• 제목/요약/키워드: Waiting list

검색결과 47건 처리시간 0.02초

Ex Vivo Lung Perfusion of Cardiac-death Donor Lung in Pigs

  • Paik, Hyo Chae;Haam, Seok Jin;Park, Moo Suk;Song, Joo Han
    • 대한이식학회지
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    • 제28권3호
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    • pp.154-159
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    • 2014
  • Background: Lung transplantation (LTx) is a life-saving treatment for patients with end-stage lung disease; however, the shortage of donor lungs has been a major limiting factor to increasing the number of LTx. Growing experience following LTx using donor lungs after cardiac death (DCD) has been promising, although concerns remain. The purpose of this study was to develop a DCD lung harvest model using an ex vivo lung perfusion (EVLP) system and to assess the function of presumably damaged lungs harvested from the DCD donor in pigs. Methods: The 40 kg pigs were randomly divided into the control group with no ischemic lung injury (n=5) and the study group (n=5), which had 1 hour of warm ischemic lung injury after cardiac arrest. Harvested lungs were placed in the EVLP circuit and oxygen capacities (OC), pulmonary vascular resistance (PVR), and peak airway pressure (PAP) were evaluated every hour for 4 hours. At the end of EVLP, specimens were excised for pathologic review and wet/dry ratio. Results: No statistically significant difference in OC (P=0.353), PVR (P=0.951), and PAP (P=0.651) was observed in both groups. Lung injury severity score (control group vs. study group: 0.700±0.303 vs. 0.870±0.130; P=0.230) and wet/dry ratio (control group vs. study group: 5.89±0.97 vs. 6.20±0.57; P=0.560) also showed no statistically significant difference between the groups. Conclusions: The function of DCD lungs assessed using EVLP showed no difference from that of control lungs without ischemic injury; therefore, utilization of DCD lungs can be a new option to decrease the number of deaths on the waiting list.

고형장기이식 환자의 정신건강: 이식의 시기별 이슈 (Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases)

  • 정연진;강지인
    • 대한불안의학회지
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    • 제19권2호
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

아태지역 식품안전관리 협력과 역량강화를 위한 APEC의 활동 (The Activities of APEC to Reinforce the Cooperation and the Competence of Food Safety Management in Asia Pacific Region)

  • 이꽃임;황명실;윤혜정;이철호
    • 한국식품위생안전성학회지
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    • 제27권2호
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    • pp.176-181
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    • 2012
  • 지속적인 식품안전 사고와 확대된 국제교역은 국제기구들로 하여금 식품안전 문제의 심각성을 자각하게 만들었다. 이로 인해 다양한 법 규제, 조치들, 협력 네트워크, 교육프로그램 등이 개발되었고, 특히 나라 간 식품안전 기술조화 및 전문인력 양성에 집중하고 있는 현실이다. APEC 또한 2007년 식품안전협력포럼(FSCF)를 신설하여 아시아 태평양 지역의 식품안전 향상을 위해 다양한 각도로 노력을 하고 있다. 2007년부터 현재까지 35개의 activity들이 진행되었고 APEC 프로젝트 절차에 따라 추가로 20여개가 준비 중이다. FSCF에서 수행되는 activity들은 생산에서 소비까지 식품안전 관리에 있어서 국제 최고의 기준과 조치들을 사용함으로 인해 공급사슬 내 에서의 이해당사자들의 능력을 키워 무역을 증진시키고 공중 보건을 지키는데 목적을 두고 있다. 이러한 전략적 목적을 완성하기 위해서 APEC 지역 내 식품안전 정부기관들, 산업체, 학계, 국제기구 등 전문가들 간의 다자간 협력 필요성이 요구되어 교육훈련기관네트워크(PTIN)가 차후에 만들어졌다. 이로 인해 식품 안전과 관련한 과학적 기술적 정보를 교류하고 안전관리 교육을 강화시킬 수 있게 되었다. 오늘날 식품안전 분야에서의 국제적인 공조는 필수적이다. 이에 우리나라가 APEC FSCF활동에 적극적으로 참여하여 아태지역 회원국들의 식품안전기술 향상에 기여할 뿐 아니라 국내 교육지원 프로그램과의 연계성을 검토해 볼 필요가 있다.

Efficacy of a Training Program for Long-Term Disease-Free Cancer Survivors as Health Partners: A Randomized Controlled Trial in Korea

  • Yun, Young Ho;Lee, Myung Kyung;Bae, Yeonmin;Shon, Eun-Jung;Shin, Bo-Ram;Ko, Hyonsook;Lee, Eun Sook;Noh, Dong-Young;Lim, Jae-Young;Kim, Sung;Kim, Si-Young;Cho, Chi-Heum;Jung, Kyung Hae;Chun, Mison;Lee, Soon Nam;Park, Kyong Hwa;Chang, Yoon Jung
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7229-7235
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    • 2013
  • Background: To determine whether the Health Partner Program is effective in training long-term cancer survivors to be health coaches. Materials and Methods: We randomly assigned cancer survivors who were selected through a rigorous screening process to either the Health Partner Program or the waiting-list control group. The program consisted of 8 weeks of training in health management, leadership, and coaching. At baseline, 8, and 16 weeks, we measured primary outcomes using the Seven Habit Profile (SHP), the Korean Leadership Coaching Competency Inventory (KCCI), Ed Diner's Satisfaction with Life Scale (SWLS), and the Posttraumatic Growth inventory (PTGI) and secondary outcomes using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF-36). Results: We recruited 70 subjects and randomly assigned 34 to the intervention group. The Sharpen the Saw habit of the SHP increased significantly more in intervention group than in the control group (p=0.049), as did most PTGI factors. The intervention group also showed a significantly greater enhancement of vitality (p=0.015) and mental health (p=0.049) SF-36 scores but no improvement in KCCI, SWLS, HADS, or IES-R scores. The intervention group also showed a greater clinically meaningful improvement in the "Think Win-Win" of SHP (p=0.043) and in the personal strength score (p=0.025) and total score (p=0.015) of the PTGI. Conclusions: Long-term cancer survivors can benefit from the Health Partner Program to become health coaches.

