of quality level study was 13. Result of dividing the studies using robot therapy by intervention field, language, lower extremity(gait), cognition, development and study for the region of the upper extremity of five is advancing. Conclusion : Nationally, the robot therapy has been used in various area that include the upper extremity and lower extremity's intervention of language, cognition, growth and others. We hope that this study for baseline data will be utilized in various area engaging to domestic robot therapy.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.37-44
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• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• The Journal of Korean Medicine
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• v.38 no.3
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• pp.96-102
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• 2017

Objectives: The purpose of this study was to investigate the effects of Korean Medicine on postural instability and gait difficulty(PIGD) in patient with parkinsonism. Methods: We reviewed the charts of patients with parkinsonism who were admitted to the department of Korean internal medicine, stroke and neurological disorders center, Kyung Hee University Hospital at Gangdong from October 2009 to May 2017. We analyzed the data of UPDRS (Unified Parkinson's disease rating scale) and calculated PIGD related UPDRS before and after the admission. Results: The average of PIGD score for the 23 patients of Parkinsonism significantly decreased from $8.35{\pm}5.13$ to $4.52{\pm}3.68$ after treatment. The average of PIGD score for the 16 patients of idiopathic parkinson's disease and 7 patients of atypical Parkinsonism decreased from $9.13{\pm}4.46$ to $4.63{\pm}4.15$ and from $6.57{\pm}6.45$ to $4.29{\pm}2.56$ after treatment, respectively. Conclusions: These results provide that Korean Medicine has an effect on the motor function of patients who suffer from Parkinsonism with Postural Instability and Gait Difficulty. Furthermore it could be effective for improving activities of daily life.

• Journal of dental hygiene science
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• v.14 no.3
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• pp.411-416
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• 2014

The purpose of this study was to examine the effects of conscious sedation on pain and anxiety of patients in implant surgery. A total of 95 patients who underwent implant surgery were included in the study. In this study, the patient's anxiety and pain to evaluate the pre-operative Visual Analogue Scale (VAS), during-operative Pain Question (PQ), post-operative (Short-form McGill Pain Questionnaire [SF-MPQ], VAS) was used for tools such as questionnaires. The data were analyzed using the chi-squire, independent-samples t-test, multiple linear regression analysis. As a result, the pain reduction was significantly different between the sedative dental treatment and non-sedative dental treatment (p<0.05). The finding of the study multiple linear regression analysis showed that operation time, implant surgery experience, gender, age, operation form and Pain Catastrophizing Scale (PCS) with factors that affect the pain and anxiety (p<0.05). According to the results of the study, considered to be necessary to develop intervention strategies effective using the PCS when managing pain and anxiety of behavior management of this implant patient. Thus, it is advised to provide necessary practical guidelines and dental utilization behaviors on patients with conscious sedation.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.67-96
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• 2022

"Aid in Dying" means that when a decision-making patient suffers from an incurable disease, a drug that can speed up death is prescribed by a doctor and used to lead to death. Since the suspension of life-sustaining treatment was institutionalized based on human dignity and patient autonomy, the question of whether assisted death can be legally justified in relation to the right to receive medical help to shorten one's life to die with dignity has recently been actively discussed. In Korea, since the suspension of life-sustaining treatment was institutionalized by the enactment of the Life-sustaining Treatment Decision Act in 2016, an amendment to the Life-sustaining Treatment Act was recently proposed to legalize Aid in Dying. The global trend is that human "Right to Die" is discussed in the division of life and death, from the suspension of life-sustaining treatment to assisted death, and again in the order of euthanasia. In this paper, we started discussing dignified death and institutionalized patients' right to self-determination, looked at the controversy in the United States, which legislated assisted death in many states since the 2000s, and analyzed the main contents of California's End of Life Option Act and the data after enforcement. The strict requirements for Aid in Dying, such as voluntary confirmation of patients' intentions and doctors' obligation to provide information, and the results of California's Aid in dying system, composed of relatively diverse races, were reviewed.

• Journal of Korean Neurosurgical Society
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• v.67 no.4
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• pp.451-457
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• 2024

Objective : Exploring protein requirements for critically ill patients has become prominent. On the other hand, considering the significant impact of coma therapy and targeted temperature management (TTM) on the brain as well as systemic metabolisms, protein requirements may plausibly be changed by treatment application. However, there is currently no research on protein requirements following the application of these treatments. Therefore, the aim of this study is to elucidate changes in patients' protein requirements during the application of TTM and coma therapy. Methods : This study is a retrospective analysis of prospectively collected data from March 2019 to May 2022. Among the patients admitted to the intensive care unit, those receiving coma therapy and TTM were included. The patient's treatment period was divided into two phases (phase 1, application and maintenance of coma therapy and TTM; phase 2, tapering and cessation of treatment). In assessing protein requirements, the urine urea nitrogen (UUN) method was employed to estimate the nitrogen balance, offering insight into protein utilization within the body. The patient's protein requirement for each phase was defined as the amount of protein required to achieve a nitrogen balance within ±5, based on the 24-hour collection of UUN. Changes in protein requirements between phases were analyzed. Results : Out of 195 patients, 107 patients with a total of 214 UUN values were included. The mean protein requirement for the entire treatment period was 1.84±0.62 g/kg/day, which is higher than the generally recommended protein supply of 1.2 g/kg/day. As the treatment was tapered, there was a statistically significant increase in the protein requirement from 1.49±0.42 to 2.18±0.60 in phase 2 (p<0.001). Conclusion : Our study revealed a total average protein requirement of 1.84±0.62 g during the treatment period, which falls within the upper range of the preexisting guidelines. Nevertheless, a notable deviation emerged when analyzing the treatment application period separately. Hence, it is recommended to incorporate considerations for the type and timing of treatment, extending beyond the current guideline, which solely accounts for the severity by disease.