Kim, Junwon;Kim, Jang Hun;Kim, Jong Hyun;Kwon, Taek-Hyun;Roh, Haewon
Journal of Trauma and Injury
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제32권4호
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pp.202-209
/
2019
Purpose: Cranioplasty (CP) is often required for survival after decompressive craniectomy. Several materials, including autologous bone and various artificial materials, have been introduced for CP, but it remains unclear which material is best for CP. This study aimed to explore differences in complications between patients who underwent CP using an autologous bone flap versus a three-dimensional (3D) titanium mesh and to identify significant risk factors for post-CP complications. Methods: In total, 44 patients were enrolled in this study and divided into two groups (autologous bone vs. 3D titanium mesh). In both groups, various post-CP complications were evaluated. Through a comparative analysis, we aimed to identify differences in complications between the two groups and, using binary logistic analysis, to determine significant factors associated with complications after CP. Results: In the autologous bone flap group, there were three cases of surgical infection (3/24, 12.5%) and 11 cases of bone flap resorption (BFR) (11/24, 45.83%). In the 3D titanium mesh group, there was only one case of surgical infection (1/20, 5%) and 11 cases of various complications, including mainly cosmetic issues (11/20, 55%). A subgroup risk factor analysis of CP with an autologous bone flap showed no risk factors that predicted BFR with statistical significance, although a marginal association was found between larger bone flaps and BFR (odds ratio [OR]=1.037, p=0.090). In patients treated with a 3D titanium mesh, multivariate analysis revealed that only the existence of a ventriculo-peritoneal shunt system was strongly associated with overall post-CP complications (OR=18.66, p=0.021). Conclusions: Depending on which material was used, different complications could occur, and the rate of complications was relatively high in both groups. Hence, the material selected for CP should be selected based on individual patients' conditions.
The aims of this study are to evaluate the quality of hospital food services and the evaluate the quality in selected hospitals trough the use of the questionnaires. A survey of 30 hospital food and nutrition service department was undertaken and detailed information was collected from each, including, surveys of 1, 016 patient. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis, t-test X$^2$-test ANOVA principal component analysis , and cluster analysis and cluster analysis. In the case of patient satisfaction with hospital food and food services, overall satisfaction scores of male and female were 3.54 and 3.45 showing higher levels than the average score(3.00) The aspect of the food and food service which received the lowest ratings by patients was 'meal rounding while dining'. After conduction of factor analysis of variables affecting the patients meal satisfaction 3 groups including the 'menu satisfaction factor', 'service satisfaction factor ' and 'nutrition management satisfaction factor ' were selected. 3 clusters were categorized by the 'service cluster' 'nutrition management cluster', 'men cluster', and 'menu nutrition service cluster' after conducting a cluster analysis with influencing variables affecting patients meal satisfaction. The overview results of patient satisfaction by cluster were : in the case of the service group, such factors as taste, portion size, dealing with complaints while dining meal rounding while dining should be managed with caution In case of the nutrition management group, such factors as taste, portion size, temperature of the food intake, and dependence on hospital food should be managed with care, In the case of the menu groups, such factors as punctuality of meal times, contaminated substances in meals and serving mistakes, cleanliness of dishes, kindness of the server meal rounding while dining should by particularly managed with importance.
The present study was conducted to analyze the status of food and nutrients intakes of the colorectal cancer patients in the Daegu$\cdot$Kyungpook area and to find dietary risk factors related to the occurrence of colorectal cancer in this community. The case subjects (123) were selected from the patients recently diagnosed as colorectal cancer at Kyunrpook National University Hospital, the control subjects (182) were selected from the patients of the Department of Orthopedic Surgery at the same hospital and from the healthy volunteers who did not have any gastrointestinal diseases. The food consumption survey was done by individual interviews using semi-quantitative food kequency questionnaire and nutrients intakes were analysed by CAN program. The results of the study suggested that dietary factors which are speculated as the risk factors of colorectal cancer in Daegu$\cdot$Kyungpook area were high consumption of cereals and oils low consumption of fruits and mushrooms, high consumption of energy and fat, especially animal fat, low consumption of dietary fiber, high percentage of energy intake from cereals and potatoes, high intakes of protein, fat, vitamin A and cholesterol from egg, low intake of calcium from vegetables, and high intake of iron from meats and eggs. These findings might be useful for the nuation education to prevent colorectal cancer in the community. However it is recommended to conduct more extensive and systematic survey to reconfirm these dietary risk factors under taking into consideration of the dietary characteristics in this region.