『본초정화(本草精華)』의 해제(解題)에 관한 역사학적(醫史學的) 접근 (『Bonchojeonghwa(本草精華)』, Medical Historical Approach to Bibliographic Notes)

  • 김홍균
    • 한국의사학회지
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    • 제24권2호
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    • pp.25-55
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    • 2011
  • The currently existing "Bonchojeonghwa (本草精華)" is a manuscript without the preface and the epilogue, composed of 2 books in 2 volumes. This book is a quintessence of knowledge on science of medicinal ingredients (medicinal phytology I herbal science) as well as an trial of new development in Chosun medical science. I.e. this book includes surprising change representing medical science in Chosun dynasty as a single publication on science of medicinal ingredients. It holds a value essential to clinician as a specialized book in medicinal ingredients, and Includes richer content on medicinal ingredients than any other books published before. In addition, it is away from boring list-up of superfluous knowledge as seen in "Bonchokangmok(本草綱目)" published in China, and well summarizes essential knowledge which can be used within a range of medicines available in Korea. This book has an outstanding structure that can be even used in today's textbook on science of medicinal ingredients, as it has clear theory, system and classification. Because it handles essential learning points prior to prescription to disease, it is possible to configure new prescription and adjustment of medicinal materials. Moreover, this book can play a good role for linguistic study at the time of publication, because it describes many drugs in Hangul in many parts of the book. "Bonchojeonghwa" includes a variety of animals, plants and mineral resources in Korea, like "Bonchokangmok" which was recently listed in UNESCO. As such, it has a significance in natural history as well as pharmacy in Korean Medicine. It has various academic relationships all in biologic & abiologic aspects. It has importance in sharing future biological resources, building up international potential, setting up the standard for biologic species under IMF system, and becoming a base for resource diplomacy. We should not only see it as a book on medicinal ingredients in terms of Oriental Medicine, but also make an prudent approach to it in terms of study strengthening Korea's national competitiveness. After bibliographical reviewing on the features & characteristics of the only existing copy of "Bonchojeonghwa" housed in Kyujanggak(奎章閣) of Seoul National University, the followings are noted. First, "Bonchojeonghwa" is a specialized book on medicinal ingredients voluntarily made by private hands to distribute knowledge on drugs in the desolate situation after Imjinoeran (Japanese Invasion in 1592), without waiting for governmental help. Second, it raised accessibility and practicality by new editing. Third, it classified 990 different kinds of drugs into plant, animal, and mineral at large, and dassified more in detail into 15 'Bu' and 48 'Ryu' at 258 pages. Fourth, the publication of this book is estimated to be around 1625~1633, at the time of Injo's reign in 17th century. Fifth, it contains the existing & up-to-date knowledge at the time of publication, and it is possible to see the supply-demand situation by Hangul descriptions in 149 places in the book. By the fact that there are many linguistic evidences of 17th century, explains well when the book was published.

분산 이기종 컴퓨팅 시스템에서 임계노드를 고려한 태스크 스케줄링 알고리즘 (A Novel Task Scheduling Algorithm Based on Critical Nodes for Distributed Heterogeneous Computing System)

  • 김호중;송인성;정용수;최상방
    • 전자공학회논문지
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    • 제52권3호
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    • pp.116-126
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    • 2015
  • 분산 이기종 시스템에서 병렬 응용프로그램의 성능은 태스크를 스케줄링하는 방법에 따라 크게 영향을 받는다. 따라서 병렬 응용프로그램의 성능에 영향을 미치는 요소들을 태스크 스케줄링에 반영함으로써 주어진 환경 내에서 최적의 결과를 도출할 수 있도록 해야 한다. 일반적으로 병렬 응용프로그램의 전체 처리시간에 영향을 미치는 결정적 요소는 입력 그래프의 임계경로이다. 본 논문에서는 임계 경로 상의 임계노드를 고려한 태스크 스케줄링 알고리즘인 CLTS를 제안한다. CLTS는 우선순위 결정 단계에서 계층화를 통해 노드의 병렬처리 효율을 향상시키고 임계노드 처리에 의한 지연시간을 단축시킬 수 있도록 우선순위를 결정한다. 또 프로세서 할당 단계에서는 조건적으로 복제 기반 정책, 혹은 삽입 기반 정책을 사용하여 노드를 프로세서에 할당함으로써 전체 처리시간을 단축시킨다. 제안한 CLTS의 성능 평가를 위해 기존의 리스트 스케줄링 알고리즘인 HCFPD, DCPD와 함께 성능을 비교 평가하였다. 시뮬레이션을 통해 CLTS는 평균 SLR을 기준으로 HCPFD 대비 7.29%, DCPD 대비 8.93% 향상되었고, Speedup을 기준으로 HCPFD 대비 9.21%, DCPD 대비 7.66% 향상된 성능을 보임을 확인하였다.

안전한 진료환경 구축을 위한 정책 개선과제 (A Review of Improvements for Providing Safe and Secure Environments for Medical Treatment)

  • 최아름;김성은;백경희
    • 보건행정학회지
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    • 제29권2호
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    • pp.105-111
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    • 2019
  • On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.