• 제목/요약/키워드: severity-adjusted

검색결과 107건 처리시간 0.033초

모르핀, 국마제 및 항우울제의 경막외강내 지속혼주의 효과 (Effects of the Mixture of Morphine, Bupivacaine and Antidepressants by Continuous Epidural Infusion in Cancer and Non-cancer Pain)

  • 신형철;김정순;김일호;송후빈;옥시영;황경호;박욱;김성열
    • The Korean Journal of Pain
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    • 제5권1호
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    • pp.29-36
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    • 1992
  • This study was objected to evaluate clinical progressions about both the degree of pain relief and the occurrence of morphine tolerance while the epidural analgesia with low dose of morphine, bupivacaine and antidepressant continued repeatedly at every 5 day intervals of the constant-rate infusion(0.5 ml/hr, 60 ml capacity). The subjects were divided to 56 cancer and 36 non-cancer patients who failed to respond to palliative treatments. Before the relief of pain, the pain severity was moderate(10%) and severe(90%). The dose escalation of morphine noted to 11(20%)patients in cancer pain and to one(5%) case only in non-cancer. During the epidural analgesia, the effect of pain relief was moderate(11%) and good(89%). It suggest that the morphine tolerance may be reduced to some degree such as an initial minimum dose of epidural morphine with local anesthetic and antidepressant should be adjusted on an individual basis using the constant-rate infusor, even though rapid dose escalation occurrs in some patients who the diseases progress over a short period of time.

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Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study

  • Jang, Min Jeong;Kim, Yong Joo;Hong, Shinhye;Na, Jaeyoon;Hwang, Jong Hee;Shin, Son Moon;Ahn, Yong Min
    • Clinical and Experimental Pediatrics
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    • 제63권4호
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    • pp.135-140
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    • 2020
  • Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

유방암 환자의 방사선 치료 기간 동안 재활치료 프로그램이 삶의 질, 심폐기능, 피로에 미치는 영향 (Effects of a Rehabilitation Program on Quality of Life, Cardiopulmonary Function and Fatigue During Radiotherapy for Breast Cancer Patients)

  • 도정화;성준혁;안준수;조영기
    • 한국전문물리치료학회지
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    • 제19권1호
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    • pp.56-65
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    • 2012
  • This study examines the effects of a rehabilitation program on quality of life (QOL), cardiopulmonary function and fatigue during radiotherapy for breast cancer patients. The program includes aerobic exercise, stretching and strengthening exercises. Sixty-five women participated in this study and they were asked to perform supervised exercises that last for 60 minutes five times a week for six weeks. The European organization for research and treatment of cancer-cancer (EORTC QLQ-C30) and the breast (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption ($VO_{2max}$) and fatigue severity scale (FSS) were assessed before and after the rehabilitation program. The 60-minute program consisted of a 10-minute warm-up, 30-minute of aerobic exercises, and 15-minute of strengthening exercises, followed by a five-minute cool-down. Heart rates were monitored throughout the exercise class to ensure that patients were exercising at the target heart rate of 40~75% of the age-adjusted heart rate maximum. There were statistically significant differences in the changes of physical function and cancer related symptoms in the EORTC QLQ-C30 and EORTC QLQ-BR23 (p<.05). There was a statistically significant improvement in the predicted $VO_{2max}$ (p<.05), although there were no significant differences in the FSS (p>.05). The results of our study suggest that a supervised rehabilitation program may benefit the physical aspects and QOL of patients receiving radiotherapy for breast cancer.

Prealbumin and Retinol Binding Proteins Are Not Usable for Nutrition Follow-Up in Pediatric Intensive Care Units

  • Tekguc, Hakan;ozel, Deniz;Sanaldi, Huriye;Akbas, Halide;Dursun, Oguz
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.321-328
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    • 2018
  • Purpose: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. Methods: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. Results: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. Conclusion: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

목표 시나리오를 이용한 비즈니스 프로세스 외부상황 평가 모델 (Evaluation Model of Business process Contextual Situations using goal-scenario)

  • 백수진;고종원;송영재
    • 한국콘텐츠학회논문지
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    • 제11권8호
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    • pp.43-50
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    • 2011
  • 초기에 예측하지 못한 환경에 대응하기 위한 핵심 요소로 비즈니스 활동 모니터링이 주목받고 있다. 그러나 기존의 이벤트 처리 기반 모니터링 시스템과 실시간 조기 경보 비즈니스 활동 모니터링은 고정된 환경을 가정하여 설계 시 룰 기반으로 표현하여 경보 여부를 결정하거나, 이벤트 속성값이 입력되는 매시점마다 측정하여 경보를 내리게 된다. 따라서, 복잡한 환경에서의 새로운 외부 상황 문제에 대한 발생 범위와 심각한 정도 등을 판별하는데 한계가 있으며, 추상화하지 못한다. 본 논문에서는 외부에서 발생하는 새로운 시나리오의 서비스 요구를 기존의 실행중인 모니터링을 통해 지속적인 서비스 제공을 보장하도록 목표 시나리오를 이용한 비즈니스 프로세스 외부상황 평가 모델을 제안하였다. 외부 상황에 따른 새로운 요구사항을 목표 시나리오 기반으로 분석을 하고, 유사 프로세스 모델을 찾아 유사도와 연관도를 합하여 파악한 뒤 프로세스를 사전에 중단 시키거나 원하는 방향으로 변경하도록 한다.