This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.
Purpose: By reviewing literature on the subject, we compared the survival rate of implants placed in various graft materials used for maxillary sinus augmentation. Materials and Methods: The search protocol used the Pubmed electronic database, with a time limit from 1998 to 2009. Keywords such as 'sinus lift,' 'sinus augmentation,' 'sinus floor elevation,' 'sinus graft,' 'bone graft,' 'implants,' 'oral implants,' and 'dental implants' were used, alone and in combination, to search the database. We selected articles and divided them into three groups by type of graft materials: Group 1. Autogenous bone group: autogenous bone alone; Group 2. Combined bone group: autogenous bone in combination with bone substitutes; and Group 3. Substitute group: bone substitutes alone or bone substitute combinations. Results: We selected 37 articles concerning a total of 2,257 patients and 7,282 implants; 417 implants failed. The total implant survival rate (ISR, %) was 94.3%. In Group 1, 761 patients and 2,644 implants were studied; 179 implants failed and the ISR was 93.2%. In Group 2, 583 patients and 1,931 implants were studied; 126 implants failed and the ISR was 93.5%. In Group 3, 823 patients and 2,707 implants were studied; 112 implants failed and the ISR was 95.9%. Conclusion: Implants inserted in grafts composed of bone substitutes alone or in grafts composed of autogenous bone in combination with bone substitutes may achieve survival rates better than those for implants using autogenous bone alone (P<0.05).
Purpose: This study was to examine the effects of supportive nursing care on surgical patients in the operating room. Method: This study was nonequivalent control group none-synchronized design. The data were collected during the period of July 26 through October 8, 1999 at K hospital in Kwangju. The subjects for the study were selected from those patients who were admitted to K hospital for abdominal surgery. Forty-eight adult subjects were selected and evenly divided into two groups: 24 for the experimental group and the other 24 for the control group, respectively. The tool used for measuring state and trait anxiety was the one originally worked out by Spilberger(1976), and translated by Kim Jung- Taek and Shin Dong-Kyun(1978) for suitable application for Koreans. Data were analyzed by $\chi^2$- test, t-test, Chronbach's ${\alpha}$ coefficient using SAS/PC+. Result: Results were as follows : 1. The degree of State anxiety was found to be lower in the experimental group who received supportive nursing care in the operating room immediately before an operation than the control group who did not."(p<.001). 2. There was no significant difference on the post-test blood pressure and pulse rate immediately before operation between the two groups(p>.05). Conclusion: Results of the above study reveals that the supportive nursing care in the operating room is effective in alleviating the anxiety of patients. I suggest that it is highly desirable to apply supportive nursing care for those patients who are waiting for immediate surgery.
