• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.375-379
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• 2005

Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was grade III in one patient, grade IV in two, and grade V in two. All five patients un-derwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.

• The Journal of Korean Medicine
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• v.32 no.6
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• pp.112-116
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• 2011

Objectives: To inform the clinical features of drug-induced liver injury (DILI), and study traditional Korean medicine (TKM)-based strategies or therapeutics. Methods: A female patient with hepatitis after long term use of medication for cold symptoms was treated with Oriental therapies, after which the clinical outcome was evaluated by serum biochemical parameters and ultrasonography. Results: Clinical and biochemical levels were fluctuating during administration of cold medicine, but the patient completely recovered her health with herbal medicines. Conclusion: This case report would provide information about a typical DILI by western medicine followed by treatment with traditional Korean medicine.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.230-235
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• 2010

Objective : The aim of this study is to compare the surgical outcome of the initial and recent surgical cases, during our 15-years experience, in terms of the surgical strategies and the prognostic factors for surgically remediable epilepsy. Methods : We retrospectively reviewed and compared the surgical outcomes between the initial 256 (Group I) and recent 139 (Group II) patients according to the time period of operation for a total of 518 consecutive epilepsy surgeries at our institution since 1992. The patients of the middle intermediate period, which were subjected to changed surgical strategies, were excluded. Results : The surgical outcome data from the initial and recent groups showed a much improved outcome for patients who underwent temporal lobe epilepsy (TLE) surgery over time. The number of patients with a good outcome (Engel class I-II) was much increased from 87.7% (178 TLE cases of Group I) to 94.8% (79 TLE cases of Group II) and this was statistically significant (p = 0.0324) on univariate analysis. Other remarkable changes were the decreased performance of intracranial invasive studies from 43.5% in Group I to 30.9% in Group II due to the advanced neuroimaging tools. The strip/grid ratio was reduced from 131/32 in Group I to 17/25 in Group II, because of a markedly reduced mesial TLE surgery and an increased extratemporal epilepsy surgery. Conclusion : Our results show that surgical outcome of epilepsy surgery has improved over time and it has shown to be efficient to control medically intractable epilepsy. Appropriate patient selection, comprehensive preoperative assessments and more extensive resection are associated with good postoperative outcomes.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.90-95
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• 2009

Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

• The Korean Journal of Rehabilitation Nursing
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• v.19 no.1
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• pp.12-19
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• 2016

Purpose: This study was to examine the relationships between nurse's perception of patient safety culture and performance for safety nursing activities at rehabilitation hospitals. Methods: This study applied a descriptive research design. Participants were 194 nurses who have provided nursing services for more than 6 months at 4 rehabilitation hospitals located in B metropolitan city. Data were analyzed using descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients and multiple regression. Results: There was a positive correlation between the awareness of patient safety culture and safety nursing activity. Multivariate analysis showed that hospital work environment, experience of education, hospital climate, frequency of reported events, and marital status were significantly associated with the safety nursing activity. Overall, approximately 23.1% of total variability in the safety nursing activity could be explained by the 5 variables ($R^2=0.231$, p<.005). Conclusion: Nurses at rehabilitation hospitals are relatively positive about patient safety culture. Therefore, we need to develop safety education programs at the level of organization in order to improve patient safety through performing effective safety nursing activities in addition to increase awareness of patient safety culture among nurses. Furthermore, we need hospital's strategies at the system level for open communication and outcome reports regarding patient safety.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.2
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• pp.181-188
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• 2006

Purpose: The purpose of study was to determine differences in patient outcomes that exists in terms of Nursing Outcomes Classification (NOC) during hospital days of neurosurgical and respiratory patients. Method: Before starting clinical practicum, nursing students were received two hours' lecture on how to apply NOC to patient care plan and they were required to evaluate patient condition using NOC at the beginning and at the end of their clinical practicum. Data were extracted from 62 neurosurgical patients and 66 respiratory patients and analyzed by frequency and paired t-test. Results: The most frequently used NOC were Pain Level (37.1%), Mobility Level (25.8%), and Bowel Elimination (19.4%) in neurosurgical patients and Nutritional Status (37. 9%), Respiratory Status: Ventilation (37.9%) and Pain Level (25.8%) in respiratory patients. The numbers of outcomes used were 75 and 46 neurosurgical and respiratory patients respectively. During the hospital days, the level of patient outcomes increased significantly in all patient groups. Conclusion: The finding clearly suggests that nursing interventions make differences in patient outcomes and make contribution to the patient health achieved. To more effectively use NOC, however, nursing information system should be developed and included standardized nursing languages regarding nursing diagnoses and interventions.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Health Policy and Management
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• v.24 no.4
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• pp.380-388
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• 2014

Background: The volume of surgery has been examined as a major source of variation in outcome after surgery. This study investigated the direct effect of surgery volume to in hospitals mortality and the moderating effect of structural complexity-the level of diversity and sophistication of technology a hospital applied in patient care-to the volume outcome relationship. Methods: Discharge summary data of 11,827 cancer patients who underwent surgery and were discharged during a month period in 2010 and 2011 were analyzed. The analytic model included the independent variables such as surgery volume of a hospital, structural complexity measured by the number of diagnosis a hospital examined, and their interaction term. This study used a hierarchical logistic regression model to test for an association between hospital complexity and mortality rates and to test for the moderating effect in the volume outcome relationship. Results: As structural complexity increased the probability of in-hospital mortality after cancer surgery reduced. The interaction term between surgery volume and structural complexity was also statistically significant. The interaction effect was the strongest among the patients group who had surgery in low volume hospitals. Conclusion: The structural complexity and volume of surgery should be considered simultaneously in studying volume outcome relationship and in developing policies that aim to reduce mortality after cancer surgery.

• The Journal of Korean Physical Therapy
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• v.20 no.1
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• Journal of Sasang Constitutional Medicine
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• v.29 no.3
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• pp.288-297
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• 2017

Objectives The purpose of this study was to report significant improvement of peripheral coldness in patient, who was diagnosed with 'Soyangin Chest-heat symptomatic pattern' and applied medication based on Sasang Constitutonal medicine. Methods The patient was treated with herbal medications, according to his own symptomatology. The objective outcome was measured by thermography and the subjective sensation was assessed by using Visual Analogue Scale (VAS). Results The symptoms of peripheral coldness improved remarkedly without any side effects. Accessory symptoms and original symptoms also changed for the better. Conclusions This results show that it is available that peripheral coldness is treated with herbal medications according to Sasang Constitutional medicine, especially ingenious in terms of the fact that some patient can be diagnosed with heat-based condition on the basis of original symptoms, although his/her chief complaint is classified as cold pattern.