대사증후군과 뇌심혈관질환 발병위험도 평가와의 연관성: 일개 사업장 남성 근로자를 대상으로 (The Relationship between Metabolic Syndrome and Korean Cardiocerebrovascular Risk Assessment: for Male Researchers in a Workplace)

  • 윤종완;이경진;이상윤;오장균
    • Journal of Preventive Medicine and Public Health
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    • 제40권5호
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    • pp.397-403
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    • 2007
  • Objectives: The prevalence of metabolic syndrome has recently increased, Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocerebrovascular disease has been investigated by several researchers in recent studies, This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocerebrovascular disease. Methods: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. Results: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11,7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0,001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. Conclusions: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.

소아 아토피 피부염에서 발아현미 상황버섯의 임상적 치료효과 (The Clinical Effect of Phellinus linteus Grown on Germinated Brown Rice in the Treatment of Atopic Dermatitis)

  • 홍원규;신정현;이연희;박동기;최광성
    • 대한본초학회지
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    • 제23권1호
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    • pp.103-108
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    • 2008
  • Objective: Atopic dermatitis is the most common chronic inflammatory skin disease in childhood. Phellinus linteus, an orange color mushroom, has been used as a traditional herb medicine for years. Recent preliminary animal experiments suggest that Phellinus linteus grown on germinated brown rice is effective in chronic inflammatory disease. The aim of this study was to evaluate the efficacy of Phellinus linteus grown on germinated brown rice in the treatment of atopic dermatitis(AD). Methods: 35 patients, 2 to 14 years of age, with mild to moderate AD were treated with Phellinus linteus grown on germinated brown rice powder per oral, $6{\sim}12g$/day adjusted by the body weight, divided three for up to 12 weeks without other treatment. The mean age of patients was 7.3 years. The disease activity has been monitored by objective SCORAD index. The symptom score of the pruritus was measured by using a traditional visual analogue scale (VAS). In addition, the global assessments of clinical response were also monitored by patients or their parents. Results: After 12 weeks of the study, significant reductions in mean severity scores and mean symptom scores were observed. The mean objective SCORAD indices of 35 patients decreased from 25.31${\pm}$8.96 to 18.73${\pm}$13.89(p<0.05). And the mean symptom score of pruritus assessment decreased from 7.37${\pm}$1.33 to 4.6${\pm}$2.3(p<0.05). The patient's global assessment of clinical response were also improved through the period of treatment(p<0.05). Conclusions: Phellinus linteusgrown on germinated brown rice may play a role in the treatment of mild and moderate AD in Children.

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헤링씨 법칙 비의존성 단안성 윗눈꺼풀처짐증 환자에서 수술 후 생긴 건측의 눈꺼풀처짐증 (Postoperative Contralateral Blepharoptosis in Patients with Unilateral Blepharoptosis and Negative Hering's Law Dependence Test)

  • 하원호;이용직;박대환;한동길;심정수
    • 대한두개안면성형외과학회지
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    • 제14권1호
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    • pp.36-40
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    • 2013
  • Background: Correction of unilateral blepharoptosis is unexpectedly difficult because healthy eye is often affected by Hering's law. Methods: We measured changes of marginal reflex distance (MRD1) on the unaffected eyelids between preoperative and 3-month postoperative photographs after ptosis correction. This study analyzed 134 unilateral blepharoptosis patients with ptosis correction from February 2002 to February 2011. Fifty patients among them were negative in Hering's law dependence test. From the preoperative and postoperative photographs the MRD1 of unaffected upper eyelids were measured and adjusted with the average pupil diameter of Koreans. Mean age was 34.4 and male was 30 and female was 20. Average follow-up periods were 14 months. Results: Thirteenth unaffected eyes (26%) showed decreased MRD1, and 3 patients (6%) showed decreased MRD1 value over 1.0 mm. Then 3 patients needed additional operations for correction of preoperatively unaffected but ptotic eyelids. Conclusion: There were no meaningful data statistically in the value of MRD1 in every unaffected eye of the patients and in the difference between preoperative and postoperative MRD1 of groups divided according to severity, causes, and types of operation.

격실 내 장애물이 폭압에 의한 인원 피해에 미치는 영향 (The Effect of Obstacles in a Compartment on Personnel Injury Caused by Blast)

  • 박성준
    • 한국시뮬레이션학회논문지
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    • 제26권3호
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    • pp.1-11
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    • 2017
  • 격실 내부에서의 폭발로 인한 인원의 피해를 분석하였다. 특히 격실 내에서 폭압 전파에 영향을 미치는 돌출된 장애물의 유무에 따른 인원 피해를 비교하였다. 격실 내에 장애물이 없는 경우에 경험적 고속처리모델을 이용하여 폭압을 예측할 수 있다. 하지만 격실 내부에서는 폭압 프로파일이 개활지에서와 달리 복잡하며 의자와 같은 구조물이 존재하는 경우에는 경험적 고속처리모델 적용이 불가하다. 따라서 장애물이 있는 격실 내부 폭압은 유한요소해석을 이용해 획득하였다. 또한 개활지의 폭압 프로파일을 기준으로 개발된 Friedlander 압력-충격량 곡선을 격실 내부에서의 복잡한 폭압 전파로 인해 피해평가에 적용할 수 없어, Axelsson 단자유도 모델을 적용하여 인원 피해를 분석하였다. 장애물이 있는 경우 인원의 흉벽 속도는 26에서 76 퍼센트(%) 만큼 감소되었으며 격실내 인원피해 또한 감소되었다.

조현병에서 형식적 사고장애의 임상적 특성 (Clinical Characteristics of Formal Thought Disorder in Schizophrenia)

  • 양채영;김한성;김은경;김일빈;박선철;최준호
    • 생물정신의학
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    • 제28권2호
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    • pp.70-77
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    • 2021
  • Objectives Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). Methods We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. Results After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. Conclusions This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.