Objectives : The purpose of this study is 1) to explore the general tendency of the herbs or herbal formula for acne treatment in clinical practice 2) and to provide a basis for explaining the principles of acne treatment in Korean Medicine in order to make patients understand more easily based on pharmacological mechanism by analyzing the herbs or herbal formula using for acne treatment in clinical practice. Methods : In the domestic databases (Oriental medicine Advanced Searching Integrated System-OASIS, Korean Traditional Knowledge Portal-KTKP, National Discovery for Science Leader-NDSL, Research Information Sharing Service-RISS), we selected among the papers published using search terms related to "acne". Reports related to sasang constitutional medicine were excluded and a total of 23 papers were finally selected. Results : 29 prescriptions were retrieved from 23 papers. Chungan-tang (淸顔湯) notified formulas ranked first by Cheongsangbangpung- tang (淸上防風湯), Hwangnyeonhaedok-tang (黃連解毒湯), Dangguijakyaksan (當歸芍藥散) and Bipachungpe-eum (枇杷淸肺飮). Commonly used herbs are Forsythiae Fructus (連翹), Scutellariae Radix (黃芩), Gardeniae Fructus (梔子), Ligustici Rhizoma (川芎), and Angelicae Gigantis Radix (當歸). In most patients with inflammatory lesions or excessive flushing, exterior-releasing medicinal (解表藥) and heat-clearing medicinal (淸熱藥) were mainly prescribed for acne treatment, while in patients with acne accompanied hyperkeratinization, Excess sebum secretion, Dysmenorrhea or indigestion, qi-tonifying medicinal (補氣藥) or blood-tonifying medicinal (補血藥) were mainly used. KAGS (Korean Acne Grading System) was the most commonly used method for acne severity assessment. Conclusions : These findings suggest that the herbs or herbal formula for acne treatment in Korean Medicine is prescribed differently according to the cause and symptoms of acne in a unique way for control the whole body balance. Also, our findings could provide a basis for explaining the principles of acne treatment in Korean Medicine in order to make patients understand more easily based on pharmacological mechanism in clinical practice.
Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 subjects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was performed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quality of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.
Objective : The purpose of this study is to analyze Korean patients' characteristics, who were concurrently treated with both Korean herbal medicines and Western chemical medicines using nation-wide database. Method : Using the patients sample data (HIRA-NPS 2018) provided by Health Insurance Review and Assessment Service, a group of patients who co-administered Korean herbal and Western medicines was selected, and their basic characteristics, diagnosis, and prescribed chemical medicines were analyzed. Results : Out of the 1,481,921 sample population, 17,629 patients (1.2%) were selected as a concurrent medication group. Compared to the whole sample, the concurrent medication group was composed of more women (65.8% vs. 51.1%), the more elderly people (65 or older years old) (44.5% vs. 14.6%), and the higher prevalence of chronic diseases (49.1% vs. 22.2%). The most frequent diagnosis treated with Western medicines was mental and behavioral disorders, musculoskeletal and circulatory disorders. Frequently used drugs among concurrent medication group were anti-anxiety drugs, gastric ulcer treatment drugs, and senile diseases treatment drugs. Conclusion : The evidence reported in this study is expected to provide herb-drug interaction researchers with important reference to set the priorities of research topics in the future.
Objectives: Objective: The purpose of this study is to investigate the treatment of herbal medicine for patients with COVID-19 asymptomatic infections. Method: In English, search engines such as 'PubMed', 'Science Direct', and 'Cumulative Index to Nursing and Allied Health Literature (CINAHL)' were used. In Chinese, search engines such as 'China National Knowledge Infrastructure (CNKI)' and Wanfang were used. The keywords for the search engines were 'COVID-19', 'asymptomatic infection', 'Korean Medicine', 'traditional Chinese medicine', 'herbal medicine', and etc. Only clinical studies using herbal medicine for patients without fever or respiratory symptoms were selected. We excluded the cases that do not fit the research topic. Results: A total of 5 studies were finally selected. Among them, four of them used integrated herbal medicine and Western medicine, and one of the studies treated exclusively for herbal medicine. There were a total of seven prescriptions for herbal medicine used in the study. Outcome variables were used as following: lab test, nucleic acid conversion time, hospitalization period, chest CT, and etc. In the RCT study, herbal medicine and Western medicine decreased nucleic acid conversion time, average hospitalization time compared to the control group, but it was not statistically significant. No other adverse reactions were reported in all studies. Conclusion: According to the results, integrated herbal medicine and Western medicine might be an effective treatment for patients with COVID-19 asymptomatic infection reducing hospitalization period, time of nucleic acid turning negative. No severe adverse effects were reported. However, it is thought that better-designed research will be needed in the future.
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