• Childhood Kidney Diseases
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• 제9권1호
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• pp.83-90
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• 2005

Focal segmental glomerulosclerosis(FSGS) has been detected in approximately 10% of cases of Idiopathic nephrotic syndrome in children, and exhibits a poor response to initial steroid therapy, as well as a higher rate of progression to chronic renal failure and relapse after kidney transplantation. We describe a case of an eleven year-old boy with steroid-resistant FSGS who exhibited a response to a second trial of cyclosporin h(CsA) therapy. At the age of 26 months, this patient was diagnosed with steroid-resistant FSGS. For 9 years, he had undergone a gauntlet of therapies to induce remission; oral steroids, cyclophosphamide, methylprednisolone(mehyIPd) pulse therapy, CsA, and ibuprofen therapy. Although these therapies failed to induce remission, the patient's renal function remained In the normal range during the nine years of treatment. At the age of ten years, the patient's proteinuria decreased, and complete remission was attained with a second administration of CsA, coupled with a low dose of oral steroids. This patient continues to receive CsA without relapse. Therefore, our major concern involves the possibility of relapse after the discontinuation of CsA therapy Our findings in this case suggest that, in cases of refractory FSGS, if renal insufficiency does not emerge, aggressive therapy for the amelioration of proteinuria should be continuously pursued.

• 한국콘텐츠학회논문지
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• 제9권5호
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• pp.197-205
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• 2009

컴퓨터가 도입된 이후 업무편리성이 증가한 반면 업무의 융통성이 줄어들어 업무의 일정 부분에서는 인간이 컴퓨터에 종속된 경향이 있다. 기존에는 영상의학과 접수에서 촬영완료에 이르기 까지 사람이 작업함으로써 많은 시간이 소요되고 환자 입장에서는 촬영순서 및 촬영 과정을 인지하기 어려운 단점이 있었다. 임상에서 RFID는 종합검진센터에서 환자의 위치추적을 목적으로 사용한바 있기 때문에 영상의학과에서 업무 효율성을 증가할 목적으로 RFID와 Workflow 중심의 OCS 시스템을 적용하여 업무 흐름을 개선하고자 하였다. 그래서 RFID를 접목시킨 Worklist 중심 OCS 프로그램을 개발한 결과 환자 만족도와 업무 흐름이 월등히 개선되는 효과를 거두었다. 이런 결과를 토대로 RFID 시스템은 추후 PACS등과 연계하여 Worklist에 접목 시킨다면 병원 업무에서 진정한 의미의 Ubiquitous를 구현하는 방안으로 유용한 시스템이라 여겨진다.

• 한국임상약학회지
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• 제12권1호
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• pp.13-21
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• 2002

After the introduction of cyclosporin, the graft survival rate of renal transplant and patients' life expectancy have been greatly improved. However, cyclosporin is known to cause several undesirable side effects, one of which is hyperuricemia, which may subsequently cause gouty nephropathy and graft dysfunction. The purpose of this study was to evaluate the frequency and predisposing factors of hyperuricemia in cyclosporin-treated patients within one year of kidney transplantation and uricosuric efficacy of benzbromarone. The patients who were treated with cyclosporin after kidney transplantation in 1998 and the patients who were treated with benzbromarone for the control of cyclosporin-induced hyperuricemia in 1999 were investigated retrospectively. Among the 76 patients in cyclosporin-treated patients in 1998, hyperuricemia occurred in 55 patients $(72.4\%)$ and the mean time from kidney transplantation to occurrence of hyperuicemia was $5.0\pm8.0$ months. In 1999, 22 patients were treated with benzbromarone for hyperuricemia and their mean time from kidney transplantation to occurrence of hyperuricemia was $4.5\pm10.4$ months. Acute rejection developed in one patient $(4.8\%)$ out of 21 normo-uricemic patients and 11 patients $(20.0\%)$ out of 55 hyperuricemic patients in 1998. The difference of rejection rate in these two groups was significant (p<0.001). There was no difference of rejection rate between before and after treatment of benzbromarone. Cyclosporin trough levels did not show a significant correlation with the serum uric acid levels among the three groups. However, hyperuricemic patients showed significantly higher serum creatinine levels than patients with normal uric acid levels (p<0.001). Benzbromarone decreased serum uric acid levels from $8.3\pm2.3\;mg/dl\;to\;5.1\pm2.0\;mg/dl$ (p<0.0001) and normalizing serum uric acid in all of 22 patients. Except for one patient $(4.5\%)$ who experienced diarrhea, no significant side effect was noted.

• 생물정신의학
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• 제12권1호
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• pp.13-19
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• 2005

Objective:The purposes of this study were to investigate heart rate variability(HRV) in patients with generalized anxiety disorder(GAD) compared with major depressive disorder in Korea. Methods:Fifty-six GAD patients(20 male and 36 female) was classified into their comorbid psychiatric illness. Among them, Twenty-five patients(10 male and 15 female) who do not have any psychiatric comorbidity were compared with 30 major depressive disorder patients(12 male and 18 female). Clinical symptoms, HRV and MMPI were analysed between two group. Results:Comorbid psychiatric illnesses of GAD were ranked into no diagnosis(44.6%), MDD(32.1%), panic disorder(10.7%), social phobia(5.3%), PTSD(1.7%), OCD(1.7%), MDD+panic disorder(1.7%) and MDD+specific phobia(1.7%). GAD patients showed low functioning in HRV, but degree of decreasing HRV is not so severe compared with MDD patient. Balance of sympathetic and parasympathetic nerve tone is more severely impaired in GAD patients compared with MDD patient. The score of MMPI did not reveal any differences between two groups. Conclusions:The result showed that HRV can differenciate GAD and MDD patients. GAD patients could show decreased HRV functioning, less than MDD patients. But autonomic imbalance could be more severe in GAD than MDD patients.

• 대한치과마취과학회지
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• 제7권2호
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• pp.120-125
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• 2007

Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.

• 혜화의학회지
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• 제13권1호
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• pp.39-45
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• 2004

The study sample consisted of 40 people who were complaining of current insomnia. The study groups were classified according to their age and gender, each containing 5 males and 5 females in the same age group. All the subjects were measured for heart rate (HR) and complicated degree. 1. In the 20's age group, the complicated degree of the female subjects is found to be much less than that of the males, suggesting that the pathology of insomnia would be more serious in the young females. 2. In the 30's age group, the complicated degree of both genders are decreased but there is no significant discrepancy between the reduced complicated degree. 3. In the 40's age group, the complicated degree of both genders are decreased but there is no significant discrepancy between the reduced complicated degree. 4. In the 50's age group, the complicated degree of both genders are decreased, however the females with postmenopausal conditions show much more reduction in the complicated degree, compared to the male group.

• 보건행정학회지
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• 제7권1호
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• pp.100-124
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• 1997

In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

• 대한의생명과학회지
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• 제10권3호
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• pp.253-257
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• 2004

The mechanisms by which leptospires caused disease are not well understood. A number of putative virulence factors have been suggested, but with few exceptions their role in pathogenesis remains unclear. In these days, many cases of leptospirosis are diagnosed by serological immunoassay. Leptospirosis is characterized by the histopathology of liver, kidney, heart, and lung, but the electrophoresis fractions of serum protein are not compared. We analyzed total protein, albumin, aspartic aminotranferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinine and urea nitrogen (UN) in sera of patients diagnosed leptospirosis. Total protein and albumin were decreased in 18.5％ and 31.2％ of patients, respectively. AST, ALT, ALP, UN and creatinine were increased in 90.4％, 66.9％, 28.0％, 15.9％ and 10.8％ of patients, respectively. We performed cellulose acetate membrane electrophoresis (EP) on sera of patients increased both of AST and ALT, and of patients increased both of creatinine and UN. In patients increased both of AST and ALT, and in patients increased both of AST and ALT, the relative percentage of albumin to total protein in patient serum was dcreased in 89.1 ％ of patients. α₁-globulin, α₂-globulin, β-globulin and γ-globulin were increased in 85.1 ％, 75.2％, 33.6％ and 98.0％ of patients, respectively. In patients increased both of creatinine and UN, the relative percentage of albumin to total protein in patient serum was dcreased in 93.8％ of patients. α₁-globulin, α₂-globulin, β-globulin and γ-globulin were increased in 87.5％, 100％, 31.2％ and 93.8％ of patients, respectively. These data indicate that infection of Leptospira causes severe liver damage to most of leptospirosis patients, but doesn't cause renal damage to most of them. The relative rate of serum protein electrophoresis fractions to total protein are not identical with them of typical hepatitis patient.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5229-5232
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• 2012

The incidence of malignant melanoma increases with age. One significiant effect of aging processes is an accumulation of oxidative damage in the genetical material. In this study, the relationship between malignant melanoma and damage in chromosomes and proliferative effectiveness of human peripheral lymphocytes were investigated by the micronucleus (MN) technique. A total of 15 malignant melanoma patients and appropriately matching 15 healthy controls were involved in the study. MN frequencies and proliferative indexes (PI) after non toxic levels of hydrogen peroxide treatment were also measured to determine damaging effect of oxidative stress in genome in addition to measuring the spontenous levels of micronuclei and PI. The patient group had a significantly higher rate of spontaneous MN than the control group (p<0.01). After treatment with $H_2O_2$, MN frequencies in the patient group was significantly decreased (p<0.01) although there was no difference between the treated and untreated results of control group (p=0.29). There was also difference (p<0.01) between the MN frequencies of the patient and the control group either in the spontaneous levels or in the $H_2O_2$ treated groups. The same significant difference persisted when the PI values were compared between patient and control groups. Increase in the MN frequency in patients could mean the alterations in the chromosomal structure which may lead to the chromosome instability and therefore genetic susceptibility to cancer. This increased number of micronuclei can also be used for cytological marker in identifying high risk cases for malignant melanoma.

• 성인간호학회지
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• 제20권2호
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• pp.311-320
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• 2008

Purpose: The study was done to analyze the effects of aroma inhalation method on preoperative anxiety of abdominal surgical patients. Methods: The research design was a nonequivalent control group non-synchronized design. The data were collected from July 25 to October 21, 2005 at C Medical Center in Seoul. The patients were divided into two group of 24 subjects each. In order for measuring the all patient's anxiety before operation and aroma inhalation, Spidlberger(1975) trait anxiety, VAS(visual analogue scale) state anxiety, blood pressure, pulse rate were taken. After experimental group was taken aroma inhalation, VAS state anxiety, blood pressure, pulse rate were measured for two group. Results: After aroma inhalation, VAS state anxiety level, systolic blood pressure, diastolic blood pressure, pulse rate of the experimental group were decreased significantly than those of control group(p = .000, p = .000, p = .030. p = .000). Conclusion: The aroma inhalation method can be considered an effective nursing intervention that relieves the preoperative anxiety of abdominal surgical patients and stabilizes vital signs.